An estimated 18.6% of adult Americans struggle with mental health symptoms, 22% of whom experience significant functional impairment qualifying them for status as having a serious mental illness (SMI). Despite high prevalence rates, many with mental health symptoms do not receive treatment. Barriers to treatment include those at both individual (i.e. lack of insurance) and environmental (i.e. lack of access) levels. Mental health symptoms causing an individual to be at risk for harm to self or others may lead to legal involvement via involuntary civil commitment (ICC) and evaluation. Although ICC statutes have been adopted throughout the United States, relatively little is known about ICC-involved populations and ICC caseflow. This study extends the literature by providing a description of the ICC population in southern Arizona. Findings identify risk and protective case variables in predicting ICC caseflow. Furthermore, this study is the first to examine two potential sources of problems within the ICC process: 1) disproportionate ICC-contact compared to population-based expectancies and 2) rate of agreement between ICC evaluating physicians regarding an individual’s mental health diagnoses.