Psych Central

Assisted Outpatient Treatment: Let's 'Assist' Patients By Forcing ThemAssisted outpatient treatment (AOT) is a marketing term for involuntary commitment, but in an outpatient setting. AOT is like putting lipstick on a pig and calling her a princess. Experts on AOT sometimes like to pretend AOT is something different than forced treatment:

“Forcing [a person] to take medication is assisting him to make the choice we think he would make if he had a normally functioning brain.”
~ E. Fuller Torrey, MD & Jonathan Stanley, JD

Let’s delve into the twisted logic here of assisted outpatient treatment.

2 Comments to
Assisted Outpatient Treatment: Let’s ‘Assist’ Patients By Forcing Them

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  1. Personally, I detest enforced care by the courts because it presents treatment as punitive, not beneficial and efficacious to encourage participation. And as I wrote a post at my blog about this a few months ago, no judge ever calls me or any clinic I have worked at in my 20 years of various community mental health sites that get these patients almost all the time, but judges should to get our feedback how to maximize the patient will be cooperative and more voluntary.

    If I ever got such a call, I would simply say this: “is the person at all interested in this treatment in any spontaneous comment in court he/she is honestly entertaining a diagnosis of mental health problems and could benefit from treatment?” Because I don’t want to treat people looking for “get out of jail” cards, and I certainly don’t want to substitute for substance abusers/antisocials who perhaps are better served in correctional facilities first, maybe consider mental health care once the time for the crime is completed.

    Just curious to ask any colleagues out there who have taken these court appointed cases, how many times has the “patient” accused you of making them violate their probation or have to go back to jail?

    Thanks for the laughs, court! With the increase of addiction and blatant criminals coming to CMHCs these past 10 plus years, you wonder why providers have a half life at a site of no more than 3-4 years. If community mental health is going to survive, and perhaps even thrive in these times, it is time to be a bit more selective in who is considered appropriate for care at these sites.

    And who is just a dump! But, no judge is interested in really hearing the truth, eh?

  2. I would not see my psychiatrist if there was anything coercive about it. If I were to ever end up in something like AOT, I would flee my state. Frankly, the U.S. doesn’t have the funds to hunt down everyone with mental illness. I haven’t committed any crimes, and treating me like a criminal would not do much for my mental health. My psychiatrist is a healer; I’m not interested in seeing a jailer.

    My psychiatrist told me that those who promote more use of force have actually made his job more difficult because it makes people even more afraid of psychiatry and afraid to see him. It makes people see psychiatry as punitive rather healing. He wants no part in it. I’m glad to have a doctor who thinks like him.

    The type of psychiatrists and psychologists who see anosognosia everywhere they look might do well to examine their bedside manner. I wouldn’t spend even five minutes talking to some of those pro-force folks, so it’s no surprise to me that others don’t either.

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