Appelbaum P S
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01605, USA.
Psychiatr Serv. 2001 Mar;52(3):347-50. doi: 10.1176/appi.ps.52.3.347.
We are witnessing an unprecedented wave of interest in outpatient commitment. In part, enthusiasm for outpatient commitment stems from concerns about highly publicized acts of violence by persons with mental disorders, although this is one of the weaker justifications for new laws. Provision of involuntary outpatient treatment may be an important component of a system of care for persons with schizophrenia, bipolar disorder, and other serious mental illnesses for reasons entirely unrelated to the prevention of headline-grabbing acts of violence. The existing data, all imperfect, tend to favor the efficacy of outpatient commitment as a means of stabilizing patients in the community, and many clinicians who have been involved in the process share this view. Acknowledging limitations in the empirical evidence favoring outpatient commitment, the author reviews key issues for policy makers to address in considering or revising these statutes.
我们正在见证对门诊强制治疗前所未有的关注浪潮。部分而言，对门诊强制治疗的热情源于对精神障碍患者广为人知的暴力行为的担忧，尽管这是新法律较为薄弱的正当理由之一。提供非自愿门诊治疗可能是精神分裂症、双相情感障碍及其他严重精神疾病患者护理体系的重要组成部分，其原因与预防引人注目的暴力行为完全无关。现有的数据都不完美，倾向于支持门诊强制治疗作为稳定社区患者的一种手段的有效性，许多参与这一过程的临床医生也持有这种观点。作者承认支持门诊强制治疗的实证证据存在局限性，回顾了政策制定者在考虑或修订这些法规时需要解决的关键问题。
