Dr. Christopher is Associate Professor, Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI. Ms. Pridgen is affiliated with the Department of Psychiatry, University of Massachusetts Medical School, Amherst, MA. Dr. Pivovarova is Assistant Professor, Department of Family Medicine & Community Health and Department of Psychiatry, University of Massachusetts Medical School, and Research Faculty, Massachusetts Center of Excellence for Specialty Courts, Amherst, MA.
J Am Acad Psychiatry Law. 2021 Jun;49(2):187-193. doi: 10.29158/JAAPL.200061-20. Epub 2021 Feb 12.
Civil commitment for substance use disorders is an increasingly used intervention to mitigate the risks associated with severe substance use. Although court clinicians play a vital role in helping courts determine whether respondents meet statutory requirements for commitment, little is known about their experiences conducting these evaluations. In this pilot study, we surveyed all court clinicians who perform evaluations for civil commitment for substance use disorders in Massachusetts, a state with one of the highest rates of such commitments nationally. Court clinicians reported that these evaluations are most frequently ordered for individuals who use heroin and other opioids, alcohol, and cannabis. They reported a recent suicide attempt or drug overdose, intentional physical harm to another, use of dangerous weapon, and driving while intoxicated as the behaviors most likely to satisfy the statutory requirement of imminent risk. At the same time, many court clinicians consider a much broader range of behaviors as constituting imminent risk, and many reported having endorsed commitment on one or more occasions in the absence of statutory criteria being satisfied. These findings underscore the need for additional research on the performance of civil commitment evaluations for substance use disorder and standards for such evaluations.
民事承诺治疗物质使用障碍是一种越来越常用的干预措施，可减轻与严重物质使用相关的风险。尽管法庭临床医生在帮助法庭确定被调查者是否符合承诺的法定要求方面发挥着至关重要的作用，但人们对他们进行这些评估的经验知之甚少。在这项试点研究中，我们调查了马萨诸塞州所有进行物质使用障碍民事承诺评估的法庭临床医生，该州是全国此类承诺率最高的州之一。法庭临床医生报告说，这些评估最常针对使用海洛因和其他阿片类药物、酒精和大麻的个人进行。他们报告说，最近有自杀企图或药物过量、故意伤害他人、使用危险武器和酒后驾车是最有可能满足法定紧迫风险要求的行为。与此同时，许多法庭临床医生认为更广泛的行为构成紧迫风险，许多人报告说，即使没有满足法定标准，他们也在一个或多个场合支持过承诺。这些发现强调了需要对物质使用障碍的民事承诺评估的表现以及此类评估的标准进行更多研究。
