scholarly journals Compulsory Community Treatment? I. Ontario Stakeholders' Responses to “Helping those Who Won't Help Themselves”

1993 ◽  
Vol 12 (1) ◽  
pp. 57-96 ◽  
Author(s):  
Françoise Boudreau ◽  
Philip Lambert

This paper explores the highly controversial issue of compulsory treatment of allegedly mentally disordered persons within the community. In light of American literature on the subject, we examine and contrast the positions and arguments of a variety of Ontario stakeholders. This is done through content analysis of 224 submissions to the Ontario Ministry of Health in response to its “Discussion Paper Towards Community Mental Health Services Legislation of January 1990” which addresses the specific question: “Should the legislation include provisions for out-patient commitment/compulsory community treatment?” Our purpose in this paper is not to determine the desirability or undesirability of compulsory community treatment (CCT) as such, but to examine Ontario positions as a first and necessary step in the process of acquiring perspective on the issue.

2021 ◽  
Vol 8 ◽  
pp. 237437352110331
Author(s):  
DA de Waardt ◽  
D Meijnckens ◽  
AI Wierdsma ◽  
GAM Widdershoven ◽  
CL Mulder

On January 1, 2020, the Compulsory Mental Health Care Act took effect in the Netherlands. It contains provisions for compulsory community treatment (CCT) and compulsory treatment at home (CTH). In this study, we collected the opinions of patients and their significant others on CTH and on their preferences regarding compulsory care in their homes. Patients and their significant others were involved in the experience-based co-design of a purpose-built online questionnaire. This questionnaire was completed by 624 patients and 531 significant others. Sixty-one percent of the patients and 62% of the significant others did not want compulsory treatment to take place at home but in hospital or elsewhere. Patients’ and significant others’ opinion showed few differences, except with regard to the involvement of the significant others in CTH. As the respective views of patients and significant others were mixed, we recommend that crisis plans and compulsory treatment plans should be individually tailored to the needs and wishes of patients and their significant others regarding CTH.


1995 ◽  
Vol 19 (1) ◽  
pp. 45-47 ◽  
Author(s):  
John Hambridge ◽  
Nicola Watt

The New South Wales Mental Health Act (1990) heralded a number of important changes to mental health legislation in the state. One of these was the option to give compulsory treatment to mentally ill clients living in the community. This article briefly explains community treatment under the Act, and the perceived benefits and the limitations of such legislation. A case example is used to illustrate some of these points. Involuntary community treatment is seen as a less restrictive alternative to hospitalisation for a number of mentally ill clients, but the use of such provisions demands significant resources from the supervising agency.


Author(s):  
Jo Beswick ◽  
Michael Gunn

This chapter examines the legal framework for the treatment of the mentally disordered offender in the community in England and Wales. It examines both some of the ideological questions underlying the care of this group and the legal mechanisms within which treatment can be provided. The chapter begins by examining the principle, endorsed by the Mental Capacity Act 2005, that voluntary treatment will usually be the norm, regardless of setting. It then considers exceptions to these norm situations where legally mandated treatment in the community is permitted. In England and Wales, most of these exceptions are to be found in three pieces of legislation: the Mental Health Act 1983, as amended in 2007 to include community treatment orders; the Mental Capacity Act 2005, with its associated Deprivation of Liberty Safeguards (DOLS); and the Criminal Justice Act 2003.


2020 ◽  
pp. 33-44
Author(s):  
Sally Hardy ◽  
Fabian Van Essen ◽  
Luca Pingani

The digital health technologies have gained dramatic levels of interest and offer potential for self-managed, at scale, cost effective e-mental health. In this discussion paper, we aim to outline some of the contemporary issues arising from the computer's incursion in the field of psychiatry, as the global demand for improved mental wellbeing advances. The authors bring their personal reflections and areas of interest on the subject of e-mental health, taking into consideration both potential pitfalls and therapeutic possibilities. The paper outlines as an introduction what is meant by e-mental health and explores how it is being utilized in areas such as depression, anxiety management, alongside emergent outcome data on, for example, rates of admissions to hospital, as an initial measure of e-mental health's success. Having undertaken a review of the published evidence from the past five years, it can be seen how the subject is gaining attention, yet results are as yet limited to small numbers, and thus there is a limited evidence base. However, we also consider the implications for inclusion, through the application of e-health strategies for people living with additional neurological aspects such as intellectual disabilities, which as a population tends to limit uptake and exposure to online digital activity to date. We conclude with consideration of two critical questions on how to monitor, evaluate and regulate e-mental health activities, plus the ethical implications of e-exposure.


1998 ◽  
Vol 4 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Joseph L. Mosca

This curriculum module is designed for use in an undergraduate social policy course. It focuses on mental health policy and its impact on services to the chronic mentally ill in the community. Relevant mental health research is integrated in order to provide a basis for comparing traditional service interventions with alternative approaches. Learning outcomes that are critical to social policy analysis are addressed to include: problem identification and analysis; policy reform proposals; implementation concerns; and assessment. These components of social policy are applied to mental health services by specifically comparing family-aided assertive community treatment to longstanding approaches associated with deinstitutionalization.


2001 ◽  
Vol 25 (7) ◽  
pp. 268-270 ◽  
Author(s):  
Vanessa Pinfold ◽  
Jonathan Bindman

On the evening of 23 February 2000 at the Maudsley Hospital in London the motion ‘This house believes that compulsory community treatment is not justified’ was debated in front of an audience of mental health professionals, carers, service users and other members of the general public. Peter Campbell, a mental health system survivor, and Dr Frank Holloway, consultant psychiatrist at the South London and Maudsley Trust, supported the motion. Cliff Prior, Chief Executive of the National Schizophrenia Fellowship (NSF), and Professor Tom Burns, professor of community psychiatry at St George's Hospital Medical School, opposed it.


2020 ◽  
Vol 22 (4) ◽  
pp. 217-226
Author(s):  
Ian Cummins

Purpose This paper aims to examine reform of mental health legislation in England and Wales. It covers the period from the introduction of the 1983 MHA to the proposed reforms outlined in the Wessley Review that was published in December 2018. Design/methodology/approach This is a literature-based project. Findings Reform of the mental health legislation reflects two potentially conflicting strands. One is the state’s power to incarcerate the “mad”, and the other is the move to protect the civil rights of those who are subject to such legislation. The failures to development adequately funded community-based mental health services and a series of inquiries in the 1990s led to the introduction of Community Treatment Orders in the 2007 reform of the MHA. Research limitations/implications The development of mental health policy has seen a shift towards more coercive approaches in mental health. Practical implications The successful reform of the MHA can only be accomplished alongside investment in community mental health services. Originality/value The paper highlights the tensions between the factors that contribute to mental health legislation reform.


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