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Published Online: 5 November 2024

Understanding Involuntary Hospitalization Applications Submitted to an Urban Police Department

Publication: Psychiatric Services

Abstract

Objective:

To improve understanding of the application process for temporary involuntary hospitalization (Section 12 of the Massachusetts General Laws) in Boston, the authors focused on cases involving the Boston Police Department (PD) and the information shared about the individuals involved.

Methods:

A retrospective analysis was conducted on all Section 12 applications submitted to the Boston PD by external clinicians from July 14, 2021, to June 30, 2022. The authors analyzed 488 applications processed by the Boston PD’s Street Outreach Unit, examining demographic information, reasons for requests, information provided by petitioners, and the status of the applications (completed vs. not).

Results:

The analysis revealed racial disparities: 41% of involuntary hospitalization applications were for individuals identified as Black or African American, but this racial group represents only 23% of Boston’s population. Racial-ethnic data were based on police perceptions, and 21% of cases lacked race-ethnicity data. Seventy-six percent of applications were submitted without a direct clinical examination by petitioners, who did not justify the omission. The Boston PD completed 70% of the requested involuntary hospitalization orders.

Conclusions:

This study identified substantial racial disparities in Section 12 applications, which disproportionately involved Black or African American individuals. The frequent absence of direct clinical examinations before application submissions and the lack of justification indicated a need for regulatory oversight and enhanced petitioner training. Incomplete demographic data underscored the need for improved data collection and reporting practices. These findings highlight the need for reforms to ensure equitable, transparent, and best practice–aligned involuntary hospitalization processes.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services

History

Received: 16 August 2023
Revision received: 1 July 2024
Accepted: 11 July 2024
Published online: 5 November 2024

Keywords

  1. crisis intervention
  2. involuntary commitment
  3. police
  4. public policy issues
  5. racial disparity
  6. mental health law

Authors

Details

Kevin M. Simon, M.D., M.P.H. [email protected]
Department of Psychiatry, Harvard Medical School, Boston, and Boston Public Health Commission, Boston (Simon); Office of Research and Development, Boston Police Department, Boston (Savage); School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell (Krebs, Wegiel, Morabito).
Jenna Savage, Ph.D.
Department of Psychiatry, Harvard Medical School, Boston, and Boston Public Health Commission, Boston (Simon); Office of Research and Development, Boston Police Department, Boston (Savage); School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell (Krebs, Wegiel, Morabito).
Lauryn Krebs, M.A.
Department of Psychiatry, Harvard Medical School, Boston, and Boston Public Health Commission, Boston (Simon); Office of Research and Development, Boston Police Department, Boston (Savage); School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell (Krebs, Wegiel, Morabito).
Trinity Wegiel
Department of Psychiatry, Harvard Medical School, Boston, and Boston Public Health Commission, Boston (Simon); Office of Research and Development, Boston Police Department, Boston (Savage); School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell (Krebs, Wegiel, Morabito).
Melissa S. Morabito, Ph.D.
Department of Psychiatry, Harvard Medical School, Boston, and Boston Public Health Commission, Boston (Simon); Office of Research and Development, Boston Police Department, Boston (Savage); School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell (Krebs, Wegiel, Morabito).

Notes

Send correspondence to Dr. Simon ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This study was funded by the FY21 Connect and Protect grant (15PBJA-21-GG-04330-MENT) awarded by the U.S. Department of Justice’s Bureau of Justice Assistance to the Boston Police Department, and by the American Academy of Child and Adolescent Psychiatry’s Physician-Scientist Career Development Award funded by the National Institute on Drug Abuse (K12DA000357 to Dr. Simon).

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