0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
Mental Health Court and Assisted Outpatient Treatment: Perceived Coercion, Procedural Justice, and Program Impact
Mark R. Munetz, M.D.; Christian Ritter, Ph.D.; Jennifer L. S. Teller, Ph.D.; Natalie Bonfine, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.002642012
View Author and Article Information

Dr. Munetz and Dr. Bonfine are with the Department of Psychiatry and Dr. Ritter and Dr. Teller are with the Department of Family and Community Medicine, Northeast Ohio Medical University, 4209 State Route 44, P.O. Box 44, Rootstown, OH 44272 (e-mail: mmunetz@neomed.edu).

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system.

Methods  Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The MacArthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers.

Results  Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants.

Conclusions  Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants’ perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Characteristics of mental health court and assisted outpatient treatment (AOT) participants (N=52)
Table Footer Note

a Negative numbers indicate interviews completed before administrative graduation or end of court-ordered supervision. There was one negative value for the AOT group and two for the mental health court group. For mental health court, the smallest positive value was 1 day. For the AOT group, the smallest positive value was 87 days.

Anchor for Jump
Table 2Responses to items measuring perceived coercion, perceived procedural justice, and impact of program among mental health court and assisted outpatient treatment (AOT) participants (N=52)a
Table Footer Note

a Possible responses ranged from 1, strongly agree, to 6, strongly disagree.

Table Footer Note

b Possible scale values range from 4 to 24. Cronbach’s α=.889

Table Footer Note

c Possible scale values range from 5 to 30. Cronbach’s α=.896

Table Footer Note

d Possible scale values range from 5 to 30. Cronbach’s α=.911

Table Footer Note

e Possible scale values range from 10 to 60. Cronbach’s α=.896

Anchor for Jump
Table 3Correlations between perceived coercion, perceived procedural justice, and impact of program among mental health court and assisted outpatient treatment participants (N=52)a
Table Footer Note

a All correlations are significant at p≤.01.

+

References

Monahan  J;  Bonnie  RJ;  Appelbaum  PS  et al:  Mandated community treatment: beyond outpatient commitment.  Psychiatric Services 52:1198–1205, 2001
[CrossRef] | [PubMed]
 
Monahan  J;  Swartz  M;  Bonnie  RJ:  Mandated treatment in the community for people with mental disorders.  Health Affairs 22:28–38, 2003
[CrossRef] | [PubMed]
 
Geller  JL:  Clinical guidelines for the use of involuntary outpatient treatment.  Hospital and Community Psychiatry 41:749–755, 1990
[PubMed]
 
Van Putten  RA;  Santiago  JM;  Berren  MR:  Involuntary outpatient commitment in Arizona: a retrospective study.  Hospital and Community Psychiatry 39:953–958, 1988
[PubMed]
 
Van Dorn  RA;  Swanson  JW;  Swartz  MS  et al:  Continuing medication and hospitalization outcomes after assisted outpatient treatment in New York.  Psychiatric Services 61:982–987, 2010
[CrossRef] | [PubMed]
 
Swartz  MS;  Swanson  JW;  Hiday  VA  et al:  A randomized controlled trial of outpatient commitment in North Carolina.  Psychiatric Services 52:325–329, 2001
[CrossRef] | [PubMed]
 
Swartz MS, Swanson JW, Steadman HJ, et al: New York State Assisted Outpatient Treatment Program Evaluation. Durham, NC, Duke University School of Medicine, June 9, 2009. Available at www.omh.ny.gov/omhweb/resources/publications/aot_program_evaluation
 
Munetz  MR;  Grande  TP;  Kleist  J  et al:  The effectiveness of outpatient civil commitment.  Psychiatric Services 47:1251–1253, 1996
[PubMed]
 
Ridgeley  S;  Borum  R;  Petrila  J:  The Effectiveness of Involuntary Outpatient Treatment: Empirical Evidence and the Experience of Eight States .  Santa Monica, Calif,  RAND, 2001
 
Wexler  D;  Winick  B:  Therapeutic jurisprudence as a new approach to mental health law and policy analysis and research.  University of Miami Law Review 45:979–1004, 1991
 
Handbook Guides Judges in Creating Mental Health Court Dockets. Columbus, Ohio, Supreme Court of Ohio and the Ohio Judicial System, 2008. Available at www.supremecourt.ohio.gov/PIO/news/2008/mentalhealthbook_061708.asp. Accessed Feb 3, 2013
 
Thompson M, Osher F, Tomasini-Joshi D: Essential Elements of a Mental Health Court. New York, Council of State Governments, 2005
 
Thompson  MD;  Reuland  M;  Souweine  D:  Criminal justice/mental health consensus: improving responses to people with mental illness.  Crime and Delinquency 49:30–51, 2003
[CrossRef]
 
Bennett  NS;  Lidz  CW;  Monahan  J  et al:  Inclusion, motivation, and good faith: the morality of coercion in mental hospital admission.  Behavioral Sciences and the Law 11:295–306, 1993
[CrossRef] | [PubMed]
 
Lidz  CW;  Hoge  SK;  Gardner  W  et al:  Perceived coercion in mental hospital admission: pressures and process.  Archives of General Psychiatry 52:1034–1039, 1995
[CrossRef] | [PubMed]
 
Monahan  J;  Hoge  SK;  Lidz  C  et al:  Coercion and commitment: understanding involuntary mental hospital admission.  International Journal of Law and Psychiatry 18:249–263, 1995
[CrossRef] | [PubMed]
 
Cusack  KJ;  Steadman  HJ;  Herring  AH:  Perceived coercion among jail diversion participants in a multisite study.  Psychiatric Services 61:911–916, 2010
[CrossRef] | [PubMed]
 
O'Keefe  K:  The Brooklyn Mental Health Court Evaluation: Planning, Implementation, Courtroom Dynamics, and Participant Outcomes .  New York,  Center for Court Innovation, 2006
 
Poythress  NG;  Petrila  J;  McGaha  A  et al:  Perceived coercion and procedural justice in the Broward mental health court.  International Journal of Law and Psychiatry 25:517–533, 2002
[CrossRef] | [PubMed]
 
Wales  HW;  Hiday  VA;  Ray  B:  Procedural justice and the mental health court judge’s role in reducing recidivism.  International Journal of Law and Psychiatry 33:265–271, 2010
[CrossRef] | [PubMed]
 
Appelbaum  PS;  Le Melle  S:  Techniques used by assertive community treatment (ACT) teams to encourage adherence: patient and staff perceptions.  Community Mental Health Journal 44:459–464, 2008
[CrossRef] | [PubMed]
 
Galon  P;  Wineman  NM:  Quasi-experimental comparison of coercive interventions on client outcomes in individuals with severe and persistent mental illness.  Archives of Psychiatric Nursing 25:404–418, 2011
[CrossRef] | [PubMed]
 
McKenna  BG;  Simpson  AI;  Coverdale  JH:  Outpatient commitment and coercion in New Zealand: a matched comparison study.  International Journal of Law and Psychiatry 29:145–158, 2006
[CrossRef] | [PubMed]
 
Swartz  MS;  Wagner  HR;  Swanson  JW  et al:  The perceived coerciveness of involuntary outpatient commitment: findings from an experimental study.  Journal of the American Academy of Psychiatry and the Law 30:207–217, 2002
[PubMed]
 
Gibbs  A;  Dawson  J;  Ansley  C  et al:  How patients in New Zealand view community treatment orders.  Journal of Mental Health 14:357–368, 2005
[CrossRef] | [PubMed]
 
O’Reilly  RL;  Keegan  DL;  Corring  D  et al:  A qualitative analysis of the use of community treatment orders in Saskatchewan.  International Journal of Law and Psychiatry 29:516–524, 2006
[CrossRef] | [PubMed]
 
Link  B;  Castille  DM;  Stuber  J:  Stigma and coercion in the context of outpatient treatment for people with mental illnesses.  Social Science and Medicine 67:409–419, 2008
[CrossRef] | [PubMed]
 
Phelan  JC;  Sinkewicz  M;  Castille  DM  et al:  Effectiveness and outcomes of assisted outpatient treatment in New York State.  Psychiatric Services 61:137–143, 2010
[PubMed]
 
Rain  SD;  Steadman  HJ;  Robbins  PC:  Perceived coercion and treatment adherence in an outpatient commitment program.  Psychiatric Services 54:399–401, 2003
[PubMed]
 
Gardner  W;  Hoge  SK;  Bennett  N  et al:  Two scales for measuring patients’ perceptions for coercion during mental hospital admission.  Behavioral Sciences and the Law 11:307–321, 1993
[CrossRef] | [PubMed]
 
Slobogin  C:  Involuntary community treatment of people who are violent and mentally ill: a legal analysis.  Hospital and Community Psychiatry 45:685–689, 1994
[PubMed]
 
Winick  BJ:  Outpatient commitment: a therapeutic jurisprudence analysis.  Psychology, Public Policy, and Law 9:107–144, 2003
[CrossRef]
 
Poythress  NG:  Mental health expert testimony: current problems.  Journal of Psychiatry and Law 5:201–227, 1977
 
Hiday  VA:  The attorney's role in involuntary civil commitment.  North Carolina Law Review 60:1027–1049, 1981
 
Miller  RD;  Ionescu-Pioggia  RM;  Fiddleman  PB:  The effect of witnesses, attorneys, and judges on civil commitment in North Carolina: a prospective study.  Journal of Forensic Sciences 28:829–838, 1983
[PubMed]
 
Tyler  TR:  The psychological consequences of judicial procedures: implications for civil commitment hearings.  SMU Law Review 46:443–445, 1992
 
Hiday  VA:  Outpatient commitment: the state of empirical research on its outcomes.  Psychology, Public Policy, and Law 9:8–32, 2003
[CrossRef]
 
Ray  B;  Dollar  CB;  Thames  KM:  Observations of reintegrative shaming in a mental health court.  International Journal of Law and Psychiatry 34:49–55, 2011
[CrossRef] | [PubMed]
 
Munetz  MR;  Galon  PA;  Frese  FJ  III:  The ethics of mandatory community treatment.  Journal of the American Academy of Psychiatry and the Law 31:173–183, 2003
[PubMed]
 
Steadman  HJ:  Boundary spanners: a key component for the effective interactions of the justice and mental health systems.  Law and Human Behavior 16:75–87, 1992
[CrossRef]
 
Gallagher  M;  Skubby  D;  Bonfine  N  et al:  Recognition and understanding of goals and roles: the key internal features of mental health court teams.  International Journal of Law and Psychiatry 34:406–413, 2011
[CrossRef] | [PubMed]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 39.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 35.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 9.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 48.  >
Topic Collections
Psychiatric News
APA Guidelines