Is involuntary outpatient commitment a remedy for community mental health service failure?
Involuntary outpatient commitment (IOC) statutes exist in response to disorganized community mental health service delivery and perceived treatment non-compliance. These statutes attempt to force psychiatric patients to comply with outpatient mental health services. Mental health service consumers, providers, and advocates have increasingly questioned the necessity and legality of IOC. Credible research indicates that IOC does not substantially benefit consumers and may increase mental health deterioration. IOC has proven difficult to implement, enforce, and successfully measure. Rather than resorting to expanding coercive measures, mental health systems and policymakers must ensure provision of voluntary and accessible mental health services. Furthermore, IOC cannot be legally or ethically justified even if hypothetical research supporting its alleged effectiveness exists. This article summarizes influential and contradictory IOC research, explores legal issues, and proposes that providing voluntary consumer-driven services would reduce IOC usage and prevent criminalizing individuals experiencing serious emotional distress.
Johns Hopkins University School of Public Health, Department of Mental Hygiene, 624 N. Broadway, Room 384, Baltimore, MD 21205, USA. jobrown@jhsph.edu
Jonathan D
JD
Brown
D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000941:ethics* / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D028642:Persons with Psychiatric Disorders; D017063:Outcome Assessment, Health Care; D010344:Patient Advocacy; D016312:Treatment Refusal; D014481:United States