Bipolar – Involuntary Commitment

The rules about civil commitment vary from state to state. Over the last 30 years the civil rights of the identified patient have been given much more weight in the equation. So it has made it much harder to put them into treatment on an involuntary basis. In general, psychiatric patients can only be detained for very short periods of time, 72-96 hours, for the purposes of assessment. If they are deemed to be an imminent threat to themselves or other people involuntary treatment can be provided.

In general, the courts have been reluctant to keep patients in involuntary treatment who state they are willing to accept treatment and have a place to go to. The problem you are encountering with your brother is all too common across the United States today. Some jurisdictions have enacted outpatient civil commitment to ensure the individual stays in treatment after they are released from the facility – but this is the exception rather than the rule.

If you can be present when the police are called to your brother’s house there is a much greater likelihood that they will be willing to detain him and bring him to treatment. However, this is often not possible or feasible. 

Many patients who are stable in their bipolar disorder will become unstable or psychotic even after very brief exposure to crack or methamphetamines. It is critical your brother receive treatment not only for his bipolar disorder, but for his substance abuse, if there is any chance for him to stabilize long term. In many cases where treatment appears to not be working, the person shows dramatic improvement if they stop using illicit drugs or alcohol.

One treatment, lithium, has been shown to significantly decrease suicidal risk in bipolar patients with this clinical picture.