Variation in civil commitment processes across jurisdictions: an approach for monitoring and managing change in mental health systems

This article demonstrates how unique local factors affect implementation of commitment statutes and, consequently, the extent to which implementation supports fundamental treatment philosophies. Four local variations in the implementation of Ohio's commitment statute are examined with a methodology designed to describe commitment processes. Qualitative case studies highlight factors that appear to contribute to variability across these sites. The authors contend that this information can be used as a system management tool at the state and local levels to (1) suggest needed changes in local service systems, (2) identify specific options/interventions for effecting change in desired directions and (3) assess the extent to which changes affect commitment processes in predictable ways that are consistent with philosophical principles.