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Involuntary outpatient commitment.

Elyn R Saks1

  • 1University of Southern California, The Law School, Los Angeles, CA 90089-0071, USA. esaks@law.usc.edu

Psychology, Public Policy, and Law : an Official Law Review of the University of Arizona College of Law and the University of Miami School of Law
|May 17, 2006
PubMed
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This study examines outpatient commitment (OPC), finding that preventive outpatient commitment (POC) is generally unjustified, except for a single "free shot" to encourage voluntary treatment compliance.

Area of Science:

  • Legal and Ethical Aspects of Mental Healthcare
  • Public Health Policy and Mental Illness Management

Background:

  • Outpatient commitment (OPC) is a legal mechanism for compelling individuals with mental illness to undergo community-based treatment.
  • Existing frameworks for OPC vary, necessitating a clear ethical and legal analysis of different forms.

Purpose of the Study:

  • To differentiate and evaluate the justification of four distinct types of outpatient commitment.
  • To critically assess the ethical and legal standing of preventive outpatient commitment (POC).

Main Methods:

  • Distinction and categorization of four varieties of outpatient commitment.
  • Ethical and legal analysis of the justifications for each OPC type, with a focus on POC.
  • Exploration of consequences associated with noncompliance under proposed POC models.
Keywords:
Analytical ApproachMental Health Therapies

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Main Results:

  • Three forms of outpatient commitment are deemed readily justifiable.
  • Preventive outpatient commitment (POC) presents significant justification challenges.
  • A 'one free shot' approach to POC is proposed as a potential, limited justification.

Conclusions:

  • The ethical justification for preventive outpatient commitment (POC) is generally weak.
  • A single, non-punitive opportunity ('one free shot') may allow patients to experience treatment benefits and opt for voluntary compliance.
  • Careful consideration of noncompliance consequences is crucial when evaluating POC models.