Research on the Coercion of Persons with Severe Mental Illness
Issues of concern regarding coercion of psychiatric patients, which were once relevant only to psychiatric hospitalization, are now applicable to the community arena as well. The need to understand coercive treatment strategies used in community settings for handling those with severe mental disorders is pressing, as the consequences of the competing values between preserving individual autonomy and protecting vulnerable individuals are far more visible in a growing population of mentally ill people living in the community. For example, homeless mentally ill persons on the streets of virtually every large urban area raise the issue of whether these individuals have an inherent right to remain in this situation or whether they should be forced into hospitals, homeless shelters, or other structured housing arrangements. These types of dilemmas that are being confronted today make the use of coercive strategies to force compliance with outpatient treatment quite attractive to some (Mulvey, Geller, & Roth, 1987). Coerced treatment includes mandated attendance at day programs, counseling, and acceptance of neuroleptic medication enforced by a threat of institutional controls. The situations that necessitate coercing patients into receiving needed treatment are not going to go away; therefore, coercive strategies will persist and “can no longer be ignored” (Steinwachs et al., 1992, p. 649).
KeywordsCriminal Justice System Community Psychiatry Parole Officer Civil Commitment Conditional Release
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