Involuntary Commitment and its Potential Impacts: A Multidisciplinary Dialogue Spanning Research, Et

The involuntary hospitalization of people experiencing mental health crises is a widespread practice across the US, as common as imprisonment in state and federal prisons. In spite of persistent concerns from service users and advocates, the impacts of involuntary treatment have been difficult to characterize, and causal inference limited by structural and ethical barriers. This panel will lead with important new research led by Dr. Welle utilizing administrative data from Allegheny County, Pennsylvania, and leveraging the quasi-random assignment of evaluating physicians in order to estimate causal effects of involuntary hospitalization on post-discharge death by suicide or overdose, violent crime and employment. For individuals whom some physicians would hospitalize but others would not, the team has found that hospitalization nearly doubles the probability of being charged with a violent crime or dying by suicide or overdose in the three months after evaluation. Remaining panelists – Drs. Morgan Shields, Awais Aftab, and Travis Donohoe – will reflect on these provocative findings and share their own adjacent work. Specifically, Dr. Shields will focus on inpatient psychiatry, including common experiences in inpatient settings, and the potential role of inpatient iatrogenic harm with respect to post-discharge outcomes. Dr. Awais, a community psychiatrist and philosopher of psychiatry, will discuss ethical and political implications, as well as potential ways forward. Finally, Dr. Donahoe will reflect on methods-related challenges and next steps to advance policy research across the US.