Stop The Expansion Of
Involuntary Commitment
This article first appeared in Westward Union, Vol. III, No. 1 in Spring 1999
A campaign to expand forced involuntary treatment is being introduced nationally. E. Fuller Torrey, the national spokesperson for the Treatment Advocacy Center (TAC), is promoting expanded forced treatment by linking mental disability to violence, victimization, and criminalization. Strategies in include: creating involuntary outpatient commitment, loosening the criteria for commitment, increasing the length of involuntary holds and reducing the number of appeals or reviews of the holds.
Along with bills explicitly promoting more forced treatment, we are finding that bills are being authored to fund expanded Mental Health services which include PACT programs*, bills to create parity of Mental Health coverage (including involuntary treatment) in health insurance, and bills to change confidentiality laws. Please be aware that all of these bills appear to be connected to the erosion of civil rights of mental health clients and may be ways to increase the use of forced treatment.
Some successful arguments against expansion of involuntary treatment are:
o Expanding involuntary treatment leads to increased use of costly hospital beds at the expense of more appropriate voluntary community based services.
o With increased voluntary community services, the criminalization of persons with mental disabilities would decrease. What is needed is increased access to and funding for a full array of volunteer community mental health services including options such as peer support models rather than expansion of involuntary treatment.
o Proponents of the expansion of forced treatment have conducted a campaign to link mental illness with violence, furthering the public stereotyping of people with mental disabilities as violent. Studies refute this conclusion.
o A common, but erroneous belief about medications is that there are wonder drugs that provide a cure, saying this is a safe and effective treatment for the mentally ill population. Unfortunately, everyone is exposed to the risk and side effects of medication and all are not necessarily benefiting from the drugs.
o Expansion of forced treatment will not stop non-compliance. Forced treatment is the reason for non-compliance. Studies and anecdotal information indicate that persons who have experienced forced treatment avoid treatment in the future.
o There is no evidence that Involuntary Outpatient Commitment is more effective. The "Bellevue Study" conducted at New York's Bellevue Hospital found that over a three year period access to voluntary, coordinated services was as effective as Outpatient Commitment.Dan Fisher and Laurie Ahern of NEC have introduced an alternative called PACE (Personal Assistance In Community Existence), recovery at your own pace. PACE asserts that the causation of mental illness is severe emotional distress which interferes with the social role. PACE has promotes the concept that people can completely recover.
The Resource Center in Albany has developed the Coalition to Stop Outpatient Commitment. You can request their free packet by calling 1-800-811-1175.
If you would like brochure on PACE or a copy of the Executive Summary of the Bellevue Study call us at 1-888-746-4463 PIN 9378.
-John Ho and Carol Patterson
*PACT (Program for Assertive Community Treatment) aka ACT Team can be quite intrusive reaching into people's lives. In subtle ways it can be coercive. For example, in Wisconsin, in order for people to get their SSI/SSDI checks, they needed to come in to get their shots. Coercion through guardianship then, makes Outpatient Commitment unnecessary!