The Court Ordered Assisted Outpatient Treatment

Mental Illness has been prevalent all throughout our history from Isaac Newton to Abraham Lincoln to Sylvia Plath and so on. These illnesses can be as minor as a slight bipolar disorder or as severe as schizophrenia. In recent years, mental illnesses are becoming more prevalent in our criminal justice systems than anywhere else. Mental illness is becoming an association with crime and based on the information that has been found, this paper will attempt to further define the problem of mental illness within our criminal justice system and offer alternatives or insights as to how to possibly help with this problem.

The introduction of Community Treatment Orders (CTO) has raised much debate around the issue of whether this is an ethical practice or not. This debate calls for a number of questions to be answered. For starters, can unethical practice be justified if it is for the greater good? More specifically, should the elimination of individuals’ rights be accepted if success is to be achieved from these programs. In order to gain insight into answering these questions, Community Treatment Orders need to be defined first. According to the “Mental Health Act”, a Community Treatment Order sets out terms under which a person must accept psychiatric drugs, therapy, and other services while living in the community (Mental Health Act 2007). CTO’s include

When someone you love is suffering from addiction and won 't seek help, it 's easy to feel helpless. In this situation, you have undoubtedly been tempted to find a legal way to force them into rehabilitation. However, this may not be an option in your state. In fact, it may not even be the best choice. Understanding this treatment technique can help you decide if it is necessary or if other approaches may be more valuable to you.

The shutdown of state mental hospitals and lack of available financial and institutional resources force mentally ill people to the United States Judicial System for mental health. Every year thousands of people are arrested for various crimes and they are sent to jail. Sixteen percent of these people have some type of mental health problem (Public Broadcasting System , 2001). When we consider that the United States has the largest incarcerated population in the world at 2.2 million, this number is staggering (Anasseril E. Daniel, 2007). This is about 1% of the entire population of the United States. There are many reasons as to why the situation has taken such a bad turn and when the history of the treatment of mental illness is examined one can see how the situation developed into the inhumane disaster it is today.

An unfortunate reality in today’s society is the gross overrepresentation of persons with mental illness in the criminal justice system. According to Teplin (1984), persons with mental illness have been found to be almost twice as likely as individuals without any known mental illness to be arrested for their behavior in similar situations. Furthermore, several other studies have even shown that roughly half of all persons with a mental illness have been arrested at least once in their lifetime (Solomon & Draine, 1995; Walsh & Bricourt, 2003). Although these statistics seem to further support the common belief among many citizens that mentally ill persons are dangerous criminals, research indicates that the mentally ill are more often arrested for nonviolent minor charges (Cuellar, Snowden, & Ewing, 2007). Not surprisingly, a considerable portion of individuals within the criminal justice population have a diagnosable mental illness. According to Ditton (1999), 7% of federal inmates, 16% of state inmates, and 16% of jail inmates have a mental illness. These percentages may be inflated because persons with mental illness tend to spend longer periods of time in custody than those without a mental illness. Perhaps the greatest indication of the brokenness of the system is the fact that there are more mentally ill persons in jails and prisons today than in public psychiatric hospitals (Lamb& Bachrach, 2001). In fact, according to the

The United States criminal justice system has been continuously increasing incarceration among individuals who suffer from a sever mental illness. As of 2007 individuals with severe mental illness were over twice as likely to be found in prisons than in society (National Commission of Correctional Health Care, 2002, as cited in Litschge &Vaughn, 2009). The offenses that lead to their commitment in a criminal facility, in the majority of cases, derive from symptoms of their mental illness instead of deviant behavior. Our criminal justice system is failing those who would benefit more from the care of a psychiatric rehabilitation facility or psychiatric hospital by placing them in correctional facilities or prisons.

Olmstead vs. L.C., which is the case that led to the Olmstead Decision, is considered to be one of the most important civil rights cases during the 20th century (Zubritsky, Mullahy, Allen, & Alfano, 2006). The Olmstead Decision was put into place after two women with a diagnosis of mental illness and developmental disability were voluntarily placed in a psychiatric facility and remained institutionalized for years. Even after efforts made by the women’s staff members to move them into a community setting, they were not moved until the Supreme Court’s 1999 decision in the Olmstead case (Cashmore, 2014).

In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.

One of the most controversial issues regarding the mentally ill and the prison system is the medical treatment received. According to the film, “16% of the prison population in the state of Ohio, which reflects a national average, are persons who have been diagnosed with mental illness.” Prisons began as an institution designed to rehabilitate, however, a vast majority of prisons throughout the country do not provide adequate medical care for their mentally ill inmates. However, the prisons that do possess adequate health care are most likely the first instance in which the inmates with mental illness have received any sort of treatment in their entire life. People with chronic mental illness need constant supervision which they cannot get outside of prison. Although inmates does not receive the most extensive treatment, the treatment they do receive is well beyond the treatment they would have received had they stayed out of the criminal justice system.

Over the past thirty years, there has been a 500% increase in the U.S incarceration rate. (The Sentencing project, 2014) Advances in medicine, such as the discovery of psychoactive drugs, led to the deinstitutionalization of mentally ill patients from psychiatric hospitals. With a long record of horrific abuse,

Throughout the ages, the idea of involuntary hospitalization has always had its supporters and its detractors. Many people have long debated the ethics of forcing treatment on patients that cannot always make the best decisions for themselves. Involuntary commitment is now a very hot topic, especially in a state like Florida, where their Baker Act and Marchman Act laws are greatly debated on their usefulness versus their harmfulness. The Baker Act, enacted in 1971, is Florida’s main mental health law, which allows for the voluntary and involuntary commitment of mentally ill patients who are believed to be a threat to themselves or others. Many have highlighted key issues

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.

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

Once released from an institution a mentally ill person, without the support of the community and much needed medication, might find themselves feeling very scared and threatened by interactions with the community. This leads us to another problem, which is crime and the mentally ill. About one thousand people in the U.S. are murdered by severely mentally ill people who are not receiving treatment. These killings are about 5% of all homicides nationwide, and help show once again how important it

If a patient fail to comply with the AOT the patient can be involuntary admitted to the hospital for treatment. When the committed client is noncompliant the patient poses a danger to themselves. A physician will determine after examining the patient if the patient will need inpatient care. “At the hospital, the patient may be retained for observation, examination and treatment for up to seventy-two hours in order to determine whether treatment in a hospital pursuant to one of the existing inpatient commitment standards is needed. Thus, if the physician decides that a patient on assisted outpatient treatment is non-compliant and "may" meet the inpatient commitment criteria, the doctor can order that person hospitalized for up to 72 hours