The promise and peril of involuntary outpatient commitment.

Abstract

Over the last 20 years, involuntary outpatient commitment has periodically been proposed as a possible strategy for providing mental health services to chronic mental patients. Under this approach, patients meeting certain criteria of dangerousness or need for treatment could be compelled by the courts to take part in treatment programs in the community. This article examines the available literature regarding this policy and the arguments for and against it. The final section outlines implementation issues that should be considered in designing any such policy so that it could be both legally acceptable and clinically sound.

Controllers and controlled: an analysis of participant constructions of outpatient commitment

“…According to Wilk (1988) OPC is even being promoted 'vigorously.' With increased visibility, OPC has also come under increased scrutiny (Brooks 1987, Bumsten 1986, Geller 1986, Mulvey et al 1987, Wilk 1988. The reaction to OPC is mixed.…”

“…OPC offers the promise that a compromise can be made between the individual's right to liberty and the need of society to care for and control the 'mentally ill' (Mulvey et al 1987). OPC seeks this balance by maintaining clients ill in the community rather than in state hospitals or other inpatient facilities.…”

A Survey of the Use of Community Treatment Orders by Psychiatrists in Saskatchewan

“…Coercing individuals who live in the community to take treatment has raised concerns about protecting individual rights (2). Preventing abuse of civil liberty is best achieved by regular independent review of patients who are subject to these orders.…”

Supervised community treatment and section 17 of the Mental Health Act 1983

“…Owino Supervised community treatment under section 17 editorial coercion into the community and may actually drive people away from treatment (Mulvey et al, 1987;Miller, 1999). Sensky et al (1991) found that a psychiatrist's decision to recommend a patient for treatment with a community treatment order (if such a provision existed) will depend predominantly on specific criteria related to the patient's recent past, particularly in terms of default from follow-up.…”