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133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA |
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Virgina Hiday, PhD, Sociology and Anthropology, North Carolina State University, Campus Box 8107, Raleigh, NC 27695-8107, 919-515-3114, ginny_hiday@ncsu.edu, John Crilly, PhD, MPH, MSW, Psychiatry, University of Rochester, 300 Crittenden Blvd., Rochester, NY 14642, and Steven Lamberti, MD, Department of Psychiatry, University of Rochester, 601 Elmwood Avenue Box PSYCH, Rochester, NY 14642.
Over the past three decades, outpatient commitment has decreased overuse of involuntary hospitalization and helped avoid incarceration of people with mental illness. Minimization of costs brought about by managed care and, concurrently, significant loss of inexpensive housing and a social safety net made persons with untreated severe mental illnesses more isolated, vulnerable and visible. Whereas outpatient commitment is still proffered as a less restrictive alternative to involuntary hospitalization for all persons with mental illness, current proponents now focus on a target group of persons with severe mental illness who resist or do not seek community treatment and thus cycle through courts. Proponents view outpatient commitment as a less costly and less restrictive alternative to repeated cycles of involuntary hospitalization for this target group of revolving door patients. Because members of this target group are disproportionately arrested and jailed, proponents also see it as a humane and less restrictive alternative to incarceration in the criminal justice system. Opponents consider outpatient commitment to be an unjustifiable and unnecessary extension of the net of social control. The recent Duke Mental Health Study demonstrated an approach that was effective in reducing hospitalization, violence, arrests, and victimization for the outpatient commitment group over the control group. It appears that outpatient commitment is effective in reducing not only hospitalization, incarceration, and other factors in high risk populations. Is outpatient commitment an Evidence-Based Practice?
Learning Objectives:
Keywords: Mental Health Services, Mental Health System
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA