The negotiation of involuntary civil commitment

Involuntary commitment to mental hospitals has been a topic of scholarly interest for the last twenty years. That interest has resulted in dozens of studies which have informed the legal reform of many state commitment statutes. In this paper we analyze the organizational context in which the decision to commit takes place. Relying on observations of the commitment process in an urban setting, we discuss the negotiating among the actors involved in the decision to commit. Our data suggest that formal disposition to involuntarily commit accounts for only a small percentage of those held at the hospital against their will. Court procedures and professional persuasion are used to coerce citizens into "voluntary" stays at the hospital in order to avoid court proceedings. We conclude with some thoughts about the meaning of commitment rates in light of these findings.