Monahan J, Bonnie R J, Appelbaum P S, Hyde P S, Steadman H J, Swartz M S
University of Virginia School of Law, Charlottesville 22903-1789, USA.
Psychiatr Serv. 2001 Sep;52(9):1198-205. doi: 10.1176/appi.ps.52.9.1198.
Outpatient commitment, although often viewed as merely an extension of inpatient commitment, is only one of a growing array of legal tools used to mandate treatment adherence. The authors describe various forms of mandated community treatment. People with severe and chronic mental disorders often depend on goods and services provided by the social welfare system. Benefits disbursed by representative payees and the provision of subsidized housing have both been used as leverage to ensure treatment adherence. Many discharged patients are arrested for criminal offenses. Favorable disposition of their cases by a mental health court may be tied to participation in treatment. Under outpatient commitment statutes, judges can order committed patients to comply with prescribed treatment. Patients may attempt to maximize their control over treatment in the event of later deterioration by executing an advance directive. The ideological posturing that currently characterizes the field must be replaced by an evidence-based approach.
门诊强制治疗，尽管常常被视为仅仅是住院强制治疗的一种延伸，但它只是用于强制患者坚持治疗的一系列不断增加的法律手段之一。作者描述了各种形式的法定社区治疗。患有严重慢性精神障碍的人往往依赖社会福利系统提供的商品和服务。由受托收款人支付的福利以及提供补贴住房都被用作确保患者坚持治疗的手段。许多出院患者因刑事犯罪被捕。心理健康法庭对他们案件的有利处置可能与参与治疗有关。根据门诊强制治疗法规，法官可以命令被强制治疗的患者遵守规定的治疗。如果病情后来恶化，患者可能会试图通过签署预先指示来最大限度地控制治疗。目前该领域以意识形态姿态为特征的情况必须被基于证据的方法所取代。
