Legal intervention in civil commitment: the impact of broadened commitment criteria.

Recent legal changes in Washington State have broadened the grave-disability criterion for civil commitment of the mentally ill. Analysis of data from state mental hospitals and from records of commitment authorities in Washington's two largest counties revealed that, while there was an increase in the number of involuntary hospitalizations immediately before and after the changes in law, there was a virtual disappearance of voluntary patients in state hospitals. Moreover, expansion of the definition of "grave disability" resulted in a move toward a parens patriae-dominated civil commitment system. Analysis of the empirical consequences of the legal changes on commitment decisions is presented, along with the response of mental health officials and the public.