North Carolina Resident Psychiatrists Knowledge of the Commitment Statutes: Do They Stray from the Legal Standard in the Hypothetical Application of Involuntary Commitment Criteria?

Objectives are to examine North Carolina (NC) resident psychiatrists knowledge of commitment statutes and their willingness to involuntarily admit hypothetical patients who do not meet statutory criteria. It is hypothesized that the need for transportation may be a salient factor. In one vignette the patient had schizophrenia and the other alcohol dependence. The respondents were asked to make a decision about commitment and to rate how 9 specified factors affected their decision. Sixty-one residents responded. Thirty percent answered incorrectly about statutory provisions for ‘mental illness’ and ‘dangerousness’, 10% answered incorrectly that grave disability does not meet the dangerousness criterion, and 41% answered incorrectly about the NC statutory language of the ‘least restrictive alternative’ principle. While neither hypothetical patient met the commitment standard, 74% of respondents would involuntarily admit the patient with psychotic illness and 87% would involuntarily admit the patient with alcohol dependence. Training in commitment standards with clinical vignettes should be conducted with residents to protect patient rights.