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Saks Institute Holds Discussion on Involuntary Commitment

Wednesday, Nov 22, 2017

Judge James Bianco '87 rules on cases in mental health court

-By Gilien Silsby

More than three decades ago, USC Gould Prof. Elyn Saks was involuntarily placed in a mental hospital for 15 days after a psychotic breakdown at Yale Law School. The experience still haunts Saks, who was diagnosed with schizophrenia shortly after the episode.

Saks, a MacArthur Genius Award winner and founder of USC’s Saks Institute for Mental Health Law, Policy and Ethics, recently shared her experiences with involuntary commitment at a sold-out event at USC Gould School of Law. 

Scott Altman, Elyn Saks and Judge James Bianco at Saks Institute discussion. 

The Saks Institute’s annual distinguished lecture event, moderated by Prof. Scott Altman, also featured Judge James Bianco ‘87, who rules on cases in Los Angeles’ mental health court.

 “Held Against My Will: Mental Health, Consent and the Law,” explored the personal, professional and legal challenges impacting the courts and people struggling with mental illness.

While Saks shared her personal experiences, Bianco spoke about issues facing the courts when deciding if an individual with mental illness should be committed. Bianco said his mission is to treat each person fairly and make decisions based on what is presented in court.


“We are fortunate that both sides are represented by attorneys, typically from the Public Defender’s and District Attorney’s Offices, who are very experienced and committed to this work; they do an excellent job of developing the facts and presenting the issues,” Bianco said.

Bianco supervises court rooms that hear cases involving a variety of topics, including criminal competency, conservatorship, involuntary hospitalization hearings, involuntary medication petitions, and sexually violent predator allegations.

Saks said that involuntary commitment brings a high cost to patient in terms of liberty and dignity. “Putting someone away without their consent is a kind of assault on a person’s integrity and lifestyle,” said Saks. 

Elyn Saks with Jackie Lacey, Los Angles County District Attorney. 

Saks said that although she is philosophically opposed to most involuntary commitments, she understands circumstances may force judges to intervene.  “If someone has a mental illness and is suicidal or a danger to others, there’s no question that intervention is necessary. But there are often times that people are put away simply because they are acting oddly.” 

“I believe we should help people seek treatment on their own instead of using force. This is the best for everyone in the long run,” Saks said.

The sheer number of mental health cases is one of the many challenges facing the courts. “The volume is huge,” said Bianco, who was appointed to the bench in 2005, and has served in the mental health court since 2013. “The cases we hear in court are only a fraction of what’s heard at the hospital level.”

Because individuals held for 14 days and beyond are entitled to a hearing at the hospital, hearing officers administer up to 30,000 hearings at the hospital each year. After that time, they are entitled to another hearing in court.


“In some cases, we also hear patients’ appeals regarding the use of involuntary medication at hospitals,” said Bianco.  “The law requires us to determine whether a patient has the capacity to consent to medication.  Those are obviously very important, sensitive issues.”

Despite enjoying a lifetime of academic success - Saks was valedictorian at Vanderbilt University, a Marshall scholar at Oxford University, and honors student at Yale Law School and today is a respected legal scholar at USC law -  Saks continues to endure stigma and challenges.

“That’s why I want to hold these dialogues,” she said. “The more we know about the legal and societal challenges and issues facing people who have mental illness, the less we will be stigmatized.”



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