To his co-workers at a Los Angeles aerospace plant, Herbert Hill seemed odder and odder. The angry exmarine, a purchasing expediter, refused to speak, neglected his work, shoved his chair at passersby, rejected all psychiatric help. Last month Hill's boss ap pealed to a special psychiatric court in the county general hospital. Hill was arrested, examined by two court psychiatrists, and diagnosed as a potentially dangerous schizophrenic. After an informal hearing, at which he was rep resented by a public defender, the court sent Hill to Camarillo State Hospital and scheduled a jury trial to review his commitment. But Hill responded so well to treatment that in a few weeks the hospital advised the court to release him. Now he is getting private medical care, and has a fair chance of recovery.
At some point in their lives, roughly 10% of Americans will probably wind up in mental hospitals — a statistic that poses hard questions of civil liberty and medical necessity. Though critics decry the use of police to "arrest" mental patients, Hill's rights were well guarded by California's relatively enlightened rules. But what of others in Hill's position throughout the country?
No Railroading. The ancients had legal sanctions to exorcise demons by crushing or cutting open the bodies of the afflicted. The Middle Ages permit ted even worse therapeutic tortures.
Colonial Americans whipped the mentally deficient. But in 1773 Virginia opened the country's first state mental hospital, and the law soon honed the classic standard that involuntary commitment is justified for persons "dangerous to themselves or others."
It was so easy to pin this label on enemies or unwanted wives, however, that in the 1870's reformers pushed through strict judicial safeguards against railroading. Since mental hospitals were then regarded as fearful places, the law's chief aim was to make sure that only the truly ill were committed. Today's most advanced screening procedures require careful precommitment medical examination, legal notice, and informal hearings before special courts. Some judges follow up with personal bedside visits; the patient's legal remedies range from jury trial to writs of habeas corpus. Says one Chicago judge: "It would take a massive conspiracy to railroad anyone."
No Restraint. But a new legal problem has arisen as a result of the mid-1950s' introduction of tranquilizers that ease savage symptoms. Bars, screams, straitjackets—all signs of restraint are disappearing from mental hospitals as new remedies make mental illness more tractable. The law's new problem is how far to liberalize involuntary commitment procedures at a time when psychiatrists argue for earlier admission (leading to earlier discharge), long before patients become "dangerous."