
Contents
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Legal Context Legal Context
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Origins of Current Commitment Laws Origins of Current Commitment Laws
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Major Decisions Major Decisions
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General Legal Standards General Legal Standards
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Legal Procedures Legal Procedures
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Initiating the Commitment Process Initiating the Commitment Process
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Psychiatric Emergency Psychiatric Emergency
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Other Options Other Options
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Commitment Hearings Commitment Hearings
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Presentation of Evidence Presentation of Evidence
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Privilege Issues Privilege Issues
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Commitment Outcomes Commitment Outcomes
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Forensic Mental Health Concepts Forensic Mental Health Concepts
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Substantial Mental Disorder Substantial Mental Disorder
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Risk or Danger Risk or Danger
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Danger to Self, Danger to Others, and “Grave Disability” Danger to Self, Danger to Others, and “Grave Disability”
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The Practical Meaning of Dangerousness in Civil Commitment The Practical Meaning of Dangerousness in Civil Commitment
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Empirical Foundations and Limits Empirical Foundations and Limits
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Research on Assessment Practices Research on Assessment Practices
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Reliability of Psychiatric Diagnoses Reliability of Psychiatric Diagnoses
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Clinicians’ Decisions to Initiate Commitment Clinicians’ Decisions to Initiate Commitment
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Alternatives to Hospitalization Alternatives to Hospitalization
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Research on Outpatient Commitment Research on Outpatient Commitment
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The Evaluation The Evaluation
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The Interview The Interview
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Structured Diagnostic Interviews Structured Diagnostic Interviews
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Other Assessment Instruments Other Assessment Instruments
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Report Writing and Testimony Report Writing and Testimony
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Testimony Testimony
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Summary Summary
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References References
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12 Evaluation for Civil Commitment
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Published:December 2012
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Abstract
This chapter reviews concepts of forensic mental health assessment (FMHA) that are relevant to civil commitment. It first provides an overview of the legal context underlying evaluations for civil commitment, with particular emphasis on issues such as psychiatric emergency, commitment hearings, and presentation of evidence. It then turns to a discussion of what constitute “best practices” in civil commitment assessments, with a view to helping judges and attorneys understand how psychiatrists and psychologists should gather information and prepare to testify at hearings on involuntary psychiatric hospitalization. It also examines FMHA concepts such as “substantial” mental disorder and the “risk” of harm posed by the respondent to him or herself or others because of that disorder; the empirical foundations and limitations of evaluations for civil commitment; and the steps involved in conducting civil commitment evaluations. Finally, the chapter outlines key aspects of report writing and testimony concerning evaluations for civil commitment.
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