Case Against Outpatient Commitment

• NCJ Number: 185437
• Journal: Journal of the American Academy of Psychiatry and the Law Volume: 28 Issue: 2 Dated: 2000 Pages: 165-170
• Author(s): Michael A. Hoge Ph.D.; Elizabeth Grottole MPH
• Date Published: 2000
• Length: 6 pages
• Publication Format: Article
• Publication Type: Legislation/Policy Analysis
• Language: English
• Country: United States of America

Annotation

This article challenges the logic and legitimacy of using the courts to force treatment compliance of individuals who are neither incompetent by legal standards nor at imminent risk of harming themselves or others.

Abstract

The American Psychiatric Association Council on Psychiatry and Law has issued a Resource Document that supports the use of mandatory outpatient treatment. There are major flaws in the logic and recommendations of this report, as well as problems with the concept of outpatient commitment in general. This article outlines these concerns and then presents the case of an individual who is in many ways typical of those targeted for outpatient commitment. The authors use this case to suggest that providing intensive ambulatory treatment rather than depriving patients of their rights should be the primary concern. The authors argue that society, through its mental health systems, has been offering inadequate behavioral health services to those most in need; this has resulted in the use of mandated outpatient treatment as a mechanism for ensuring adequate service provision to selected individuals. Resorting to depriving patients of their rights to ensure that they receive adequate services is misguided and does serious injustice to those being treated. Individuals suffering from mental disorders should first receive intensive treatments without the imposition of a judicial order that mandates compliance. This will allow a determination as to whether this less restrictive approach is sufficient. Legal mandates for treatment, if they are to be used, should not occur until appropriate treatments have been provided on a voluntary basis and have been shown to be ineffective. The most challenging part of professional responsibility may be refraining from the violation of patient liberties to achieve the desired ends of treatment. 20 references