Article: Involuntary Outpatient Commitment

Involuntary Outpatient Commitment also known as "Assisted Outpatient Treatment" limits the options that individual,s hahve regarding the conduct of their lives, narrowing their oportunities for growth. IOC laws generally require that individuals with psychiatric diagnoses take medication and comply with involuntary outpatient treatment recommendations or risk being placed in inpatient psychiatric hospitals. The requirements for IOC vary from state to state and may be defined loosely as a diagnosis of a major mental disorder with a record of treatment noncompliance or tightly as being an immenent risk of danger to self or others. Overall there is little standardization and few specific guidelines for recommending IOC. It's at this point that my opinion varies from that of those who oppose any form of IOC. I believe that if an individual meets a state's requirements for inpatient commitment they should also be considered to be eligible for IOC. It appears that those who oppose IOC, such as the U.S. Psychiatric Rehabilitation Association [USPRA] and perhaps the New York Association of Psychiatric Rehabilitation Services [NYAPRS], among others may be lumping seclusion and restraint procedures with IOC. It seems to me that these are separate issues and that a state could have IOC while at the same time outlawing seclusion and restraint procedures. The USPRA objects to the use of IOC in any form for the following reasons: [1] IOC fundamentally violates the constitutional right to privacy and due process among individualS in recovery from psychiatric disabilities; [2] IOC has been historically overused in urban areas and disproportionately applied to people of color;and [3] IOC represents an abject failure of the public mental health system, coercing and forcing treatment as a substitute for poor public funding and systems transformation to use of evidence based practices [EPBs]. USPRA notes that in the literature, IOC represents a form of treatment contrary to the principle of rcovery and the promotion of community integration and self-determination. The USPRA in its position paper gtoes onh to discuss each of these three issues documenting empirical evidence from numerous research and program evaluation studies. In summary, the USPRA says that its core values "state that all people have the capacity to learn and grow, and that a diagnosis of mental illness does not nullify this potential. USPRA believes tht people have the right to make choices and live with the consequences of those choices both good and bad." People in recovery "will, with guidanceand understanding, learn as much or more by making their own life choices compared to having those choices made for them." They understand and embrace a process of collaboration tailored to their individual needs, wants and experiences. This is the foundation of self-determination and recovery. Involuntary Outpatient Commitment destroys this collaborative relationship by introducing force, coercion and broken confidentiality, making recovery all the more difficult. It is antithetical to the idea of recovery to decide, in advance, that a person will act self-destructively; then, on the basis of that assumption deny him/her the right of free choice." Psychiatric rehabilit ation practioners recognize the importance of developing partnerships with persons served so that the input and feedback can be exchaged in a systematic and on-going basis. "It is to this colaborative mission and the further promotion of self-determination and recovery that the USPRA is firmly committed." "In recent years, state legislatures struggling with finding the most appropriate and effective means to best engage and serve at risk individuals with psychiatric disabilities have increasingly rejected mandated outpatient measures in favor of more broadly supported, scientifically backed approaches that balance effective ahd cost-effective evidence-based practices with respect for the rights and relationship-based issues that are involved." New Mexico, Virginia, New York, Connecticut and Maryland are all states that have recently revisited these issues. New Mexico 2007-Last month the state legislature rejected mandated outpatient treatment for the second year in a row and approved an enhancement of New Mexico's nationally acclaimed Behavioral Health Collaborative,a single statewide entity that integrates funding and services formerly housed in 19 separate state agencies. Virginia 2007-The state legislature rejected a number of bills in 2007 that would have expanded mental health treatment criteria. And, the Chief Justice of the Virginia Supreme Court has convened a mental health commission that is likely to make comprehensive reform recommendations for the 2008 legislative session. The actions in other states took place in 2005 and 2000 and are similar in nature to those outlined above. The fact is, however, that IOC, in some form, remains in place in several states. Bibliography: U.S.Psychiatric Rehabilitation Association [USPRA], www.uspra.org/ New York Association of Psychiatric Rehabilitatiion Services [NYAPRS].org/ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Involuntary Outpatient Commitment Involuntary Outpatient Commitment als0 known as "Assisted Outpatient Treatment" limits the options that individual,s hahve regarding the conduct of their lives, narrowing their oportunities for growth. IOC laws generally require that individuals with psychiatric diagnoses take medication and comply with involuntary outpatient treatment recommendations or risk being placed in inpatient psychiatric hospitals. The requirements for IOC vary from state to state and may be defined loosely as a diagnosis of a major mental disorder with a record of treatment noncompliance or tightly as being an immenent risk of danger to self or others. Overall there is little standardization and few specific guidelines for recommending IOC. It's at this point that my opinion varies from that of those who oppose any form of IOC. I believe that if an individual meets a state's requirements for inpatient commitment they should also be considered to be eligible for IOC. It appears that those who oppose IOC, such as the U.S. Psychiatric Rehabilitation Association [USPRA] and perhaps the New York Association of Psychiatric Rehabilitation Services [NYAPRS], among others may be lumping seclusion and restraint procedures with IOC. It seems to me that these are separate issues and that a state could have IOC while at the same time outlawing seclusion and restraint procedures. The USPRA objects to the use of IOC in any form for the following reasons: [1] IOC fundamentally violates the constitutional right to privacy and due process among individualS in recovery from psychiatric disabilities; [2] IOC has been historically overused in urban areas and disproportionately applied to people of color;and [3] IOC represents an abject failure of the public mental health system, coercing and forcing treatment as a substitute for poor public funding and systems transformation to use of evidence based practices [EPBs]. USPRA notes that in the literature, IOC represents a form of treatment contrary to the principle of rcovery and the promotion of community integration and self-determination. The USPRA in its position paper gtoes onh to discuss each of these three issues documenting empirical evidence from numerous research and program evaluation studies. In summary, the USPRA says that its core values "state that all people have the capacity to learn and grow, and that a diagnosis of mental illness does not nullify this potential. USPRA believes tht people have the right to make choices and live with the consequences of those choices both good and bad." People in recovery "will, with guidanceand understanding, learn as much or more by making their own life choices compared to having those choices made for them." They understand and embrace a process of collaboration tailored to their individual needs, wants and experiences. This is the foundation of self-determination and recovery. Involuntary Outpatient Commitment destroys this collaborative relationship by introducing force, coercion and broken confidentiality, making recovery all the more difficult. It is antithetical to the idea of recovery to decide, in advance, that a person will act self-destructively; then, on the basis of that assumption deny him/her the right of free choice." Psychiatric rehabilit ation practioners recognize the importance of developing partnerships with persons served so that the input and feedback can be exchaged in a systematic and on-going basis. "It is to this colaborative mission and the further promotion of self-determination and recovery that the USPRA is firmly committed." "In recent years, state legislatures struggling with finding the most appropriate and effective means to best engage and serve at risk individuals with psychiatric disabilities have increasingly rejected mandated outpatient measures in favor of more broadly supported, scientifically backed approaches that balance effective ahd cost-effective evidence-based practices with respect for the rights and relationship-based issues that are involved." New Mexico, Virginia, New York, Connecticut and Maryland are all states that have recently revisited these issues. New Mexico 2007-Last month the state legislature rejected mandated outpatient treatment for the second year in a row and approved an enhancement of New Mexico's nationally acclaimed Behavioral Health Collaborative,a single statewide entity that integrates funding and services formerly housed in 19 separate state agencies. Virginia 2007-The state legislature rejected a number of bills in 2007 that would have expanded mental health treatment criteria. And, the Chief Justice of the Virginia Supreme Court has convened a mental health commission that is likely to make comprehensive reform recommendations for the 2008 legislative session. The actions in other states took place in 2005 and 2000 and are similar in nature to those outlined above. The fact is, however, that IOC, in some form, remains in place in several states. Bibliography: U.S.Psychiatric Rehabilitation Association [USPRA], www.uspra.org/ New York Association of Psychiatric Rehabilitatiion Services [NYAPRS].org/ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Involuntary Outpatient Commitment Involuntary Outpatient Commitment als0 known as "Assisted Outpatient Treatment" limits the options that individual,s hahve regarding the conduct of their lives, narrowing their oportunities for growth. IOC laws generally require that individuals with psychiatric diagnoses take medication and comply with involuntary outpatient treatment recommendations or risk being placed in inpatient psychiatric hospitals. The requirements for IOC vary from state to state and may be defined loosely as a diagnosis of a major mental disorder with a record of treatment noncompliance or tightly as being an immenent risk of danger to self or others. Overall there is little standardization and few specific guidelines for recommending IOC. It's at this point that my opinion varies from that of those who oppose any form of IOC. I believe that if an individual meets a state's requirements for inpatient commitment they should also be considered to be eligible for IOC. It appears that those who oppose IOC, such as the U.S. Psychiatric Rehabilitation Association [USPRA] and perhaps the New York Association of Psychiatric Rehabilitation Services [NYAPRS], among others may be lumping seclusion and restraint procedures with IOC. It seems to me that these are separate issues and that a state could have IOC while at the same time outlawing seclusion and restraint procedures. The USPRA objects to the use of IOC in any form for the following reasons: [1] IOC fundamentally violates the constitutional right to privacy and due process among individualS in recovery from psychiatric disabilities; [2] IOC has been historically overused in urban areas and disproportionately applied to people of color;and [3] IOC represents an abject failure of the public mental health system, coercing and forcing treatment as a substitute for poor public funding and systems transformation to use of evidence based practices [EPBs]. USPRA notes that in the literature, IOC represents a form of treatment contrary to the principle of rcovery and the promotion of community integration and self-determination. The USPRA in its position paper gtoes onh to discuss each of these three issues documenting empirical evidence from numerous research and program evaluation studies. In summary, the USPRA says that its core values "state that all people have the capacity to learn and grow, and that a diagnosis of mental illness does not nullify this potential. USPRA believes tht people have the right to make choices and live with the consequences of those choices both good and bad." People in recovery "will, with guidanceand understanding, learn as much or more by making their own life choices compared to having those choices made for them." They understand and embrace a process of collaboration tailored to their individual needs, wants and experiences. This is the foundation of self-determination and recovery. Involuntary Outpatient Commitment destroys this collaborative relationship by introducing force, coercion and broken confidentiality, making recovery all the more difficult. It is antithetical to the idea of recovery to decide, in advance, that a person will act self-destructively; then, on the basis of that assumption deny him/her the right of free choice." Psychiatric rehabilit ation practioners recognize the importance of developing partnerships with persons served so that the input and feedback can be exchaged in a systematic and on-going basis. "It is to this colaborative mission and the further promotion of self-determination and recovery that the USPRA is firmly committed." "In recent years, state legislatures struggling with finding the most appropriate and effective means to best engage and serve at risk individuals with psychiatric disabilities have increasingly rejected mandated outpatient measures in favor of more broadly supported, scientifically backed approaches that balance effective ahd cost-effective evidence-based practices with respect for the rights and relationship-based issues that are involved." New Mexico, Virginia, New York, Connecticut and Maryland are all states that have recently revisited these issues. New Mexico 2007-Last month the state legislature rejected mandated outpatient treatment for the second year in a row and approved an enhancement of New Mexico's nationally acclaimed Behavioral Health Collaborative,a single statewide entity that integrates funding and services formerly housed in 19 separate state agencies. Virginia 2007-The state legislature rejected a number of bills in 2007 that would have expanded mental health treatment criteria. And, the Chief Justice of the Virginia Supreme Court has convened a mental health commission that is likely to make comprehensive reform recommendations for the 2008 legislative session. The actions in other states took place in 2005 and 2000 and are similar in nature to those outlined above. The fact is, however, that IOC, in some form, remains in place in several states. Bibliography: U.S.Psychiatric Rehabilitation Association [USPRA], www.uspra.org/ New York Association of Psychiatric Rehabilitatiion Services [NYAPRS].org/ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Involuntary Outpatient Commitment Involuntary Outpatient Commitment als0 known as "Assisted Outpatient Treatment" limits the options that individual,s hahve regarding the conduct of their lives, narrowing their oportunities for growth. IOC laws generally require that individuals with psychiatric diagnoses take medication and comply with involuntary outpatient treatment recommendations or risk being placed in inpatient psychiatric hospitals. The requirements for IOC vary from state to state and may be defined loosely as a diagnosis of a major mental disorder with a record of treatment noncompliance or tightly as being an immenent risk of danger to self or others. Overall there is little standardization and few specific guidelines for recommending IOC. It's at this point that my opinion varies from that of those who oppose any form of IOC. I believe that if an individual meets a state's requirements for inpatient commitment they should also be considered to be eligible for IOC. It appears that those who oppose IOC, such as the U.S. Psychiatric Rehabilitation Association [USPRA] and perhaps the New York Association of Psychiatric Rehabilitation Services [NYAPRS], among others may be lumping seclusion and restraint procedures with IOC. It seems to me that these are separate issues and that a state could have IOC while at the same time outlawing seclusion and restraint procedures. The USPRA objects to the use of IOC in any form for the following reasons: [1] IOC fundamentally violates the constitutional right to privacy and due process among individualS in recovery from psychiatric disabilities; [2] IOC has been historically overused in urban areas and disproportionately applied to people of color;and [3] IOC represents an abject failure of the public mental health system, coercing and forcing treatment as a substitute for poor public funding and systems transformation to use of evidence based practices [EPBs]. USPRA notes that in the literature, IOC represents a form of treatment contrary to the principle of rcovery and the promotion of community integration and self-determination. The USPRA in its position paper gtoes onh to discuss each of these three issues documenting empirical evidence from numerous research and program evaluation studies. In summary, the USPRA says that its core values "state that all people have the capacity to learn and grow, and that a diagnosis of mental illness does not nullify this potential. USPRA believes tht people have the right to make choices and live with the consequences of those choices both good and bad." People in recovery "will, with guidanceand understanding, learn as much or more by making their own life choices compared to having those choices made for them." They understand and embrace a process of collaboration tailored to their individual needs, wants and experiences. This is the foundation of self-determination and recovery. Involuntary Outpatient Commitment destroys this collaborative relationship by introducing force, coercion and broken confidentiality, making recovery all the more difficult. It is antithetical to the idea of recovery to decide, in advance, that a person will act self-destructively; then, on the basis of that assumption deny him/her the right of free choice." Psychiatric rehabilit ation practioners recognize the importance of developing partnerships with persons served so that the input and feedback can be exchaged in a systematic and on-going basis. "It is to this colaborative mission and the further promotion of self-determination and recovery that the USPRA is firmly committed." "In recent years, state legislatures struggling with finding the most appropriate and effective means to best engage and serve at risk individuals with psychiatric disabilities have increasingly rejected mandated outpatient measures in favor of more broadly supported, scientifically backed approaches that balance effective ahd cost-effective evidence-based practices with respect for the rights and relationship-based issues that are involved." New Mexico, Virginia, New York, Connecticut and Maryland are all states that have recently revisited these issues. New Mexico 2007-Last month the state legislature rejected mandated outpatient treatment for the second year in a row and approved an enhancement of New Mexico's nationally acclaimed Behavioral Health Collaborative,a single statewide entity that integrates funding and services formerly housed in 19 separate state agencies. Virginia 2007-The state legislature rejected a number of bills in 2007 that would have expanded mental health treatment criteria. And, the Chief Justice of the Virginia Supreme Court has convened a mental health commission that is likely to make comprehensive reform recommendations for the 2008 legislative session. The actions in other states took place in 2005 and 2000 and are similar in nature to those outlined above. The fact is, however, that IOC, in some form, remains in place in several states. Bibliography: U.S.Psychiatric Rehabilitation Association [USPRA], www.uspra.org/ New York Association of Psychiatric Rehabilitatiion Services [NYAPRS].org/ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>