Grading the States: An Analysis of Involuntary Psychiatric Treatment Laws 2020

TAC Report

Assisted Outpatient Treatment Involuntary Treatment

Grading the States: An Analysis of U.S. Psychiatric Treatment Laws examines the laws that provide for involuntary treatment for psychiatric illness in each state. To do so, we asked a crucial question: Does the state law allow an individual in need of involuntary evaluation or treatment to receive timely care, for sufficient duration, in a manner that enables and promotes long-term stabilization?

The United States is effectively running 50 different experiments, with no two states taking the same approach. As a result, whether or not an individual receives timely, appropriate treatment for an acute psychiatric crisis or chronic psychiatric disease is almost entirely dependent on what state he or she is in when the crisis arises.

In addition to providing a detailed assessment of each state’s treatment laws in comparison with those of the rest of the country, the report also identifies specific statutory changes states can make to greatly improve access to care for this population.

Key Findings

Ten states earned an “A” grade, while eight received an “F.”
Minnesota achieved the highest combined score, with 97 out of 100 points.
Maryland received the lowest combined score, with 18 out of 100.
Six states (Alabama, Delaware, Georgia, Oklahoma, Pennsylvania and Tennessee) still have an outdated requirement that harm to self or others be imminent for a person to qualify for inpatient commitment, and seven (Georgia, Ohio, Oklahoma, Oregon, Rhode Island, Wisconsin and Wyoming) require harm from failing to meet basic needs to be imminent to intervene.
Five state laws contain no path to civil commitment for those who cannot meet their basic needs due to mental illness (Alabama, Delaware, District of Columbia, Maryland and New York).
Three states still have no law allowing civil commitment to occur on an outpatient basis (AOT) (Connecticut, Maryland and Massachusetts).
Tennessee’s AOT law is the only one written to prevent its use as an alternative to hospitalization.

Treatment Advocacy Center

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