Coercion and Aggressive Community Treatment: A New Frontier in Mental Health Law

224 Pages·1996·20.91 MB·English

by  Deborah L. Dennis

COERCION AND
AGGRESSIVE
COMMUNITY
TREATMENT
A NEW FRONTIER IN
MENTAL HEALTH LAW
THE PLENUM SERIES IN
SOCIAL/CLINICAL PSYCHOLOGY
Series Editor: C. R. Snyder
University of Kansas
Lawrence, Kansas
Current Volumes in this Series:
AGGRESSIVE BEHAVIOR
Current Perspectives
Edited by L. Rowell Huesmann
COERCION AND AGGRESSIVE COMMUNITY TREATMENT
A New Frontier in Mental Health Law
Edited by Deborah L. Dennis and John Monahan
THE ECOLOGY OF AGGRESSION
Arnold P. Goldstein
EFFICACY, AGENCY, AND SELF-ESTEEM
Edited by Michael H. Kernis
HUMAN LEARNED HELPLESSNESS
A Coping Perspective
Mario Mikulincer
PATHOLOGICAL SELF-CRITICISM
Assessment and Treatment
Raymond M. Bergner
PROCRASTINATION AND TASK AVOIDANCE
Theory, Research, and Treatment
Joseph R. Ferrari, Judith L. Johnson, and William G. McCown
THE PSYCHOLOGY OF VANDALISM
Arnold P. Goldstein
SELF-EFFICACY, ADAPTATION, AND ADJUSTMENT
Theory, Research, and Application
Edited by James E. Maddux
A Continuation Order Plan is available for this series. A continuation order will bring delivery of each
new volume immediately upon publication. Volumes are billed only upon actual shipment. For further
information please contact the publisher.
COERCION AND
AGGRESSIVE
COMMUNITY
TREATMENT
A NEW FRONTIER IN
MENTAL HEALTH LAW
EDITED BY
DEBORAH L. DENNIS
Policy Research Associates, Inc.
Delmar, New York
AND
JOHN MONAHAN
University of Virginia
Charlottesville, Virginia
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Coercion and aggress1ve community treatment a new front1er 1n mental
health law I ed1ted by Deborah L. Dennis and John Monahan.
p. em. -- !The plenum series in soclal/cllnlcal psychology!
ISBN 978-1-4757-9729-9 ISBN 978-1-4757-9727-5 (eBook)
DOI 10.1007/978-1-4757-9727-5
1. Community mental health serv1ces. I. Dennis. Deborah L.
II. Monahan, John, 1946- III. Ser1es.
RA790.C666 1996
362.2'2--dc20 95-51527
CIP
ISBN 978-1-4757-9729-9
©1996 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1996
Softcover reprint of the hardcover 1st edition 1996
All rights reserved
10 9 8 7 6 54 3 2 1
No part of this book may be reproduced, stored in a retrieval system, or transmitted in
any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
CONTRIBUTORS
NANCY S. BENNETT, Bronx, New York 10463
JESSICA WILEN BERG, Department of Psychiatry, University of
Massachusetts Medical Center, Worcester, Massachusetts 01655
RICHARD J. BONNIE, School of Law, University of Virginia, Char
lottesville, Virginia 22903
SUZAN HURLEY COGSWELL, Legislative Office of Education Over
sight, Columbus, Ohio 43266
DEBORAH L. DENNIS, Policy Research Associates, Inc., Delmar,
New York 12054
RONALD J. DIAMOND, Department of Psychiatry, University of
Wisconsin Hospital, Madison, Wisconsin 53792-2475
MARLENE M. EISENBERG, Institute of Law, Psychiatry, and Public
Policy, University of Virginia, Charlottesville, Virginia 22902
DIANE ENGSTER, 3825 Gibbs Street, Alexandria, Virginia 22309
WILLIAM P. GARDNER, Western Psychiatric Institute and Clinic,
Pittsburgh, Pennsylvania 15213
VIRGINIA ALDIGE HIDAY, Department of Sociology, North Carolina
State University, Raleigh, North Carolina 27695
v
vi CONTRIBUTORS
STEVEN K. HOGE, Institute of Law, Psychiatry, and Public Policy,
University of Virginia, Charlottesville, Virginia 22902
KIM HOPPER, Nathan Kline Institute for Psychiatric Research,
Orangeburg, New York 10962
HENRY KORMAN, Cambridge and Somerville Legal Services, Cam
bridge, Massachusetts 02141
CHARLES W. LIDZ, Western Psychiatric Institute and Clinic, Pitts
burgh, Pennsylvania 15213
MARGARITA LOPEZ, 606 East 11th Street, New York, New York
10009
ANNE M. LOVELL, Department of Sociology, University of Tou
louse, Le Mirail, 31058 Toulouse, Cedex, France
BONNIE M. MILSTEIN, David L. Bazelon Center for Mental Health
Law, Washington, D.C. 20005
JOHN MONAHAN, School of Law, University of Virginia, Char
lottesville, Virginia 22903
EDWARD P. MULVEY, Western Psychiatric Institute and Clinic, Pitts
burgh, Pennsylvania 15213
BRENDA ROCHE, Division of Epidemiology and Community Psy
chiatry, New York State Psychiatric Institute, Columbia Presbyterian
Medical Center, New York, New York 10032
LOREN H. ROTH, Western Psychiatric Institute and Clinic, Pitts
burgh, Pennsylvania 15213
PHYLLIS SOLOMON, School of Social Work, University of Pennsyl
vania, Philadelphia, Pennsylvania 19104
EZRA SUSSER, Division of Epidemiology and Community Psychia
try, New York State Psychiatric Institute, Columbia Presbyterian Med
ical Center, New York, New York 10032
PREFACE
Although it is a relatively new field, mental health law has undergone
major developments in the past decade, including landmark judicial
decisions, dramatic legislative initiatives, and the publication of pro
fessional standards and guidelines in both criminal and civil law. All
of these developments, however, have been predicated on plausible
but untested assumptions about persons with mental disorders, the
service delivery system, and the law-and about how these elements
affect one another.
In 1988, the John D. and Catherine T. MacArthur Foundation cre
ated a Research Network on Mental Health and the Law with the goal
of building the empirical foundation for the next generation of mental
health laws. The Network has two overriding mandates: to develop
new knowledge about the relationship between mental health and the
law and to turn that understanding into improved tools and criteria
for evaluating individuals and making decisions that affect their
lives.
The Network's research portfolio focuses on three pivotal issues
facing the field of mental health law: the competence of people with
mental disorders to make autonomous decisions, the risk of violence
that sometimes accompanies mental disorder, and the coercion that
often characterizes interventions to redress incompetence or reduce
risk. It is with the last of these that this book deals.
The coercive imposition of mental health services has always
been the most controversial issue in mental health law. Debates on the
involuntary inpatient hospitalization of persons with mental disor
ders are several centuries old. Debates on whether people so hospital-
vii
viii PREFACE
ized have a right to refuse mental health treatment are now several
decades old. While these controversies over involutary institutional
ization and inpatient treatment have by no means been resolved, they
have to a considerable extent been overtaken by events in recent
years. As the locus for the provision of mental health services has
moved from the hospital to the community, so has the venue for de
bates about coercion. Once, the legal and ethical issues to be resolved
included whether and for how long a person could be hospitalized
before a formal judicial hearing took place. Now, the legally and ethi
cally perplexing questions are more likely to concern whether a per
son with a mental disorder but without a home in the community can
be made dependent on an outreach worker's food and friendship as a
method of inducing compliance with outpatient treatment.
Little is known about how mental health services are actually
provided on the street level. Even less is known about how coercion is
used to engage and maintain in community treatment people with se
vere mental disorders who have rejected-or been rejected by-more
traditional interventions. It is to address this sea-change in the con
text in which mental health services are coercively administered that
this volume was developed.
The Network invited leaders in the field of community treat
ment, including consumers of that treatment, to describe and discuss
the issues that arose when treatment was "aggressively" pursued. We
were struck with how often treatment providers told us that "we
never talk about coercion, but we do it all the time," and with the
depth of ambivalence that community coercion generated in both
providers and recipients. It was to widen and deepen the conversa
tion about coercion in the community that the Network decided to
commission these original chapters.
We hope that this book will interest mental health professionals
providing front line services in communities throughout the coun
try, those in legal and policy-making positions who are influencing
the content of service provision, and health service researchers who
can document the costs and the consequences of coercion in the com
munity.
We are grateful to the members of the Network-in particular to
Henry Steadman, who encouraged us to commit this fascinating in
terdisciplinary dialogue to print-to the participants at our meetings,
and to the authors of these timely chapters, for sharing their experi
ences and their insights.
ACKNOWLEDGMENT
This volume was conceived and supported by the Research Network
on Mental Health and the Law of the John D. and Catherine T.
MacArthur Foundation.