Involuntary outpatient commitment is a highly controversial issue in mental health law. Strong supporters of outpatient commitment see it as a form of access to community-based mental health care and a less restrictive alternative to hospitalization for people with severe mental illness; vocal opponents see it as an instrument of social control and an unwarranted deprivation of individual liberty. Kahan and colleagues apply the theory of "cultural cognition" in an empirical study of how cultural worldviews influence support for outpatient commitment laws among the general public and shape perceptions of evidence for these laws' effectiveness. This article critiques Kahan et al. and offers an alternative perspective on the controversy, emphasizing particular social facts underlying stakeholders' positions on outpatient commitment laws.
"However, in the debate, arguments relating to the forensic context are implicitly extended to patients who have been civilly committed. Swanson (2010) has pointed out that CCC was not originally understood as an instrument to control dangerous patients. Rather, the motivation for CCC was to address problems of lack of compliance with regard to medication and revolving-door patients in mental health services. "
[Show abstract][Hide abstract] ABSTRACT: The aim of this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State. In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, there was agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framed within an ideology of integrating the disabled. The new legislation allowed for a broad range of measures to control patients at the same time as it was presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed - from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community. The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.
International Journal of Law and Psychiatry 11/2011; 34(6):419-28. DOI:10.1016/j.ijlp.2011.10.007 · 1.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In the following article Dr. Jeffrey Swanson (see record 2010-09719-002) presents a critique of a recently published article by Kahan, Braman, Monahan, Callahan, and Peters (see record 2010-05230-003). The complete references for the original article and commentary appear below. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
International disability studies 02/1988; 10(4):169. DOI:10.3109/09638288809164072
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