scholarly journals The Utility of Outpatient Commitment: I. A Need for Treatment and a Least Restrictive Alternative to Psychiatric Hospitalization

2017 ◽  
Vol 68 (12) ◽  
pp. 1247-1254 ◽  
Author(s):  
Steven P. Segal ◽  
Stephania L. Hayes ◽  
Lachlan Rimes
Keyword(s):  
Psychiatric Hospitalization ◽  
Outpatient Commitment ◽  
Need For Treatment ◽  
Least Restrictive Alternative

The Quandaries of Enforced Community Treatment and Unenforceable Outpatient Commitment Statutes

1986 ◽  
Vol 14 (1-2) ◽  
pp. 149-158 ◽  
Author(s):  
Jeffrey L. Geller
Keyword(s):  
Informed Consent ◽  
Community Treatment ◽  
Outpatient Commitment ◽  
Legal Sanctions ◽  
Least Restrictive Alternative

One response to the problems created by deinstitutionalization has been outpatient commitment. Involuntary community treatment presents a series of dilemmas, including those involving the role of enforced treatment in psychiatry, the implementation of informed consent, the application of “least restrictive alternative,” and the ever-widening liability of psychiatrists. While outpatient commitment itself presents conundrums, outpatient commitment which is unenforceable brings the psychiatrist to even further quandaries. Using Pennsylvania as an example, the difficulties posed by unenforceable outpatient commitment are presented. The author concludes that although coerced community treatment may be successful even without legal sanctions, this is not an ethically sound solution.

The Least Restrictive Alternative to Involuntary Hospitalization, Outpatient Commitment: Its Use and Effectiveness

1982 ◽  
Vol 10 (1) ◽  
pp. 81-96 ◽  
Author(s):  
Virginia Aldigé Hiday ◽  
Judge Rodney R. Goodman
Keyword(s):  
Success Rate ◽  
Mentally Ill ◽  
Outpatient Treatment ◽  
Civil Commitment ◽  
Time Frame ◽  
High Success Rate ◽  
Involuntary Hospitalization ◽  
Outpatient Commitment ◽  
Select Group ◽  
Least Restrictive Alternative

For two years, all court-ordered outpatient treatment in one civil commitment court was followed for the maximum time of an initial commitment, three months. Based on involuntary readmissions and involuntary commitments, outpatient commitment for the dangerously mentally ill was found to have a high success rate; only 12.5% of the respondents were involuntarily rehospitalized during the time frame. For the select group of respondents ordered to outpatient treatment by this court, outpatient commitment provided an effective, less restrictive alternative to involuntary hospitalization.

Case Exercise: Biomechanics in Rearend Motor Vehicle Collisions

2007 ◽  
Vol 12 (3) ◽  
pp. 4-7
Author(s):  
Charles N. Brooks ◽  
Christopher R. Brigham
Keyword(s):  
Motor Vehicle ◽  
Body Position ◽  
Motor Vehicle Collisions ◽  
Time Curve ◽  
Vehicle Collisions ◽  
Need For Treatment ◽  
Multiple Factors ◽  
Bodily Injury ◽  
Vehicle Collision ◽  
Physical Findings

Abstract Multiple factors determine the likelihood, type, and severity of bodily injury following a motor vehicle collision and, in turn, influence the need for treatment, extent of disability, and likelihood of permanent impairment. Among the most important factors is the change in velocity due to an impact (Δv). Other factors include the individual's strength and elasticity, body position at the time of impact, awareness of the impending impact (ie, opportunity to brace, guard, or contract muscles before an impact), and effects of braking. Because Δv is the area under the acceleration vs time curve, it combines force and duration and is a useful way to quantify impact severity. The article includes a table showing the results of a literature review that concluded, “the consensus of human subject research conducted to date is that a single exposure to a rear-end impact with a Δv of 5 mph or less is unlikely to result in injury” in most healthy, restrained occupants. Because velocity incorporates direction as well as speed, a vehicular occupant is less likely to be injured in a rear impact than when struck from the side. Evaluators must consider multiple factors, including the occupant's pre-existing physical and psychosocial status, the mechanism and magnitude of the collision, and a variety of biomechanical variables. Recommendations based solely on patient history and physical findings (and, perhaps, imaging studies) may be ill-informed.

Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Coping Styles ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Coping Behaviors ◽  
Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

External Validity of SCORS-G Ratings of Thematic Apperception Test Narratives in a Sample of Outpatients and Inpatients

2015 ◽  
Vol 36 (1) ◽  
pp. 58-81 ◽  
Author(s):  
Michelle B. Stein ◽  
Jenelle Slavin-Mulford ◽  
Caleb J. Siefert ◽  
Samuel Justin Sinclair ◽  
Michaela Smith ◽  
...  
Keyword(s):  
Life Events ◽  
Psychiatric Hospitalization ◽  
Clinical Care ◽  
Thematic Apperception Test ◽  
Clinical Samples ◽  
Cross Sectional ◽  
Conduct Disordered ◽  
Global Ratings ◽  
Thematic Apperception ◽  
History Of

Abstract. The Social Cognition and Object Relations Scale-Global Ratings Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker-Aspen, 2011 ) is a reliable system for coding narrative data, such as Thematic Apperception Test (TAT) stories. This study employs a cross-sectional, correlational design to examine associations between SCORS-G dimensions and life events in two clinical samples. Samples were composed of 177 outpatients and 57 inpatients who completed TAT protocols as part of routine clinical care. Two experienced raters coded narratives with the SCORS-G. Data on the following clinically relevant life events were collected: history of psychiatric hospitalization, suicidality, self-harming behavior, drug/alcohol abuse, conduct-disordered behavior, trauma, and education level. As expected, the clinical life event variable associated with the largest number of SCORS-G dimensions was Suicidality. Identity and Coherence of Self was related to self-harm history across samples. Emotional Investment in Relationships and Complexity of Representations were also associated with several life events. Clinical applications, limitations of the study, and future directions are reviewed.

Evaluation of the New York City (Bellevue) Involuntary Outpatient Commitment Pilot Program

1999 ◽  
Author(s):  
Kim Hopper ◽  
Henry J. Steadman ◽  
Jeanne Dumont ◽  
David L. Shern ◽  
Marvin Swartz
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Pilot Program ◽  
Outpatient Commitment
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