The Mentally Ill in Community-Based Sheltered Care: A Study of Community Care and Social Integration

1979 ◽  
Vol 136 (7) ◽  
pp. 999-a-1000 ◽  
Author(s):  
JOHN A. TALBOTT
1990 ◽  
Vol 45 (11) ◽  
pp. 1238-1240 ◽  
Author(s):  
Edward M. Kennedy
Keyword(s):  

1987 ◽  
Vol 15 (1) ◽  
pp. 117-127 ◽  
Author(s):  
Mark R. Pogrebin ◽  
Eric D. Poole

Policies of deinstitutionalization, together with a general tightening of civil commitment laws and inadequate funding for community-based programs, have resulted in an increase of mentally ill people on the streets. Growing numbers of former mental patients and individuals whose bizarre behavior might have landed them in a state hospital bed a few years ago are now being arrested and ending up in jail. Four key areas––deinstitutionalization, police decision making, decline of mental health programs, and criminal histories of mental patients—are examined with respect to the shifting of mentally disordered persons from the mental health system to the criminal justice system.


The use of coercion is one of the defining issues of mental health care and has been intensely controversial since the very earliest attempts to contain and treat the mentally ill. The balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it has never been finer, with the ‘move into the community’ in many high-income countries over the last 50 years and the development of community services. The vast majority of patients worldwide now receive mental health care outside hospital, and this trend is increasing. New models of community care, such as assertive community treatment (ACT), have evolved as a result and there are widespread provisions for compulsory treatment in the community in the form of community treatment orders. These legal mechanisms now exist in over 75 jurisdictions worldwide. Many people using community services feel coerced, but at the same time intensive forms of treatment such as ACT, which arguably add pressure to patients to engage in treatment, have been associated with improved outcome. This volume draws together current knowledge about coercive practices worldwide, both those founded in law and those ‘informal’ processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology, and medicine and for is explored


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