Thursday, June 28, 2007

Handcuffs & commitment standards

Being committed to a psychiatric facility can rescue a person from the uncontrolled symptoms of a severe mental illness. Involuntary treatment, at the same time, should not be used if voluntary care is a viable alternative. No one wants to unnecessarily invoke a measure that, by its very nature, is laced with restriction.

Yet, the coercive tone of an inpatient commitment can be muted.

For too long, for instance, a trip to a hospital has automatically included a police car and handcuffs for people being committed to treatment. Vermont has ended the mandatory use of restraints in that situation. A recent law in the state requires that mechanical restraints not be used unless circumstances dictate that such methods are necessary. Restraints are still used if required to maintain safety, but the justifications for their use must be documented.

Thus in Vermont, patients can be brought in for psychiatric evaluations by mental health professionals and without handcuffs. To the advocates in many other states, the adoption of a similar policy would be frustratingly fruitless. For Vermont allows individuals to be placed in treatment for reasons other than immediate danger. The state’s commitment standard encompasses those who are “receiving adequate treatment, and who, if such treatment is discontinued” will likely become a danger to themselves or others.

As they do not present a current risk, no handcuffs are required for those patients in Vermont. In those states where actual danger is the sole trigger for commitment, there is and will remain no option but law enforcement officers and restraints.

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