Clinical encounters with outpatient coercion at the CMHC: questions of implementation and efficacy

UMMS Affiliation

Department of Psychiatry



Document Type


Medical Subject Headings

Adult; *Ambulatory Care; Chronic Disease; *Coercion; Commitment of Mentally Ill; Community Mental Health Centers; Female; Hospitals, Psychiatric; Humans; Length of Stay; Male; Massachusetts; Mental Disorders; Middle Aged; Psychiatric Status Rating Scales; Treatment Refusal


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


Clinical encounters with three outpatients at a CMHC who were managed with alternating periods of voluntary or uncoerced and involuntary or coerced treatment are presented. The two periods of coerced community treatment--of eight months and then two to four years duration--produced positive results quite distinct from the periods of uncoerced community treatment. In discussing the implementation and efficacy of coerced outpatient treatment at the CMHC, the author addresses legal, clinical, and resource issues which form the basis for seven arguments often heard as to why staffs at CMHCs hesitate to employ involuntary or coercive interventions.

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Citation: Community Ment Health J. 1992 Apr;28(2):81-94.

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