Blue states forced to reconsider involuntary commitment laws amid homeless, mental health crisis

By HPN Staff

Several state legislatures with Democratic majorities are pivoting away from their long-held positions on involuntary commitment as their states grapple with homelessness, mental illness, and drug abuse. 

Their positions now more closely align with President Donald Trump’s calls to ease rules on involuntary commitments and to move more homeless people into institutions.

Both New York and Oregon voted to revise their laws this year. 

California’s legislature approved modifications in 2023 that went into effect this year.

Why it matters

Data shows there could be a shift in how homelessness and mental health issues are treated. There’s broad agreement among the general public and clinicians that the United States has a mental health problem.

Every state allows involuntary commitment, where a court can order someone into treatment against their will, but the rules vary, as do available beds and funding.

An attempt to catalog involuntary commitment rates, published earlier this year, looked at data from 32 states and found commitments increased significantly from 2010 to 2022 in nine states and the District of Columbia. They stayed about the same in another 23 states.

“No states showed significant decreases in civil commitment rates,” the researchers found. The team also noted that “the lack of standardized processes, definitions and data across states” made it difficult to explore the issue in a way that could inform policy decisions.

Trump issued an executive order in July that argued “shifting homeless individuals into long-term institutional settings for humane treatment through the appropriate use of civil commitment will restore public order.”

Among other things, that order calls on the U.S. Attorney General and the federal Department of Health and Human Services to try to roll back court decisions that limit civil commitments. The order also instructs federal officials to reassess and potentially reallocate funding for programs in this area.

The bigger picture

New York moved toward loosening its involuntary commitment standards this spring as part of a broader state budget deal. At the time, Politico reported that the change “points to broadening Democratic support for coercive approaches to mental health crises.”

Laws that the California legislature revised in 2023 took effect at the start of this year. They loosen the definition of “gravely disabled” to make it easier for authorities to detain people with a mental illness or substance abuse problem.

Oregon lawmakers voted this year to change their state’s rules and make it easier to commit people. They paired those reforms with several other bills, including a $65 million increase in treatment funding and $6 million in grants to help hire mental health and addiction care workers.

Additional details

Boston’s NPR station reported in September on a push to increase involuntary commitments there, even though Massachusetts already “has one of the highest rates of involuntarily committing people to treatment in the country.”