[pachyderm]

A study of the New York program of involuntary outpatient treatment of some psychiatric patients was found to work well -- possibly because the state has funded treatment sufficiently:

http://www.nytimes.com/2013/07/30/us...agewanted=1&hp

[Travelinglady]

Interesting article, Pachy!

[Perna]

I did not read the article yet, I was having trouble grasping the concept. What do they do, follow the people around and nag them? How do you have involuntary outpatient; don't you have to congregate somewhere they want (making it involuntary) and wouldn't that make you an inpatient of sorts? Are we just talking about whether you spend the night or not?

[pachyderm]

Originally Posted by Perna

How do you have involuntary outpatient...?

I assume they say "If you don't agree to this treatment [medications and/or psychotherapy] we will be sure to make you regret it." I assume they check on medication ingestion. They can put one into an inpatient facility if one does not comply with the outpatient prescriptions.

[Perna]

It's called Assisted Outpatient Treatment (AOT) and is based on Kendra's Law

I think one gets a court order, kind of like one would for other mental disabilities/senility, etc. If you cannot live in the community safely by yourself. . .

[anneo59]

helpful for some I'm sure, very scary for many. . .

[grace428]

and particularly for those who don't/can't acknowledge they have a mi.

[Hellion]

I worry about lack of resources, like if someone is ordered to receive treatment what if they can't get to therapy appointments or they can't afford their court ordered prescription or something happens and they can't get it...I hope those difficulties are acknowledged and someone doesn't end up in jail because they couldn't get a ride to go get their prescription for instance.

[pachyderm]

Originally Posted by Hellion

I worry about lack of resources, like if someone is ordered to receive treatment what if they can't get to therapy appointments or they can't afford their court ordered prescription or something happens and they can't get it...I hope those difficulties are acknowledged and someone doesn't end up in jail because they couldn't get a ride to go get their prescription for instance.

If I remember correctly, the law in New York, called Kendra's law, was originally prompted by an attack by someone with a mental illness on Kendra -- and some people used it to promote involuntary treatment even though the attacker was not one of those people who had resisted treatment, but instead had sought it and could not find treatment resources.

[splitimage]

We have the same thing in Ontario. Up here they're called Community Treatment Orders. CTO's are issued by mental health courts to patients who have a history of meds non-compliance and multiple hospital admissions. They're administered/enforced by Assertive Community Treatment (ACT) teams, that include psychologists, social workers, peer support workers, and nurses. The team makes sure that the patient is meds compliant, that might mean giving them an injection of a long acting antipsychotic, or delivering a weeks supply of meds from a pharmacy, and getting to treatment appointments. Most people on CTO's are on disability and so their meds are paid for by the gov't.

I have very mixed feelings about CTO's. I know one guy who signed a CTO agreement without realizing what it was he was signing, and the CTO mandated a partial hospitalization day program. When he didn't show up, the cops were sent to pick him up and brought him to the hospital in handcuffs. At their best they help people remain healthy and stay out of the hospital, at their worst they can be seen as forced treatment. It's a controversial topic in consumer circles.

splitimage

[onionknight]

This is a very one-sided article. Yeah, if you give people access to better resources they are going to do better. I feel like the tone of the article is so dehumanizing. Let's hear from participants about how they feel. Treatment is about their recovery, not how the rest of society feels about keeping them under control for the cheapest and easiest.