A Possible Approach to Gathering Standardized Data on Civil Commitments

TO THE EDITOR: I read with interest the recent Open Forum by Morris and Kleinman on involuntary psychiatric hospitalization (1). One of the main points of their essay is that researchers have surprisingly limited data on the use of civil commitment nationally, leading to the authors’ call for “systemic data collection to monitor, study, and guide the use of this intervention” (i.e., civil commitments). I also appreciated the related podcast episode (2) that featured an interview with Dr. Morris about this piece, during which he candidly admitted that, while having called for this, he did not have a clear idea of how to get this done, in that civil commitment laws, policies, and data collection practices are overseen at a state— and sometimes local—level, with a lot of variation.

One relatively straightforward approach may be through the state mental health block grant application. All state mental health authorities (MHAs) are eligible to receive federal mental health block grant funding by completing an annual application that includes a wide variety of required data elements. The state MHAs (especially those in states that have limited central authority) may have insufficient capacity to report accurately on each of these data elements, but they are at least incentivized to figure out a way to get the best information possible. The mental health block grant is overseen by the Substance Abuse and Mental Health Services Administration. Adding a few questions to the block grant application regarding numbers of individuals each year who underwent civil commitment proceedings would seem to be a relatively simple, straightforward way to begin to compile the kind of systematic data collection that the authors rightly point out is very much needed.