Rights, wrongs, and the dilemma of coerced community treatment

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adult; Aftercare; Ambulatory Care; Coercion; Commitment of Mentally Ill; Community Mental Health Services; Ethics, Medical; Female; Forensic Psychiatry; Humans; Male; *Mandatory Programs; Mental Disorders; *Mentally Ill Persons; Middle Aged; Paternalism; Patient Advocacy; Patient Rights; Personal Autonomy; Psychiatry


Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology


An outpatient treatment approach directed to patients with histories of psychotically based dangerousness, poor compliance, and recidivism is described. Cases are presented that suggest favorable outcomes of this approach, but the coercive nature of the treatment raises questions about the psychiatrist's violation of patients' rights and transgression of ethical standards. If psychiatrists are to successfully treat the most difficult chronic patients, can we do it without legally sanctioned, benevolent, coercive treatments? One model of such treatment is outpatient commitment. There is concern that without sound outpatient commitment statutes, we may witness the reemergence of asylums.

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Citation: Am J Psychiatry. 1986 Oct;143(10):1259-64.

Journal/Book/Conference Title

The American journal of psychiatry

Related Resources

Link to Article in PubMed

PubMed ID