by Chuck Sharman

At the center of mass incarceration in the United States is a deeply troubling fact: More than two of every five people locked up have been diagnosed with a mental disorder. With nearly two million people caged in U.S. prisons and jails, that means the mental health caseload in these lockups is now near 870,000. But that number misses another 25,000 who have been involuntarily committed to state and local health departments for mental health treatment, according to recent data from the nonprofit Prison Policy Initiative; this group uses many beds that might otherwise be used to treat those outside the criminal justice system who’ve been diagnosed with a serious mental illness (SMI). These people are considered a danger to themselves or others—including a group, mostly men, who have been deemed sexually violent predators (SVP).

It should be obvious that a prison or jail is not the best place for anyone needing mental health treatment, especially someone with SMI, which by definition impairs their ability to feed, clothe and/or clean themselves. Nevertheless, the practice has become normalized, driving the incarceration of those waiting for treatment—and then, once they are in treatment, driving the incarceration of those they have displaced. Even worse for this group, a significant number have already completed criminal sentences. But they must remain confined for treatment—or confined in prison when a treatment bed isn’t available—because the state believes that’s the only way to prevent them from committing additional crimes. This extra confinement, beyond a criminal sentence to await mandated treatment, effectively punishes them for crimes they haven’t yet committed. How is this constitutional?

Welcome to the upside-­down world of civil commitment.

To get a sense of its scale, another report published in Psychiatric News on September 29, 2025, found that there were, on average, 213.84 civil commitments per 100,000 population between 2010 and 2022 in the 32 states, plus the District of Columbia, which reported data. See: Civil Commitment Increasing, but Data Is Marred by Variation in Reporting (Moran), Psychiatric News (Sep. 2025). The number of civil commitments includes those found not guilty by reason of insanity (NGRI), who are usually ordered into involuntary treatment. But that’s not many people—about 30 every year nationwide, according to recent studies.

Also included are those deemed incompetent to stand trial (IST) on criminal charges, defined by the Supreme Court of the U.S. (SCOTUS) as someone who lacks “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding,” as well as lacking “a rational as well as factual understanding of the proceedings against him.” See: Dusky v. United States, 362 U.S. 402 (1960). They can then be held, for no “more than the reasonable period of time necessary that he will attain that capacity in the foreseeable future.” See: Jackson v. Indiana, 406 U.S. 715 (1972). And they may not be subjected to forced medication “solely to render [them] competent to stand trial” without an “alternative ground, such as dangerousness.” See: Sell v. United States, 539 U.S. 166 (2003).

 There are no national statistics on IST commitments, on top of considerable confusion about what gets reported. Is an involuntary mental health “hold”—which typically lasts from a few days to a week—considered a civil commitment? One 2023 estimate pegged the total number of IST commitments at 130,000 annually; the majority of those committed were “restored” to competency within months. On average, this group represented the largest share of all civil commitments, and their numbers are rapidly climbing. See: Evaluations of Competence to Stand Trial are Evolving Amid a National “Competency Crisis,” (Murray, et al), Behavioral Sciences & the Law (Apr. 13, 2023).

Another group that’s growing in number is the SVP population, estimated in 2020 at 6,300 people in those jurisdictions that make the determination, which include the District of Columbia and 20 states: Arizona, California, Florida, Illinois, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Pennsylvania, South Carolina, Texas, Virginia, Washington and Wisconsin.

In these jurisdictions, researchers at the UCLA School of Law Williams Institute found that post-­sentence incarceration for an SVP determination reflected the same bias against racial and sexual minorities found in the overall prison and jail population. Civil commitment was twice as likely for Black SVPs as for whites and two to three times higher for those with a same-­sex victim than for those whose victim was a member of the opposite sex. See: Civil Commitment of People Convicted of Sex Offenses in the United States. UCLA Sch. of Law Williams Inst. (Oct. 2020).

Yet even the 6,300 number is incomplete; as PLN reported, there are about 250 New Yorkers incarcerated for sex offenses who become eligible for release every year but remain in prison due to their inability to find housing compliant with the requirements of the state Sexual Assault Reform Act (SARA). Among those requirements is that post-­release accommodation must be over 1,000 feet from a school. This is not an uncommon requirement found in sex offender registration laws around the country. But it is almost impossible to satisfy if your home is in a densely populated area like New York City. SCOTUS refused to hear the case of one such man in 2022. An April 2024 ruling by the state Court of Appeals in another case ordered the state Department of Corrections and Community Supervision (DOCCS) to make “reasonable efforts”—but no more—to secure employment and training to provide additional income necessary to move. [See: PLN, July 2022, p.38; and Dec. 2024, p.44.]

When extra-­constitutional government behavior meets judicial paralysis, the result is not good for prisoners.

A Burgeoning Crisis

Nationally, PPI estimated that 43% of those in state prisons and 44% of those in local jails had a diagnosed mental disorder; estimates run somewhat higher in facilities operated by the federal Bureau of Prisons (BOP) at 45%. Adding in the population civilly committed, that’s 895,000 people locked up and suffering from a mental illness, representing nearly 2% of the entire U.S. population of mentally ill adults. Put another way, the risk of incarceration, which is less than 1% for all Americans, more than doubles for the mentally ill.

Confinement has become the default response to mental illness in the U.S., but a large share of those held in prisons and jails reported receiving no treatment while incarcerated, PPI said. Many of those stuck in jails have been civilly committed but must wait for treatment space to open up in a secure psychiatric hospital. Others are stuck in prison waiting on a secure treatment bed. Yet their mental illnesses do not stop progressing while they wait—lengthening their stay once they finally get a bed and forcing the number of those still waiting to grow as the wait gets even longer.

Treatment beds for those who have been civilly committed are typically run by a state health department, rather than its department of corrections—which in part explains the missing data, like those 18 states which provided no data for the study reported in Psychiatric News.

In Florida, which had the highest rate of civil commitments, that same report estimated there were almost 180,000 people civilly committed from 2010 to 2022—an average of 15,000 each year. But the state maintains just 1,335 forensic treatment beds, each occupied on average for a stay of 165 days—leaving up to 12,000 people stranded every year in a prison or jail cell waiting for treatment. This creates an enormous risk of violating the constitutional rights of people confined for their mental illness, especially so for those who have served their prison sentence and remain civilly committed.

How did we get here? For one, SCOTUS, rather than protecting the rights of these vulnerable individuals, has been complicit in directing lower courts to look the other way while those rights are trampled on. Of course, courts cannot provide the treatment beds needed for so many patients; that is the job of lawmakers at all levels of government, one they continue to fail at as the need has exploded while the number of available beds has shrunk—from a nationwide average of 337 beds per 100,000 in population in 1955 to just 11.7 by 2016.

As more and more “forensic” mental health patients are dumped into state psychiatric hospitals for NGRI treatment and IST restoration, they crowd out those whose needs are deemed less acute, like SVPs—both those deemed too violent to release and those unable to find appropriate housing. For this group, they remain incarcerated despite having served their time.

In New York, Correction Law § 2(6) says that SVP prisoners who complete their prison sentences must be released to a Residential Treatment Facility (RTF), which is defined as “a correctional facility consisting of a community-­based residence in or near a community where employment, educational and training opportunities are readily available for persons who are on parole or conditional release and for persons who are or who will soon be eligible for release on parole who intend to reside in or near that community when released.” In practice, however, the RTF is just a cell among the general population of a state prison.

Those penned at RTFs are compelled to work like other prisoners, 15 to 30 hours every week for no more than $5 every three hours, with up to 80% of that skimmed off to pay court fees and fines, court-­ordered restitution and state-­imposed fees to recoup the cost of their incarceration. It’s hard to imagine how someone who may have as a little as $5 a week left over can ever save enough to return home and find any housing at all, much less housing that is SARA-­compliant.

From Bedlam to Bellevue

Before it became a synonym for chaos, Bedlam was the nickname of a London landmark, one whose history now stretches back eight centuries. Founded in 1247 as the home of a religious order, St. Mary of Bethlehem, it became a medieval “hospital,” or home for the indigent. By 1403, it was devoted exclusively to housing—and confining—the “mentally insane.” Science in the 15th century attributed symptoms of mental illness to melancholic “humors.” Treatment involved removing these from the body, though blood-­letting, induced vomiting and forced laxative purges. It was this chamber of horrors that brought “bedlam” into the language as a “scene of uproar or confusion.”

Within another 200 years, after moving to a new home, Bedlam was still holding England’s most miserable but also earning fees collected from tourists curious to gape at them, almost 100,000 of which paid to pass through every year. The structure was eventually abandoned and demolished in 1815. For the past 200 years, the hospital has persisted through several moves and the improving diagnosis and treatment of mental illness, which now continues at Bethlem Royal Hospital in the London suburb of Beckenham.

It was during the eighteenth century when Bedlam’s model was copied in the New World at Eastern State Hospital, which opened in 1773 near Virginia’s colonial capital at Williamsburg as the “Public Hospital for Persons of Insane and Disordered Minds.” From there, similar “asylums” spread across the U.S., culminating in a Pavillion for the Insane opened at New York City’s Bellevue Hospital, which was state-­of-­the-­art in 1869.

After 1900, as industrialization drove migration from farms to cities, these institutions became de facto retirement homes for indigent laborers too old to work but no longer living with family members who might care for them. By 1955, every other hospital bed in the country was in a psychiatric hospital. The poor, elderly patients were disproportionately afflicted with syphilis and alcoholism, and 29% died within three months of admission. Media exposés in the mid-­20th century brought a new generation to gawk at the horrors of institutionalization, just as increases in social security retirement benefits passed in 1950 began to help a generation of retirees remain out of state hospitals. Further construction of state psychiatric hospitals stalled.

The death spiral began in 1965 with the Congressional authorization of Medicaid, whose coverage rules excluded patients in state institutions with more than 16 beds. Almost overnight, a new industry was born to absorb all those sick, indigent retirees into private nursing homes funded with Medicaid payments.

By 2016, the effective reduction in U.S. psychiatric hospital beds totaled over 1 million. What became of the other patients displaced as state psychiatric hospitals shut down? Not coincidentally, almost the same number of people diagnosed with a mental disorder have bloated the populations of the country’s prisons and jails.

Meanwhile, the National Alliance to End Homelessness counted over 770,000 unhoused Americans as of January 2024. Up to three-­quarters of them struggle with mental illness, according to the National Institutes of Health. Even Bellevue’s storied Pavillion for the Insane has been repurposed as a homeless shelter.

That has led to concerns like the one voiced by the Hawai’i chapter of the American Civil Liberties Union (ACLU) in a March 2025 announcement criticizing a proposed state law, SB 1322, which “would reduce the current panel of three medical experts required for involuntary medical treatment for hospitalized individuals to just one individual,” thereby “open[ing] the door to arbitrary decision-­making, unchecked human error and an expedited ‘rubber stamp’ process.” Of particular concern to the ACLU was the potential use of the relaxed standards to criminalize homelessness. “Increasing forced treatments but not implementing programs to help people after treatment constitutes a policy failure,” the ACLU declared.

The specter of unnecessary forced treatment haunts any discussion of civil commitment. Under the standards in place in 1860, Rev. Theophilus Packard was legally able to commit his wife, Elizabeth, to Illinois’ first hospital for the mentally ill, claiming that she was “slightly insane” for disagreeing with his religious views. Refusing to change her mind, she was deemed incurable and discharged three years later. Her husband then locked her in their home, but she managed to sneak out a letter to a friend, who alerted a judge, who issued a habeas corpus order. At a subsequent trial, a jury took seven minutes to acquit her of insanity.

Packard prompted changes to the law to ensure minimal protections of civil liberties for those facing confinement for forced treatment. But there are still hospitals treating patients that were once known as the “criminally insane”—NGRI and IST defendants remanded for treatment. Beds are in short supply, however, and the number of these “forensic” patients keeps growing. NRI, formerly the National Research Institute of the National Association of State Mental Health Program Directors, reported in May 2024 that over 40,900 people were receiving inpatient treatment at a state psychiatric hospital, with forensic patients representing over half of the total. See: Use of State Psychiatric Hospitals, 2023, MRI (May 2024).

This is the wall which states say they are backed up against when they continue to confine a prisoner declared SVP at the end of their sentence: There’s nowhere else to put them. And they can’t be released until the court that made the SVP declaration removes it.

SORNA and Tier III

Another source of civil commitments comes from the federal Sex Offender Registration and Notification Act (SORNA), 18 U.S.C. § 2250. While individual state health departments run their own psychiatric treatment programs, those convicted of sex offenses are also subject to federal penalties for failure to register with state or tribal authorities.

SORNA was passed in 2006 as the Adam Walsh Child Protection and Safety Act, named for a six-­year-­old, kidnapped from a Florida Sears store in 1981, whose severed head was later found 100 miles away. State prisoner Otis Toole, whose IQ was estimated at just 75, repeatedly offered and recanted confessions to raping and killing the child before he died of liver cirrhosis in 1996. A dozen years later, police decided to accept his last confession and closed the case.

According to the Congressional Research Service (CRS), qualifying SORNA convictions include “(1) designated federal sex offenses” and “(2) specified military offenses,” as well as state or tribal “(3) crimes identified as one of the ‘special offenses against a minor’; (4) crimes in which some sexual act or sexual conduct is an element; and (5) attempts or conspiracies to commit any offense in one of these other classes of qualifying offenses.”

The registration term and renewal requirements vary by severity of the conviction. The most serious Tier III convictions require lifetime registration updated by in-­person appearance every three months, while Tier II convictions require registration for 25 years and in-­person updates every six months. All other sex offenses not classified in either of those categories are Tier I convictions, requiring registration for 10 years and annual in-­person updates.

Congress cannot compel a state to adopt the same registration requirements, but SORNA does allow the federal government to withhold funds from states that resist. The law anticipated as much, providing an affirmative defense to a charge of failure to register as long as a good faith effort is repeatedly made. In practice, this criminalizes the individual for non-­registration. Failure to comply with SORNA requirements is a separate federal offense punishable by a $250,000 fine and up to 10 years in prison, plus “preventative detention” when the prison term ends.

The law’s reach is extended by virtue of its application to anyone engaged in interstate travel, though SCOTUS has held that the registration requirement cannot be imposed based on interstate travel before § 2250 was passed. See: Carr v. United States, 560 U.S. 438 (2010). The high Court also made the law retroactive in a case from Alaska, Smith v. Doe, 538 U.S. 84 (2003). But it declined to issue a writ of certiorari to hear an appeal to Doe v. Snyder, 834 F.3d 696 (6th Cir. 2016), which voided retroactive application of parts of Michigan’s sex offender registry law containing provisions—“residency and location restrictions, tier classifications, in-­person verification requirements, and public disclosure of otherwise non-­public information”—that distinguished it from the Alaska law, as the Mitchell Hamline School of Law (MHSOL) recalled. See: SORNA 2022: A Guide for Practitioners to New Federal SORNA Regulations Effective January 7, 2022, MHSOL (May 2, 2022).

It’s unclear how many people have been subjected to SORNA’s “preventative detention”; the MHSOL report said only that “federal prosecutions of individuals who complied with all state registration rules were possible in principle but rare in practice.”

SCOTUS Weighs In

Federal courts at one point stood on the front lines to protect civil liberties in these cases. In 1966, the U.S. Court of Appeals for the District of Columbia Circuit held that involuntary commitment of those who are mentally ill but not dangerous must involve an individualized evaluation of treatment settings and options to select the one that is least restrictive. See: Lake v. Cameron, 364 F.2d 657 (1966).

Nine years later, SCOTUS weighed in, protecting any citizen from involuntarily commitment absent a showing that they were both dangerous and incapable of caring for themselves with available help from family and friends. See: O’Connor v. Donaldson, 422 U.S. 563 (1975).

Four years after that, the Court raised the burden of proof required for a showing of mental disorder or defect that would justify involuntary commitment. No longer can a petition be sustained with a showing by “the preponderance of the evidence.” Instead, a civil commitment order requires “clear and convincing evidence” of the alleged disorder or defect. See: Addington v. Texas, 441 U.S. 418 (1979).

But just four years later, the Court pulled back, declaring that involuntary commitment was permissible immediately upon a NGRI acquittal, without need of further due process. See: Jones v. United States, 463 U.S. 354 (1983).

By 1997, the Court’s reactionary turn had advanced to validate Kansas’ first-­in-­the-­nation SVP law. To do so, the Court rejected an argument that the law violated the Due Process Clause, though it resulted in confinement past completion of a prison sentence without additional charges or trial. Also rejected were arguments that the law violated the protection against double jeopardy and ex post facto adjudication, even though it resulted in two confinements for the same crime. See: Kansas v. Hendricks, 521 U.S. 346 (1997).

Is Anything Being Accomplished with Civil Commitment?

Given the expanding reach of civil commitment, and its entrenchment in U.S. case law, it’s fair to ask whether any successful “treatment” results from confining thousands of people in a prison or prison-­like setting without any underlying criminal conviction. The answer seems to be “no.”

SCOTUS had an opportunity to review this question and punted it, declining to issue a writ of certiorari in 2017 to hear a challenge to the Minnesota Sex Offender Program (MSOP). See: Karsjens v. Piper, 138 S. Ct. 106(2017). That left to stand an earlier finding by the U.S. Court of Appeals for the Eighth Circuit that no constitutional injury was inflicted on those confined under MSOP because “[t]he extensive process and protections provided” to them “were rationally related to the State’s legitimate interest of protecting its citizens from sexually dangerous persons or persons who had a sexual psychopathic personality.” See: Karsjens v. Piper, 845 F.3d 394 (8th Cir. 2017).

However, MHSOL’s Sex Offense Litigation and Policy Resource Center reported in 2024 that the program had achieved less than a one-­half percentage point reduction in a recidivism risk that was already strikingly low, nudging it from 3.2% to 2.8% in an estimate by the state’s own Department of Corrections (DOC). As PLN reported, the study found that MSOP’s $100 million annual budget would be far better spent on “more effective evidence-­based sexual violence interventions,” including “primary prevention, adequate services for victims of sexual violence, and practices that improve perpetrator accountability.” [See: PLN, Oct. 2024, p.48.]

One thing that has been accomplished with civil commitment programs is providing a place to warehouse former prisoners whose chances of successful re-­entry have been almost entirely foreclosed by restrictions on the places they may live and work. In researching her 2025 doctoral dissertation for Walden University’s College of Psychology and Community Services, Katheryn Winslow “found that 80% of the offenders had housing trouble in addition to 87% being unemployed”—including a shocking first-­year unemployment rate of 54.7% that “caus[ed] many to be homeless.”

Unsurprisingly, Winslow continued, “the sex offenders interviewed expressed how the stigma of being labeled a sex offender affected their self-­esteem and confidence,” which bled over directly into their employment performance. This was only amplified by their housing insecurity, which was driven by restrictions on living up to 2,500 feet from a school, daycare or playground in some jurisdictions. By 2010, these restrictions were on the books in 30 states, plus numerous municipalities which “soon followed suit in imposing more local residency restrictions.” Among the “unintended consequences” of these restrictions, Winslow noted, was physical isolation that left sex offenders “secluded from the rest of society.” This in turn “could lead an offender to live a disillusioned life,” potentially contributing to “recidivism, stress, and mental problems.” See: Lived Experiences of Sex Offenders on Probation with Housing and Employment, Walden Univ. (June 2, 2025).

Meanwhile, the bias against racial and sexual minorities observed in the overall prison and jail population is reflected among those who were civilly committed. Admission decisions are based on risk assessment tools that “are generally problematic and frequently make incorrect predictions,” PPI found. Chicago attorney Daniel Coyne said that the tools were just 58% accurate “in sex offense cases,” or “not much better than a coin toss.” Many of the tools use data from unpublished studies, making their scoring needlessly opaque. The Static-­99/99R used in Illinois and other states assigns an extra point to those with a same-­sex victim, injecting an element of homophobia without offering any rational basis for it.

As a result, PPI found startling overrepresentations of some groups in Illinois’ Rushville Treatment and Detention Facility. There, 31% of those confined were Black, versus just 14% in the state DOC. Those who identified as Lesbian, Gay or Bisexual accounted for 37% of the total locked up, versus just 4% in the DOC. The treatment they reported in Rushville also didn’t come close to “therapeutic” and included solitary confinement—which was reported by two-­thirds of those detained—as well as more invasive measures like “chemical castration.”

With a constantly changing staff of resident physicians and psychiatrists, who are free to reverse placement and treatment decisions of preceding staffers, it was also unsurprising that the average detention at Rushville stretched to 9.5 years, PPI said. Among those detained there, 76% reported being discriminated against by staff and 26% were harmed, including 8% who reported sexual assault. The state Department of Human Services, which operates the lockup, reported in 2020 that aggregate deaths numbered twice as many as releases.

Civil Commitment for Substance Abuse

In the states reporting the most civil commitments, they can be used to force someone accused of a crime into treatment for substance abuse. In 38 states that have laws permitting it, courts may order this sort of “diversion” for a low-­level related crime, like DUI or shoplifting, in lieu of a sentence to time in a cell.

In the context of this century’s opioid crisis, this sounds humane. But a 2018 report by Harvard Health found that “data on both the short-­ and long-­term outcomes following involuntary commitment for substance use is ‘surprisingly limited, outdated, and conflicting.’” In fact, some research suggested that the practice was not only ineffective but dangerous; a state-­sponsored study in Massachusetts, which is one of the 38 jurisdictions permitting civil commitment for substance abuse treatment, found that “people who were involuntarily committed were more than twice as likely to experience a fatal overdose as those who completed voluntary treatment.”

The report said that more research was needed to understand this, but it suggested several possible explanations. First, there is the difference in “internal motivation” between those who seek treatment voluntarily and those forced into it by the state. When the state routes patients into a less effective “treatment” like detox, they are also exposed to higher risks than with medication treatments like methadone or buprenorphine. In addition, those treated in facilities other than a state treatment lockup reportedly have more access to treatment for “physical or mental health needs, which are often at the root of problematic substance use.” See: Involuntary Treatment for Substance Use Disorder: A Misguided Response to the Opioid Crisis, Harvard Health Publishing(Jan. 28, 2018).

The opioid crisis has been blamed for a 600% spike in deaths from alcohol and substance abuse in state prisons from 2001 to 2018, as PLN also reported. Most of this contraband is smuggled to prisoners by staff, yet efforts to stem it have repeatedly been cited by prison officials to shut down prisoners’ access to letters and reading materials by mail. Finding no shortage of profiteering companies offering to scan and digitize prisoner communications, these same officials have then bootstrapped a drug crisis to exercise even tighter control over prisoners’ thoughts. [See: PLN, Nov. 2023, p.1.]

Corresponding to the explosion in substance abuse deaths behind bars is the growth of involuntary commitments to force abusers into treatment. But data on the phenomenon is spotty. A 2020 study published in the journal Psychiatric Services found that “involuntary psychiatric detentions outpaced population growth by a rate 3 to 1” in the nearly half of U.S. states with available data. To determine that, however, the authors were forced to “scour[] health and court websites for all U.S. states [before they] were able to cull usable counts on emergency and longer-­term involuntary detentions from just 25 of them for the period from 2011 to 2018.”

“This is the most controversial intervention in mental health—you’re deprived of liberty, can be traumatized and then stigmatized—yet no one could tell how often it happens in the United States,” said lead author David Cohen, a professor of social welfare at the UCLA Luskin School of Public Affairs. He called the rise in civil commitments “a bad sign” for those who “think that coercion is punishment, that we need services to prevent or defuse crises in families and society before they get out of control.” See: Incidences of Involuntary Psychiatric Detentions in 25 U.S. States (Lee and Cohen), Psychiatric Services (2018).

Where Do We Go Next?

In an essay published in Perspective on May 12, 2025, Drs. John C. Messinger and Leo Beletsky sounded the alarm about Robert F. Kennedy, Jr., the current Secretary of Health and Human Services, and his “support for involuntary commitment at abstinence-­ and faith-­based ‘healing farms’ for people struggling with addiction.”

Though states have passed more laws regulating involuntary commitment in recent years, the authors noted that use of the laws has not kept pace with their expanding number, citing California’s SB 43 as an example. As PLN reported, that was a 2023 measure which expanded the definition of “gravely ill” in order to justify involuntary commitment for substance abusers, once they can no longer provide for their basic needs such as food, clothing, shelter, personal safety or medical care. [See: PLN, May 2024, p.57.] However, as Messinger and Beletsky noted, use of SB 43 has been “exceedingly rare because most patients fail to meet the criteria for involuntary commitment once they are no longer acutely intoxicated from substances.” And even those who meet the criteria “are unable to be placed because residential addiction treatment facilities do not have the infrastructural capacity to enact involuntary holds.”

That is cold comfort when the U.S. is “sitting on a sleeping giant where nearly every state has the capability to forcibly treat people for substance use disorders provided that the political climate allows,” the authors continued, calling on voters not “to resort to this as the primary means of addressing the overdose crisis.”

This is one reason that PLN has consistently opposed civil commitment of sex offenders: because it opens the door for involuntary commitment of other groups, like substance abusers or the homeless, deemed socially undesirable. The drive to put more and more tools for social control in the hands of government, combined with the steady erosion of civil rights safeguards, means that we must remain vigilant and vocal in our opposition to civil commitment except as a last resort, and even then, only in the face of imminent danger.  

Additional sources: ACLU, A&E TV, Prison Policy Initiative, Psychiatry, Psychiatry Online, Science Museum, Social Security Admin.

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