AbstractMany jurisdictions across North America have revised their statutes pertaining to the criteria for civil commitment with the legislative intent to either increase or decrease the use of involuntary hospitalization. The impact of these revised statutes has been examined in many jurisdictions, but there has been no consensus regarding their effectiveness in changing the rates of involuntary admissions. The present article reviews the literature from a methodological perspective, comparing the differing analyses, results and interpretations. When the legislative revision has sought to expand medical prerogative, results indicate a sustained increase in civil commitments. When legislation has aimed at limiting medical discretion, there was an immediate decline in civil commitment rates, but a subsequent increase in the period following the initial post‐reform declines. These results are discussed in terms of readmission trends, deinstitutionalization, and the possible reaction of mental health professionals who perceive legislation as an unnecessary constraint in the treatment of the mentally il