The prediction of violent behavior during short-term civil commitment

The predictive validity of the clinical judgment of dangerousness in the context of short-term civil commitment was studied prospectively by comparing the behavioral scale ratings of both verbal and physical aggression between 37 persons committed on the basis of "danger to others" versus 31 persons committed on other grounds. No statistically significant difference was found between these two groups of detainees with regard to the levels of aggression measured during their approximately three-day detention. This finding is in agreement with abundant previous research which documents the inability of psychiatrists to accurately predict future dangerousness, prompting the author to suggest that the "dangerousness" criterion for civil commitment be rejected. Although society is unlikely to resurrect the broadly defined "in need of treatment" criterion because of its historically demonstrated ever present potential for abuse, the author suggests an alternative criterion for civil commitment which, in perhaps a more well-defined and more practical way, would allow the state to maintain its doctrine of parens patriae toward mental patients.