Why all the brouhaha now about coercion and involuntariness in community settings? Throughout the 20th century, psychiatry has had the authority to require compliance with outpatient treatment. It has exercised this authority within a belief system that has viewed benevolent coercion as necessary for treating some persons with serious mental illness. For example, in 1938 a total of 2,269 of 26,086 patients in the Massachusetts state hospital system (8.6 percent) were on "visit status." These patients lived outside the hospital, received some form of supervision, and could be returned to the institution at the superintendent's discretion. That discussions of coercion or involuntariness now focus on coercion outside of institutions may simply reflect the fact that most potential beneficiaries now live outside of state hospitals.