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Some doctors now argue that admission should be governed entirely by medical boards, without interference from lay judges and juries. But lawyers fear that even harmless neurotics might wind up in institutions that are still primarily geared to restraint. The consensus is that involuntary admission should be extended to nondangerous persons only where hospitals are fully equipped to treat early symptoms. On the other hand, state hospitals are allowed to discharge patients without court intervention. In many places, nondangerous patients who succeed in going over the hill and staying free for a year are considered discharged, on the theory that they must have come to terms with society.
In such advanced states as Illinois and New York, the admission trend is nonetheless toward maximum medical control. Hospital judges in Illinois now work so closely with medical advisers that, in general, they decide only whether a committal involves bias or unethical conduct. Boasts one Chicago judge: "This is the only court where the defendant always wins. If he is released, it means he is well. If he is committed, it is for his own good."
Earlier & Faster. New York will probably lead all states next year when it puts into effect a new mental-health code based on careful bar studies and long experience with the psychiatric division of Manhattan's Bellevue Hospital, the world's biggest psychiatric admission center (18,000 cases a year).
Bellevue's mental patients may be held for observation against their will for up to 60 days. In deciding whether they should go on to state hospitals, the judges manning Bellevue's 7th-floor courtroom are amply served by psychiatric advice, but they need far more information about the patients' families and financial backgrounds.
The new law thus provides a fact-finding state mental-health service with trained case workers who will not only tell judges more about patients, but also keep better case records for the information of friends, relatives and patients themselves. While retaining such remedies as habeas corpus, the new law will put medical and legal interests in better perspective. Involuntary admission will be by application of relatives, friends or public officers, plus a certificate signed by two psychiatrists. Within five days of admission notice must be given to the patient and three relatives or friends. Though hospitals will still be able to hold patients for 60 days, they must then get court permission and court review after six months, one year, and every two years thereafter.
All this aims to get patients in earlier and out faster. If it works, New York may take credit for a major step toward putting admission to mental hospitals on virtually the same medical basis as admission to other hospitals—while safeguarding civil liberties for citizens who must be denied some freedom in order to handle full freedom later on.