Mental Health Court and Assisted Outpatient Treatment: Perceived Coercion, Procedural Justice, and Program Impact
adherence; civil commitment; community treatment; Environmental & Occupational; Health; Health Care Sciences & Services; hospital admission; new-york; north-carolina; outcomes; people; perceptions; Psychiatry; Public; state
Objective: Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system. Methods: Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The Mac-Arthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers. Results: Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants. Conclusions: Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants' perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.
Munetz M R; Ritter C; Teller J L S; Bonfme N
Psychiatric Services
2014
2014-03
Journal Article
<a href="http://doi.org/10.1176/appi.ps.002642012" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.002642012</a>
Elements of an Ideal Statutory Scheme for Mental Health Civil Commitment
assisted outpatient treatment; new-york; Psychiatry
Watching a loved one fall into the grip of severe mental illness can be painful and terrifying in equal measure. And yet sometimes, to the chagrin and astonishment of those who want to help the ill person find a way back to the life he once had, pleas to seek treatment are met with emphatic insistence that everything is fine. At some point, when things become unbearable for the concerned observer, a call will be made to police or a local mental health facility. It is at this moment that the situation becomes not merely a health emergency, but also a legal matter. This leads to a critical question: what exactly are the societal imperatives activated by a psychiatric crisis? This is a major question that states have had to grapple with in crafting their laws on involuntary treatment. Laws must also address the circumstances that typically follow a diagnosis of severe mental illness, such as how long and under what criteria the person should be held by a court of law for continued inpatient treatment against his wishes, whether the state should require him to adhere to a prescribed treatment plan, and how far into relapse a person must fall before he is involuntarily re-hospitalized.
Stettin B; Lamb R; Frese F
Psychiatric Annals
2014
2014-02
Journal Article
<a href="http://doi.org/10.3928/00485713-20140205-09" target="_blank" rel="noreferrer noopener">10.3928/00485713-20140205-09</a>