The less restrictive the criteria, the lower the homicide rate
A new study from the University of California reports that broader civil commitment criteria for involuntary treatment of mental illness correlate with a lower homicide rate.
In “Civil commitment law, mental health services, and US homicide rates,” researcher Steven P. Segal of the University of California, Berkeley, examines the impact of civil commitment statues based solely upon dangerousness criteria on homicide rates and concludes:
“(T)he results show the importance and potentially preventative utility of broader (involuntary civil commitment) criteria, increased psychiatric inpatient-bed access, and better performing mental health systems as factors in how many people die of homicide each year. “
Upon review of the research, Dr. E. Fuller Torrey said, “Predictably, Segal found that social and demographic factors such as poverty, being a young male or substance abuse have the strongest correlation with homicide. The real news here is that, not far behind, three mental health factors – narrow civil commitment laws, lack of psychiatric beds and poor mental health systems – were also significant predictors."
A international authority on mental illness and violence, Dr. Torrey said that "this means we can decrease homicides by using broader commitment criteria such as assisted outpatient treatment (AOT), providing an adequate supply of psychiatric beds and improving the mental health system.” Of these three factors, Segal found that civil commitment criteria limited to "dangerousness" were most predictive of higher himicide rates.
Segal is a member of the Mental Health and Social Welfare Research Group and the Mack Center on Mental Health and Social Conflict at the University of California Berkeley. Among his findings:
- The association of violent behavior and schizophrenia “has been established.”
- Socio-economic, demographic and other social factors account for 25% of the difference in homicide rates between states.
- Mental health factors account for 17% of the differences.
- Using narrow “dangerousness” standards for civil commitment instead of broader ones seems to have the paradoxical effect of feeding stigma by contributing to mental illness-related violence.
Segal’s report is in press from Social Psychiatry and Psychiatric Epidemiology (Nov. 10, 2011) and temporarily available online. Because it validates arguments the Treatment Advocacy Center makes in favor of reforming and implementing civil commitment laws – and refutes arguments made against them – the study is a valuable resource for lawmakers and advocates for treatment law reform.
Click to read “Civil commitment law, mental health services, and US homicide rates” by Steven P. Segal.