Torrey E F, Zdanowicz M
Treatment Advocacy Center in Arlington, Virginia, USA.
Psychiatr Serv. 2001 Mar;52(3):337-41. doi: 10.1176/appi.ps.52.3.337.
The authors describe studies showing the effectiveness of involuntary outpatient commitment in improving treatment compliance, reducing hospital readmission, and reducing episodes of violence among persons with severe psychiatric illnesses. They point out that because of its role in enhancing compliance with treatment, outpatient commitment can be regarded as a form of assisted treatment, such as assertive case management, representative payeeship, and mental health courts. The authors argue that such assisted treatment is necessary for persons with severe psychiatric illnesses who are noncompliant with their medication regimens because many lack awareness of their illnesses because of biologically based cognitive deficits. They recommend outpatient commitment for any individual with a severe psychiatric disorder who has impaired awareness of his or her illness and is at risk of becoming homeless, incarcerated, or violent or of committing suicide, and they provide case examples. The authors conclude by addressing eight of the most common objections to outpatient commitment by mental health professionals and civil liberties groups that oppose outpatient commitment.
作者们描述了一些研究，这些研究表明非自愿门诊治疗在提高治疗依从性、减少医院再入院率以及减少重症精神疾病患者的暴力事件方面的有效性。他们指出，由于门诊治疗在增强治疗依从性方面的作用，它可被视为一种辅助治疗形式，如积极个案管理、代领津贴人制度和心理健康法庭。作者们认为，对于不遵守药物治疗方案的重症精神疾病患者来说，这种辅助治疗是必要的，因为许多患者由于基于生物学的认知缺陷而对自己的病情缺乏认识。他们建议，对于任何患有严重精神障碍且对自己的病情认识受损、有成为无家可归者、被监禁者、暴力者或自杀者风险的个人进行门诊治疗，并提供了案例。作者们最后回应了心理健康专业人员和反对门诊治疗的公民自由团体对门诊治疗最常见的八项反对意见。
