Involuntary Outpatient Commitment Essay

Other housing needs for the mentally ill include specialized in- house primary care, health promotion programmes, open access mental services (accessible to all at any time, missed appointments are also tolerated), assertive management, street based service provision, holistic and generalist support apart from just clinical diagnosis, talking therapies and full access to mainstream services. Most importantly, the housed mentally ill persons have to be shielded from becoming homeless again. Such assurance that they will forever have a comfortable place to stay will relax their minds. This will go a long way in promoting their mental well being (Randall et al. 2006).

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

Today, it seems almost incomprehensible that so many people with serious mental illnesses reside in prisons instead of receiving treatment. Over a century and a half ago, reform advocates like Dorothea Dix campaigned for prison reform, urging lawmakers to house the mentally ill in hospitals rather than in prisons. The efforts undertaken by Dix and other like-minded reformers were successful: from around 1870 to 1970, most of the United States’ mentally ill population was housed in hospitals rather than in prisons. Considering reformers made great strides in improving this situation over a century and a half ago. Granted, mental hospitals in the late 19th and early 20th century were often badly run and critically flawed, but rather than pushing for reform of these hospitals, many politicians lobbied for them to close their doors, switching instead to a community-based system for treating the mentally ill. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people. Nevertheless, there are things that can be done to lower the rate mentally ill persons are being incarcerated. Such

Olmstead vs. L.C., which is the case that led to the Olmstead Decision, is considered to be one of the most important civil rights cases during the 20th century (Zubritsky, Mullahy, Allen, & Alfano, 2006). The Olmstead Decision was put into place after two women with a diagnosis of mental illness and developmental disability were voluntarily placed in a psychiatric facility and remained institutionalized for years. Even after efforts made by the women’s staff members to move them into a community setting, they were not moved until the Supreme Court’s 1999 decision in the Olmstead case (Cashmore, 2014).

The conditions of psychiatric hospitals were poorly maintained yet again. From the late 1800s until the mid-1900s, the conditions of these institutions were hit or miss. Despite the rising population of those in need of mental health treatment, conditions were deteriorating across the board. This pushed in the deinstitutionalization movement (Nevid, Rathus, & Green, 2014). This was a push to remove patients from state-run hospitals into a more community-based treatment center. In most cases today, there are treatment plans in place depending upon the severity of the disorder an individual may be suffering from. It’s more about treating an individual with any variety of modern techniques or therapies and trying to reintegrate them into society rather than a lifelong stay in an institution. Deinstitutionalization didn’t work the way it was intended. After it was put into place there was a rise in the homeless population and different programs that were supposed to be put into place didn’t live up to

Florida Assertive Community Treatment (FACT) is a program that provides comprehensive community counseling to individuals diagnosed with a debilitating mental illness. It is federally funded by the State of Florida Department of Children and Families and serves a clientele of 100 clients in the Volusia and Flagler County areas. It is a derivative of the Program of Assertive Treatment (PACT) which was developed in Wisconsin in the 1970s when deinstitutionalization was a major practice in the mental health field. This outpatient program is rehabilitation and recovery oriented. FACT is unique in that it is the only service available that offers a housing, medication, and flexible funding subsidy to enrolled individuals which help to

Mental Health Association of San Francisco (MHASF). (2013). 1421: Involuntary Outpatient Treatment/AOT/Laura’s Law: Ineffective, Redundant, Discriminatory. Retrieved from:

The deinstitutionalisation of the severely mentally ill in the 60ties qualifies a as one of the largest social experiments in American history. In 1995, there were 558,239 severely mentally ill patients in the nations public psychiatric

Bachrach, the author of dozens of articles on mental health, reports on the development deinstitutionalization in “Deinstitutionalisation: promises, problems and prospects” (1995). Bachrach argues that deinstitutionalization is not a perfect solution to the problem of the treatment of PMI and supports her argument with discussions about both the drawbacks and “positive legacy” of deinstitutionalization. She explains that deinstitutionalization has three parts: the release of patients into the community, the diversion of possible new patients and the development of newer community programs; Bachrach logically explains that the last process is “particularly important” because it impacts the entirety of the patients new independent life in the community. Multiple sources remarked that the third step of deinstitutionalization had not been properly handled (SOURCES?), one author going so far as to call the last step, and deinstitutionalization as a whole, an “abject failure” (Kara, 2014). While the author supports this claim with the consequences that things such as the lack of community resources has had on the population of PMI, she does not concede any of the positive outcomes of deinstitutionalization making her argument somewhat one sided. The article explains that while institutions began closing, “hundreds of vulnerable people were displaced” to communities that were not properly equipped to support them. An article from the Canadian Mental Health Association website by Diana Ballon supports this claim with a more concrete figure stating that since 1950s and 60s and the beginnings of deinstitutionalization there has been “the closure of almost 80 percent of beds in psychiatric hospitals” (n.d.). This increase of PMI living in communities with a lack of proper housing lead to a disproportionally large number of PMI being homeless or living in poverty which “greatly increase[s] the odds of PMI

Due in part to the community's lack of preparedness and resources, the needs of many of the deinstitutionalized has not been meet. Therefore many of the mentally ill have ended up exchanging hospitalization for institutionalization in prison or jail." This situation left many mentally ill on the streets with no one to look after them except the nation's police. Another reason for the increasing number of mentally ill individuals in the community is the expense of mental health services. Many individuals are unemployed and therefore without income. Many are not covered by health insurance and the individuals who do have insurance are often smothered under restrictions on coverage for mental illness. Others face time limits on in-patient treatment that will have rewarding effects. Others have difficulty accessing government-funded health coverage. Others depending upon their condition are not even aware that this program exits. Regardless of the reasoning police, as well as judge's and probation officers are on a daily basis faced with the increasing number of mentally ill individuals that are rotated amongst the system.

This was the first effective antipsychotic medication. Most of those who were deinstitutionalized were severely mentally ill. Between 50 and 60 percent of them were diagnosed with schizophrenia. Another 10 to 15 percent were diagnosed with manic-depressive illness and severe depression and an additional 10 to 15 percent were diagnosed with organic brain diseases, such as epilepsy, strokes, and Alzheimer's disease. Deinstitutionalization further worsened the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill. This situation continues up to the present. As a result, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment. Patients were kicked out with no choice. Many untreated mentally ill patients were incarcerated instead of being placed in asylums. The goal of deinstitutionalizing was that these patients should be treated in the least restrictive settings. But the settings ended up being on the streets or behind

Resources for Human Development (RHD) is a national human services nonprofit founded in 1970. The company currently oversees and supports more than 160 programs in 14 states. The programs fall under the following categories: Intellectual Disabilities, Behavioral Health, Addiction Recovery, Homelessness, Women & Children, Family Health & Counseling, Youth Development, Returning Citizens, Economic Development, Employment & Training, Veterans, Nonprofit Incubator, and Outsider Art. Within the Behavioral Health program, there are two Assertive Community Treatment (ACT) teams. The ACT Program provides community-based services to individuals with severe and persistent mental illness. The mental illness may also be accompanied by a substance abuse disorder and/or a developmental disability. The program is an outpatient agency and each ACT team has about 100 clients.

One century prior, government mental institutions prevented harmful interactions between the mentally ill and the public through involuntary commitment and medication; deinstitutionalization—the closing down facilities and releasing of patients—moved many patients in need of care onto the streets, but we desperately need these facilities. Dr. Fuller E. Torrey, founder of the Treatment Advocacy Center, which works to eliminate barriers for mental illness treatment, concluded that “extensive research on the history of deinstitutionalization by various individuals and organizations have shown increase in jail population inversely related to the population of psychiatric institutions; as patients decreased, prisoners increase” ("The Release of

In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.

Schizophrenia is a psychiatric disorder that is characterized by a variety of symptoms and the disorganization of feeling and thought. It is an incurable disease whose causes are unknown, yet whose effects are mind and body crippling. (Young, 1988, p.13-14) This topic was chosen because it is interesting to study a disorder that worldwide, is viewed as a classic example of madness and insanity. Another reason of interest is because unlike many illnesses, schizophrenia doesn't have a noticeable pattern and its difficulty to be diagnosed as a disease makes the collection of statistics difficult. It is important to learn more about schizophrenia because a significant numbr of people are affected everyday