Involuntary Commitment and its Potential Impacts: A Multidisciplinary Dialogue Spanning Research, Ethics and Methodology.

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...Read more 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 and Awais Aftab – 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.

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Learning Objectives

Explain instrumental variable analysis and its application to understanding the impact of involuntary commitment.
Describe some of the ways in which inpatient psychiatric experiences can impact post- discharge outcomes.
Describe concrete ways in which providers can minimize the harms of involuntary commitment.

Learning Levels

All Levels

Thursday, April 10, 2025

Live Interactive Webinar

01:00 PM EDT - 02:30 PM EDT

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$10.00 - $40.00

EARN 1.5 CE Credit Hours
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About the speakers

Pim Welle, PhD

Chief Data Scientist

Dr. Pim Welle is a health economist whose research focuses on how public policies can reduce harms from addictive substance use at the population level. Dr. Welle's work on this topic features applied economic theory, state-of-the-art econometric methods, and large and novel datasets.

Morgan Shields, PhD

Morgan Shields’ researches the quality and accountability of behavioral healthcare. Her work seeks to identify implementation strategies to improve the use of evidence-based practices, with a focus on patient-centered care and equity. She is particularly focused on identifying policies (e.g., payment, regulations) to motivate and support quality improvement. Shields is one of few people studying the quality of inpatient psychiatry. Her research identifying disparities in quality performance at the Veterans Health Administration led to internal investigations by the Deputy Under Secretary for Health and Organizational Excellence.

In 2019, the Massachusetts Department of Mental Health revamped its critical incident monitoring system in response to Shields’ research. Her analyses highlighting the systematic exclusion of psychiatric patients from national measurement of patient experience has prompted action from national entities to address this discrimination. Shields serves as an expert in related legal cases.

Shields received training in implementation science and community-academic research through an NIMH T32 postdoctoral fellowship at the University of Pennsylvania. She has a Ph.D. from Brandeis University’s Heller School for Social Policy and Management, where she was an NIAAA T32 fellow and a Harvard Kennedy School Rappaport Public Policy fellow, and an M.Sc. from the Harvard T.H. Chan School of Public Health. Shields publishes in outlets such as Health Affairs, Medical Care, and the JAMA Network. Shields directs the IDEAL (Inclusive, Dignified, Equitable and Effective, Accountable, and Loving) Lab, which identifies strategies for providing patient-centered care.

Awais Aftab, MD

Awais Aftab, MD is a psychiatrist at Southwest General Medical Center and a Clinical Assistant Professor of Psychiatry at Case Western Reserve University in Cleveland, Ohio. His academic, educational, and public-facing work focuses on conceptual and critical issues in psychiatry. His peer-reviewed work has been published in top psychiatric journals such as JAMA Psychiatry, American Journal of Psychiatry, and World Psychiatry. He has written for the New York Times and has been quoted in publications such as the LA Times, VICE News, and the Rolling Stones Magazine. He led the interview series “Conversations in Critical Psychiatry” for Psychiatric Times, and a book adaptation is forthcoming from Oxford University Press. He is a senior editor for the journal “Philosophy, Psychiatry, & Psychology.” He writes online on his Substack newsletter Psychiatry at the Margins, which has more than 8000 subscribers from 110 countries. (https://psychiatrymargins.com/).

Agenda

5 minute introduction

60 minute presentation on Involuntary Commitment and its Potential Impacts

25 minute question and answer between the audience and presenter