Involuntary Outpatient Commitment Essay

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Involuntary Outpatient Commitment

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the
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The Olmstead Act requires public agencies to provide services “in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” Further, the act mandates that states place qualified individuals with mental illnesses in community settings, rather than in institutions. Being placed under IOC is contingent upon whether or not such placement is appropriate, affected persons do not oppose such placement, and the state can reasonably accommodate the placement, taking into account resources available to the state and needs of others with disabilities, (The Center for an Accessible Society, 1999). In conclusion, the Olmstead Act provided for the legal groundwork to both provide and enforce IOC.
Research has shown IOC to be more effective when combined with additional components. Examples of these components include psychiatric advance directives, Assertive Case Management (ACM), representative payees, conditional release, conservatorship/guardianship, and mental health courts. Psychiatric advance directives are legal documents that permit mentally ill individuals to authorize and specify treatment in anticipation of future periods of mental incapacity. ACM consists of mental health teams that actively assist with treatment in the home. Representative payees are trusted persons designated by a mentally ill individual that help that individual use funds wisely by being the payee of benefits. Conditional
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