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Involuntary commitment

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Involuntary commitment , civil commitment , or involuntary hospitalization / hospitalisation is a legal process through which an individual who is deemed by a qualified person to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily . This treatment may involve the administration of psychoactive drugs , including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as outpatient commitment and shares legal processes with commitment.

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72-419: Criteria for civil commitment are established by laws which vary between nations. Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals who may then determine whether further civil commitment

144-522: A courtroom , and the building as a courthouse ; court facilities range from simple and very small facilities in rural communities to large complex facilities in urban communities. The practical authority given to the court is known as its jurisdiction (from Latin iūrisdictiō , from iūris , "of the law ", + dīcō , "to declare", + -tiō , noun-forming suffix ), the court's power to decide certain kinds of questions or petitions put to it. According to William Blackstone 's Commentaries on

216-554: A jury . The word court comes from the French cour , an enclosed yard, which derives from the Latin form cōrtem , the accusative case of cohors , which again means an enclosed yard or the occupants of such a yard. The English word court is thus a descendant of the Latin word hortus from Ancient Greek χόρτος ( khórtos ) (meaning "garden", hence horticulture and orchard), both referring to an enclosed space. The meaning of

288-423: A legal remedy . It is also usual in the superior courts to have barristers, and attorneys or counsel, as assistants, though, often, courts consist of additional barristers, bailiffs , reporters , and perhaps a jury . Jurisdiction is defined as the official authority to make legal decisions and judgements over a person or material item within a territory. "Whether a given court has jurisdiction to preside over

360-483: A body of law by combining local customs they were made aware of through traveling and visiting local jurisdictions. This common standard of law became known as "Common Law". This legal tradition is practiced in the English and American legal systems . In most civil law jurisdictions, courts function under an inquisitorial system . In the common law system, most courts follow the adversarial system . Procedural law governs

432-421: A court hearing, or sentencing as part of a criminal trial. Indefinite commitment is rare and is usually reserved for individuals who are violent or present an ongoing danger to themselves and others. New York City officials under several administrations have implemented programs involving the involuntary hospitalization of people with mental illnesses in the city. Some of these policies have involved reinterpreting

504-541: A court. Similarly, the rights of those accused of a crime include the right to present a defense before a court. The system of courts that interprets and applies the law is collectively known as the judiciary . The place where a court sits is known as a venue . The room where court proceedings occur is known as a courtroom , and the building as a courthouse ; court facilities range from simple and very small facilities in rural communities to large complex facilities in urban communities. The practical authority given to

576-499: A danger to self or others. Other jurisdictions have broader criteria. The legal process by which commitment takes place varies between jurisdictions. Some jurisdictions have a formal court hearing where testimony and other evidence may also be submitted and the subject of the hearing is typically entitled to legal counsel and may challenge a commitment order through habeas corpus . Other jurisdictions have delegated these power to physicians, though may provide an appeal process that involves

648-615: A determination about potential risk and apply treatment protocols. Observation is sometimes used to determine whether a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person should be committed. Austria, Belgium, Germany, Israel, the Netherlands, Northern Ireland, the Republic of Ireland, Russia, Taiwan, Ontario (Canada), and the United States have adopted commitment criteria based on

720-430: A given case" is a key question in any legal action. Three basic components of jurisdiction are personal jurisdiction over an individual or thing ( rēs ), jurisdiction over the particular subject matter ( subject-matter jurisdiction ) and territorial jurisdiction . Jurisdiction over a person refers to the full authority over a person regardless of where they live, jurisdiction over a particular subject matter refers to

792-621: A judicial assembly is first attested in the 12th century, and derives from the earlier usage to designate a sovereign and his entourage, which met to adjudicate disputes in such an enclosed yard. The verb "to court", meaning to win favor, derives from the same source since people traveled to the sovereign's court to win his favor. The term the court is used to refer to the presiding officer or officials, usually one or more judges . The judge or panel of judges may also be collectively referred to as "the bench " (in contrast to attorneys and barristers , collectively referred to as "the bar "). In

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864-816: A long-term or indefinite form of commitment applicable to people convicted of some sexual offences . United Nations General Assembly Resolution 46/119, " Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care ", is a non-binding resolution advocating certain broadly drawn procedures for the carrying out of involuntary commitment. These principles have been used in many countries where local laws have been revised or new ones implemented. The UN runs programs in some countries to assist in this process. The potential dangers of institutions have been noted and criticized by reformers/ activists almost since their foundation. Charles Dickens

936-416: A mainstay of psychiatric care" since the field first began. Some individuals who have been involuntarily hospitalized perceived their experience to be beneficial and fair. Lastly, they also note how many states require that the least invasive measures be taken before involuntary hospitalization is considered. Its opponents claim that an obligatory dangerousness criterion is unethical. Some believe it denies

1008-424: A patient's involuntary hospitalization would be re-evaluated over the span of a short period of time, ranging from two days to two weeks before a patient could have a court hearing to potentially be released. The obligatory dangerousness criterion is controversial. Supporters claim that the criterion is necessary in order to ensure that those who are in vital need of psychiatric care will receive it, and to prevent

1080-417: A person is involuntarily hospitalized varies and is determined by the state.   An obligatory dangerousness criterion has two main parts. First is the Latin phrase parens patriae , which translates to "parent of his or her nation", which "assigns to the government a responsibility to intervene on behalf of citizens who cannot act in their own best interest". The second part "requires a state to protect

1152-562: A physician agreed to provide a treatment. Individuals could be at the hospital indefinitely until a court ruled they could be released. An obligatory dangerousness criterion was officially established in the United States in 1964 by the Ervin Act in Washington, D.C. It provided a more lenient interpretation of "dangerousness" as well as alternatives to involuntary hospitalization . It is meant to protect individuals with mental health disorders on

1224-521: A rally in support of the anarchists. Throughout the 1940s and 1950s in Canada , 20,000 Canadian children, called the Duplessis orphans , were wrongfully certified as being mentally ill and as a result were committed to psychiatric institutions where they were allegedly forced to take psychiatric medication that they did not need and were abused. They were named after Maurice Duplessis , the premier of Quebec at

1296-466: A safe, healthy environment. Ancient Rome allowed guardianship over mentally ill individuals. In the US, psychiatric hospitals were not established until the late 18th and early 19th centuries. Before their establishment, individuals suffering with mental illnesses were imprisoned or kept from society. After their establishment, anyone could be admitted to a psychiatric hospital if a family member brought them and

1368-402: A similar manner to twin studies . In these studies people with schizophrenia are found to be between 1.3 and 1.8 times more likely to engage in violent behaviour. People with certain types of personality disorders can occasionally present a danger to themselves or others. This concern has found expression in the standards for involuntary commitment in every US state and in other countries as

1440-563: Is a quite recent development. A mental health first aid training course was developed in Australia in 2001 and has been found to improve assistance provided to persons with an alleged mental illness or mental health crisis. This form of training has now spread to a number of other countries (Canada, Finland, Hong Kong, Ireland, Singapore, Scotland, England, Wales, and the United States). Mental health triage may be used in an emergency room to make

1512-466: Is appropriate or necessary. Civil commitment procedures may take place in a court or only involve physicians. If commitment does not involve a court there is normally an appeal process that does involve the judiciary in some capacity, though potentially through a specialist court. For most jurisdictions, involuntary commitment is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that

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1584-421: Is known as its jurisdiction , the court's power to decide certain kinds of questions or petitions put to it. There are various kinds of courts, including trial courts that hold trials and appellate courts that hear appeals . Two major legal traditions of the western world are the civil law courts and the common law courts. A court is any person or institution , often as a government institution, with

1656-495: The reus or defendant , who is called upon to make satisfaction for it; and the jūdex or judicial power, who is to examine the truth of the fact, determine the law arising upon that fact, and, if any injury appears to have been done, ascertain and by its officers apply a legal remedy . It is also usual in the superior courts to have barristers, and attorneys or counsel, as assistants, though, often, courts consist of additional barristers, bailiffs , reporters , and perhaps

1728-607: The American Psychiatric Association (APA) strongly oppose the practice. The Task Force on Sexually Dangerous Offenders, a component of APA's Council on Psychiatry and Law, reported that "in the opinion of the task force, sexual predator commitment laws represent a serious assault on the integrity of psychiatry, particularly with regard to defining mental illness and the clinical conditions for compulsory treatment. Moreover, by bending civil commitment to serve essentially non-medical purposes, statutes threaten to undermine

1800-405: The authority to adjudicate legal disputes between parties and carry out the administration of justice in civil , criminal , and administrative matters in accordance with the rule of law . In both common law and civil law legal systems , courts are the central means for dispute resolution , and it is generally understood that all people have an ability to bring their claims before

1872-674: The finders of fact (these are known as jury trials ) or trials in which judges act as both finders of fact and finders of law (in some jurisdictions these are known as bench trials ). Juries are less common in court systems outside the Anglo-American common law tradition. Appellate courts are courts that hear appeals of lower courts and trial courts. Some courts, such as the Crown Court in England and Wales, may have both trial and appellate jurisdictions. The two major legal traditions of

1944-491: The Laws of England , a court (for civil wrongs ) is constituted by a minimum of three parties: the āctor or plaintiff , who complains of an injury done; the reus or defendant , who is called upon to make satisfaction for it; and the jūdex or judicial power, who is to examine the truth of the fact, determine the law arising upon that fact, and, if any injury appears to have been done, ascertain and by its officers apply

2016-514: The UK. The haste of these closures, driven by the Conservative governments led by Margaret Thatcher and John Major , led to considerable criticism in the press, as some individuals slipped through the net into homelessness or were discharged to poor quality private sector mini-institutions. There are instances in which mental health professionals have wrongfully deemed individuals to have been displaying

2088-405: The United States, the legal authority of a court to take action is based on personal jurisdiction over the parties to the litigation and subject-matter jurisdiction over the claims asserted. The system of courts that interprets and applies the law is collectively known as the judiciary . The place where a court sits is known as a venue . The room where court proceedings occur is known as

2160-403: The abolition or substantial reduction of involuntary commitment, a trend known as deinstitutionalisation . In many currents, individuals can voluntarily admit themselves to a mental health hospital and may have more rights than those who are involuntarily committed. This practice is referred to as voluntary commitment . In the United States, Kansas v. Hendricks established the procedures for

2232-441: The agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. In some jurisdictions, this is a proceeding distinct from being found incompetent . Involuntary commitment is used in some degree for each of the following although different jurisdictions have different criteria. Some jurisdictions limit involuntary treatment to individuals who meet statutory criteria for presenting

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2304-502: The authority of the mental institutions, culminating in their closure. During the 1970s and 1990s the hospital population started to fall rapidly, mainly because of the deaths of long-term inmates. Significant efforts were made to re-house large numbers of former residents in a variety of suitable or otherwise alternative accommodation. The first 1,000+ bed hospital to close was Darenth Park Hospital in Kent , swiftly followed by many more across

2376-679: The authority over the said subject of legal cases involved in a case, and lastly territorial jurisdiction is the authority over a person within an x amount of space. Other concepts of jurisdiction include general , exclusive , appellate , and (in the United States federal courts ) diversity jurisdiction . Courts may be organized into a hierarchy of courts and have specific jurisdiction and include specialized courts . Trial courts are courts that hold trials . Sometimes termed "courts of first instance", trial courts have varying original jurisdiction . Trial courts may conduct trials with juries as

2448-426: The basis of parens patria . In order to be involuntary hospitalized under the obligatory dangerousness criterion, one must have a mental illness, and most states also require that the individual is in need of medical treatment for the illness. In 1964, Washington, D.C., established that an individual may only be involuntarily hospitalized if the individual has a mental illness, may be threat to others or their self in

2520-572: The body appeared in an earlier form in 1841. At the turn of the century, England and France combined had only a few hundred individuals in asylums. By the late 1890s and early 1900s, those so detained had risen to the hundreds of thousands. However, the idea that mental illness could be ameliorated through institutionalization was soon disappointed. Psychiatrists were pressured by an ever-increasing patient population. The average number of patients in asylums kept increasing. Asylums were quickly becoming almost indistinguishable from custodial institutions, and

2592-523: The circumstances under which a person may be committed or treated against their will as such actions have been ruled by the United States Supreme Court and other national legislative bodies as a violation of civil rights and/or human rights . The Supreme Court case O'Connor v. Donaldson established that the mere presence of mental illness and the necessity for treatment are not sufficient by themselves to justify involuntary commitment, if

2664-487: The city won on appeal she was ultimately released after a subsequent case determined she could not be forcibly medicated. In 2022, Mayor Eric Adams announced a similar compulsory hospitalization program, relying on similar legal interpretations. Historically, until the mid-1960s in most jurisdictions in the United States , all committals to public psychiatric facilities and most committals to private ones were involuntary. Since then, there have been alternating trends towards

2736-461: The closure of all NHS asylums and their replacement by wards in general hospitals: "There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside - the asylums which our forefathers built with such immense solidity to express the notions of their day. Do not for a moment underestimate their powers of resistance to our assault. Let me describe some of

2808-556: The community, a shift known as "deinstitutionalization". Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless. In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated severe mental illness to take psychiatric medication while living outside

2880-462: The court is known as its jurisdiction (from Latin iūrisdictiō , from iūris , "of the law ", + dīcō , "to declare", + -tiō , noun-forming suffix ), the court's power to decide certain kinds of questions or petitions put to it. According to William Blackstone 's Commentaries on the Laws of England , a court (for civil wrongs ) is constituted by a minimum of three parties: the āctor or plaintiff , who complains of an injury done;

2952-419: The criterion is necessary to protect the mentally ill and those impacted by their involuntary treatment. If a court determines that a person may cause long-term harm to themselves or others, then the person can be hospitalized or be required to outpatient treatment and treated involuntarily. In order to be released, the court must determine whether the person is no longer dangerous. The length of time that

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3024-422: The danger to self or others standard, sometimes supplemented by the requirement that the danger be imminent. In some jurisdictions, the danger to self or others standard has been broadened in recent years to include need-for-treatment criteria such as "gravely disabled". Starting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in

3096-463: The defenses which we have to storm." Scandal after scandal followed, with many high-profile public inquiries. These involved the exposure of abuses such as unscientific surgical techniques such as lobotomy and the widespread neglect and abuse of vulnerable patients in the US and Europe. The growing anti-psychiatry movement in the 1960s and 1970s led in Italy to the first successful legislative challenge to

3168-623: The end of the eleventh century and became a foundation for university legal education starting in Bologna, Italy and subsequently being taught throughout continental European universities. Civil law is firmly ensconced in the French and German legal systems . Common law courts were established by English royal judges of the King's Council after the Norman Invasion of Britain in 1066. The royal judges created

3240-587: The first school for intellectually disabled people. His method of treatment was based on the idea that intellectually disabled people did not suffer from disease. In the United Kingdom, provision for the care of the mentally ill began in the early 19th century with a state-led effort. Public mental asylums were established in Britain after the passing of the 1808 County Asylums Act . This empowered magistrates to build rate-supported asylums in every county to house

3312-422: The general public. However, because other confounding factors such as childhood adversity and poverty are correlated with both schizophrenia and violence it can be difficult to determine whether this effect is due to schizophrenia or other factors. In an attempt to avoid these confounding factors, researchers have tried comparing the rates of violence amongst people diagnosed with schizophrenia to their siblings in

3384-420: The harm caused must have a long-term effect on the person(s). Psychiatric hospitals and involuntary commitment have been around for hundreds and even thousands of years around the world, but the obligatory dangerousness criterion was created in the United States in the 1900s. The criterion is a controversial topic, with opponents claiming that it is unethical and potentially harmful. Supporters claim that

3456-470: The hospital (e.g. Laura's Law , Kendra's Law ). In a study of 269 patients from Vermont State Hospital done by Courtenay M. Harding and associates, about two-thirds of the ex-patients did well after deinstitutionalization. In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the country. Édouard Séguin developed a systematic approach for training individuals with mental deficiencies, and, in 1839, he opened

3528-589: The individual of consent, is discriminatory based on mental health, and may increase the patient's risk of suicide, psychotic symptoms, or other harmful behaviors. They worry an obligatory dangerousness criterion might lead individuals without a serious mental illness to be involuntarily hospitalized, or that individuals without a serious mental illness will be involuntarily hospitalized as a "preventative" means. Those who oppose an obligatory dangerousness criterion also argue that there are less restrictive alternatives to involuntary hospitalization that can help those with

3600-437: The interests of its citizens", meaning that the government must do what it can to care for greater society, which may involve limiting one individual's rights to avoid harming the greater society. Psychiatric asylums and guardianship over the mentally ill have been present for centuries. In Greece, individuals, such as Hippocrates , believed that those with mental illnesses should be separated from others and maintained within

3672-689: The judicial system and are generally private arbitrators , are depicted within the court show genre; however, the courts depicted have been criticized as misrepresenting real-life courts of law and the true nature of the legal system. Notable court shows include: Obligatory Dangerousness Criterion The obligatory dangerousness criterion is a principle present in the mental health law of many developed countries . It mandates evidence of dangerousness to oneself or to others before involuntary treatment for mental illness . The term "dangerousness" refers to one's ability to hurt oneself or others physically or mentally within an imminent time frame, and

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3744-549: The judiciary but may also involve physicians. For example, in the UK a mental health tribunal consists of a judge, a medical member, and a lay representative. Training is gradually becoming available in mental health first aid to equip community members such as teachers, school administrators, police officers, and medical workers with training in recognizing, and authority in managing, situations where involuntary evaluations of behavior are applicable under law. The extension of first aid training to cover mental health problems and crises

3816-401: The legitimacy of the medical model of commitment." Court A court is any person or institution , often as a government institution, with the authority to adjudicate legal disputes between parties and carry out the administration of justice in civil , criminal , and administrative matters in accordance with the rule of law . The practical authority given to the court

3888-481: The local police secretly arrested and involuntarily committed him to a mental hospital for 12 days. Patients are able to sue if they believe that they have been wrongfully committed. In one instance, Junius Wilson, an African American man, was committed to Cherry Hospital in Goldsboro, North Carolina in 1925 for an alleged crime without a trial or conviction. He was castrated. He continued to be held at Cherry Hospital for

3960-480: The many "pauper lunatics". Nine counties first applied, and the first public asylum opened in 1812 in Nottinghamshire . Parliamentary Committees were established to investigate abuses at private madhouses like Bethlem Hospital - its officers were eventually dismissed and national attention was focused on the routine use of bars, chains and handcuffs and the filthy conditions in which the inmates lived. However, it

4032-399: The mentally ill individual from potentially harming themselves or others. They also note that mental health disorders can impair one's judgement, for example, if an individual with depression does not think that they need help. They argue that psychiatric care often involves some form of hospitalization or treatment, and as a result, "involuntary hospitalization, or civil commitment, has been

4104-477: The near future, or is unable to survive on their own. States followed suit and began implementing a dangerousness criteria, as well. In the 1975 Supreme Court case O'Connor v. Donaldson , the Supreme Court ruled that the individual must have a mental illness, pose a known threat to the safety of their self or others, be unable to care for themselves, or need psychiatric care. States adjusted their rules so that

4176-477: The next 67 years of his life. It turned out he was deaf rather than mentally ill. In many U.S. states, sex offenders who have completed a period of incarceration can be civilly committed to a mental institution based on a finding of dangerousness due to a mental disorder. Although the United States Supreme Court determined that this practice does not constitute double jeopardy , organizations such as

4248-405: The patient is capable of surviving in freedom and does not present a danger of harm to themselves or others. Criteria for involuntary commitment are generally set by the individual states, and often have both short- and long-term types of commitment. Short-term commitment tends to be a few days or less, requiring an examination by a medical professional, while longer-term commitment typically requires

4320-406: The presumed danger of the defendant to self or to others. People with suicidal thoughts may act on these impulses and harm or kill themselves. People with psychosis are occasionally driven by their delusions or hallucinations to harm themselves or others. Research has found that those with schizophrenia are between 3.4 and 7.4 times more likely to engage in violent behaviour than members of

4392-638: The provisions of the Act; the compulsory construction of asylums in every county, with regular inspections on behalf of the Home Secretary . All asylums were required to have written regulations and to have a resident qualified physician . A national body for asylum superintendents - the Medico-Psychological Association - was established in 1866 under the Presidency of William A. F. Browne , although

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4464-709: The reputation of psychiatry in the medical world had was at an extreme low. Sectioning is now regulated by the Mental Health Act 2007 in England and Wales, the Mental Health (Care and Treatment) (Scotland) Act 2003 in Scotland and other legislation in Northern Ireland. In the United States, the erection of state asylums began with the first law for the creation of one in New York, passed in 1842. The Utica State Hospital

4536-431: The rest of society. British playwright Tom Stoppard wrote Every Good Boy Deserves Favour about the relationship between a patient and his doctor in one of these hospitals. Stoppard was inspired by a meeting with a Russian exile. In 1927, after the execution of Sacco and Vanzetti in the United States, demonstrator Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in

4608-719: The rules by which courts operate: civil procedure for private disputes (for example); and criminal procedure for violation of the criminal law. In recent years, international courts are being created to resolve matters not covered by the jurisdiction of national courts. For example, the International Criminal Court , based in The Hague , in the Netherlands, or the Court of Permanent Lok Adalat (Public Utility Services), based in India. Television show courts, which are often not part of

4680-493: The standard of "harm to themselves or others" to include neglecting their own well-being or posing a harm to themselves or others in the future. In 1987–88, a homeless woman named Joyce Brown worked with the New York Civil Liberties Union to challenge her forced hospitalization under a new Mayor Ed Koch administration program. The trial, which attracted significant media attention, ended in her favor, and while

4752-551: The symptoms of a mental disorder , and committed the individual for treatment in a psychiatric hospital upon such grounds. Claims of wrongful commitment are a common theme in the anti-psychiatry movement . In 1860, the case of Elizabeth Packard , who was wrongfully committed that year and filed a lawsuit and won thereafter, highlighted the issue of wrongful involuntary commitment. In 1887, investigative journalist Nellie Bly went undercover at an asylum in New York City to expose

4824-560: The terrible conditions that mental patients at the time had to deal with. She published her findings and experiences as articles in New York World , and later made the articles into one book called Ten Days in a Mad-House . In the first half of the twentieth century there were a few high-profile cases of wrongful commitment based on racism or punishment for political dissenters . In the former Soviet Union , psychiatric hospitals were used as prisons to isolate political prisoners from

4896-515: The time, who deliberately committed these children to misappropriate additional subsidies from the federal government. Decades later in the 1990s, several of the orphans sued Quebec and the Catholic Church for the abuse and wrongdoing. In 1958, black pastor and activist Clennon Washington King Jr. tried enrolling at the University of Mississippi , which at the time was white, for summer classes;

4968-413: The western world are the civil law courts and the common law courts. These two great legal traditions are similar, in that they are products of western culture, although there are significant differences between the two traditions. Civil law courts are profoundly based upon Roman law , specifically a civil body of law entitled Corpus Juris Civilis . This theory of civil law was rediscovered around

5040-413: Was an outspoken and high-profile early critic, and several of his novels, in particular Oliver Twist and Hard Times demonstrate his insight into the damage that institutions can do to human beings. Enoch Powell , when Minister for Health in the early 1960s, was a later opponent who was appalled by what he witnessed on his visits to the asylums, and his famous "water tower" speech in 1961 called for

5112-629: Was not until 1828 that the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums. The Lunacy Act 1845 was a landmark in the treatment of the mentally ill, as it explicitly changed the status of mentally ill people to patients who required treatment. The Act created the Lunacy Commission , headed by Lord Shaftesbury , focusing on reform of the legislation concerning lunacy. The commission consisted of eleven Metropolitan Commissioners who were required to carry out

5184-585: Was opened approximately in 1850. The creation of this hospital, as of many others, was largely the work of Dorothea Lynde Dix , whose philanthropic efforts extended over many states, and in Europe as far as Constantinople . Many state hospitals in the United States were built in the 1850s and 1860s on the Kirkbride Plan , an architectural style meant to have curative effect. In the United States and most other developed societies, severe restrictions have been placed on

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