The ethics of mandatory community treatment.
Humans; United States; Mental Disorders/*therapy; Patient Acceptance of Health Care; Beneficence; *Coercion; Commitment of Mentally Ill/*legislation & jurisprudence; Community Mental Health Services/*ethics/legislation & jurisprudence; Legal Approach; Mental Health Therapies; Patient Rights/*ethics
The authors present three ethical arguments to address the controversy of mandatory community treatment: rights-based versus beneficence, utilitarian, and communitarian. Each approach suggests that mandatory community treatment can be an ethical intervention for individuals with severe mental disorders in well-defined circumstances. It is critical to recognize that such interventions cannot be effective in the absence of an adequately funded, quality mental health service system. Within such a system, the authors believe a program of mandatory community treatment may play an important role. In considering mandatory outpatient treatment, the authors argue that consideration of decisionmaking capacity is preferable to dangerousness criteria, that clinical criteria with some flexibility should be developed so that mandatory community treatment is used only when alternatives have failed, that mandatory community treatment should be implemented long enough to be effective, and that consumers must be involved in the development and implementation of mandatory outpatient treatment programs.
Munetz Mark R; Galon Patricia A; Frese Frederick J 3rd
The journal of the American Academy of Psychiatry and the Law
2003
1905-6
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Crisis intervention team officer dispatch, assessment, and disposition: Interactions with individuals with severe mental illness.
*Coercion; *Mental Disorders; *Police; *Severity of Illness Index; 80 and over; Adolescent; Adult; Aged; Crisis Intervention/*organization & administration; Female; Humans; Male; Middle Aged; Occupational Exposure; Young Adult
The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mental illness crisis. We analyzed 2174 CIT officers' reports from one community, which were completed during a five year period. These officers' reports described interactions with people presumed to be in a mental illness crisis. We used hierarchical logistic and multinomial regression analyses to compare transport to treatment to either transport to jail or no transport by how the calls were dispatched. The results revealed that both dispatch codes and officers' on-scene assessments influenced transport decisions. Specifically, calls dispatched as suspected suicide were more likely to be transported to treatment than calls dispatched as mental disturbance. Furthermore, calls dispatched as calls for assistance, disturbance, suspicious person, assault, suspicion of a crime, and to meet a citizen were all less likely than mental disturbance calls to result in transportation to treatment. Officer assessments of the use of substances, being off medications, signs and symptoms of mental or physical illness, and violence to self or others were associated with the likelihood of being transported to treatment. These results build on previous work that demonstrated differences in transport decisions between CIT trained and non-CIT trained officers.
Ritter Christian; Teller Jennifer L S; Marcussen Kristen; Munetz Mark R; Teasdale Brent
International journal of law and psychiatry
2011
2011-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijlp.2010.11.005" target="_blank" rel="noreferrer noopener">10.1016/j.ijlp.2010.11.005</a>