John Stuart Mill wrote, “the only purpose for which power can rightfully be exercised over any member of a civilized community, against his will, is to prevent harm to others.” This principle is most commonly regarded in relation to the criminal law, where Justice Anthony Kennedy acknowledged that “incarceration . . . is the most common and one of the most feared instruments of state oppression and state indifference . . . .” Going further, he wrote that “freedom from this restraint is essential to the basic definition of liberty in the Fifth and Fourteenth Amendments of the Constitution.”
Mill’s statement is equally applicable in cases of civil commitment. “[P]atients face lengthy—even indeterminate—[commitments.]” At the same time because the commitments are civil and not criminal, patients have no constitutional right to a speedy trial. These patients are not without rights; indeed, the courts have found that not providing procedural safeguards would violate the constitutional rights. of a patient. Yet, looming in the shadows is the disturbing fact that “it is the near-universal reality that counsel assigned to represent individuals at involuntary civil commitment hearings is likely to be ineffective.”
The United States Supreme Court has found that “incapacitation may be a legitimate end of the civil law.” This is the case even if no treatment is available to speed their recovery and release. Additionally, patients who are involuntarily hospitalized are subjected to psychiatric treatment, which may include the forced taking of medications. The result is that civil commitments invade not only the privacy of the patient, but also their person.
The reality of how these civil commitment decisions are made under the Minnesota Commitment and Treatment Act (MCTA). The MCTA ought to be closely scrutinized. Michael Perlin wrote that “the overwhelming number of cases involving mental disability law issues are ‘litigated’ in pitch darkness. Involuntary civil commitment cases are routinely disposed of in minutes behind closed courtroom doors.” In 1979, the United States Supreme Court noted that the average time for an involuntary civil commitment hearing was 9.2 minutes. While that has certainly not been this author’s experience, the important thing is to realize that a short hearing, whether 9.2 minutes or four hours, has major implications in the life of a human being.
The American Psychiatric Association once acknowledged “that ‘dangerousness’ is neither a psychiatric nor a medical diagnosis, but involves issues of legal judgment and definition, as well as issues of social policy.” Because of the monumental effect on the life and liberty of a person that a civil commitment has, the process for determining whether a civil commitment should occur ought to be narrowly defined and readily discernable for all parties to follow. Unfortunately, that is not the case.
The MCTA is, like any piece of legislation, a flawed statute. It lacks sorely needed definitions of “serious physical harm” as well as “dangerous” that would allow district courts the necessary guidance to make decisions in a consistent manner. As a result, the case law is inconsistent, leaving statutory ambiguities unresolved.
Section II of this article addresses in detail both the MCTA standards for commitment as mentally ill and mentally ill and dangerous. Each type of commitment is discussed with regard to the requirements to make such a finding, and the process that follows after such a finding is made. Section III addresses two points of ambiguity within the MCTA itself: how to determine what constitutes “serious physical harm” and how to determine whether a person is “dangerous.” Finally, Section IV offers some suggestions on how the MCTA could be more coherent, and whether the responsibility to make these changes lies with the courts or the legislature.