Encouraging pursuit of court-ordered treatment in a state hospital

The authors discuss a performance improvement project designed to encourage staff psychiatrists at a large state hospital to more assertively pursue the option of court-ordered treatment for severely mentally ill inpatients who refuse medication for more than a week. A campaign was undertaken in 1997 to educate psychiatrists about the importance of using psychotropic medications early in a patient's hospital stay. A monthly report is now circulated to all personnel identifying units on which patients have refused medication for more than a week and psychiatrists who have filed court petitions. The number of petitions filed annually has doubled, from 97 in the year before the project to 192 four years later.