“Coercion” and Leverage in Clinical Outreach

  • Ezra Susser
  • Brenda Roche
Chapter
Part of the The Springer Series in Social Clinical Psychology book series (SSSC)

Abstract

This chapter addresses the issues of coercion and leverage in clinical outreach to persons who are homeless and have a severe mental illness. The terms coercion and leverage refer to a broad array of strategies that are used to pressure patients to adhere to treatments or social acts prescribed by outreach clinicians. Coercion in the more narrow sense of “forced action” is not the primary focus. Therefore, we shall henceforth use the term leverage to refer to this broad array of strategies.

Keywords

Outpatient Treatment Assertive Community Treatment Patient Autonomy Outreach Program Community Psychiatry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. Abroms, G. M. (1968). Setting limits. Archives of General Psychiatry, 19, 113–119.PubMedCrossRefGoogle Scholar
  2. Aviram, U. (1990). Community care of the seriously mentally ill: Continuing problems and current issues. Community Mental Health Journal, 26 (1), 69–88.PubMedCrossRefGoogle Scholar
  3. Bellows-Blakely, D. S. (1985). Coercion and countertransference. Psychiatric Hospital, 16, 177–181.Google Scholar
  4. Bennett, N. S., Lidz, C. W., Monahan, J., Mulvey, E. P., Hoge, S. K., Roth, L. H., & Gardner, W. (1993). Inclusion, motivation and good faith: The morality of coercion in mental hospital admissions. Behavioral Sciences and the Law, 11, 295–306.PubMedCrossRefGoogle Scholar
  5. Bursten, B. (1986). Posthospital mandatory outpatient treatment. American Journal of Psychiatry, 143, 1255–1258.PubMedGoogle Scholar
  6. Carroll, J. S. (1993). Consent to mental health treatment: A theoretical analysis of coercion, freedom, and control. Behavioral Sciences and the Law, 9, 129–142.CrossRefGoogle Scholar
  7. Chen, A. (1991). Noncompliance in community psychiatry: A review of clinical interventions. Hospital and Community Psychiatry, 42, 282–287.PubMedGoogle Scholar
  8. Cournos, F. (1989). Involuntary medication and the case of Joyce Brown. Hospital and Community Psychiatry, 40, 736–740.PubMedGoogle Scholar
  9. Diamond, R. J., & Winkler, D. I. (1985). Ethical problems in community treatment of the chronically mentally ill. In L. I. Stein and M. A. Test (Eds.), The training in community living model: A decade of experience (pp. 85–93). New Directions in Mental Health Services, No. 26. San Francisco: Jossey-Bass.Google Scholar
  10. Frank, L. R. (1986). The policies and practices of American psychiatry are oppressive. Hospital and Community Psychiatry, 37, 497–501.PubMedGoogle Scholar
  11. Garrison, V. (1977). Doctor, espiritista, or psychiatrist? Mental health seeking behavior in a Puerto Rican neighborhood of New York City. Medical Anthropology, 1, 65–180.CrossRefGoogle Scholar
  12. Geller, J. L. (1990). Clinical guidelines for the use of involuntary outpatient treatment. Hospital and Community Psychiatry, 41, 749–755.PubMedGoogle Scholar
  13. Geller, J. L. (1991). Rx: A tincture of concern in outpatient treatment? Hospital and Community Psychiatry, 42, 1068–1069.PubMedGoogle Scholar
  14. Geller, J. L. (1992). Clinical encounters with outpatient coercion at the CMHC: Questions of implementation and efficacy. Community Mental Health Journal, 28, 81–94.PubMedCrossRefGoogle Scholar
  15. Hiday, V. A. (1989). A follow-up of chronic patients committed to outpatient treatment. Hospital and Community Psychiatry, 40, 52–59.PubMedGoogle Scholar
  16. Hoge, S. K., Lidz, C., Mulvey, E., Roth, L., Bennett, N., Siminoff, L., Arnold, R., & Monahan, J. (1993). Patient, family and staff perceptions of coercion in mental hospital admission: An exploratory study. Behavioral Sciences and the Law, 11, 281–293.PubMedCrossRefGoogle Scholar
  17. Lamb, H. R. (1980). Structure: The neglected ingredient of community treatment. Archives of General Psychiatry, 37, 1224–1228.PubMedCrossRefGoogle Scholar
  18. Marcos, L. R. (1991). Taking the mentally ill off the streets: The case of Joyce Brown. International Journal of Mental Health, 20, 7–16.Google Scholar
  19. Marcos, L. R., & Cohen, N. L. (1986). Taking the suspected mentally ill off the streets to public general hospitals. New England Journal of Medicine, 315, 1158–1161.PubMedCrossRefGoogle Scholar
  20. Marcos, L. R., Cohen, N. L., Nardacci, D., & Brittain, J. (1990). Psychiatry takes to the streets: The New York City initiative for the homeless mentally ill. American Journal of Psychiatry, 147 (11), 1557–1561.PubMedGoogle Scholar
  21. Mulvey, E. P., Geller, J. L., & Roth, L. H. (1987). The promise and peril of involuntary outpatient commitment. American Psychologist, 42, 571–584.PubMedCrossRefGoogle Scholar
  22. Rogers, A. (1993). Coercion and “voluntary” admission: An examination of psychiatric patients’ views. Behavioral Sciences and the Law, 11, 259–267.CrossRefGoogle Scholar
  23. Rubenstein, L. S. (1986). Treatment of the mentally ill: Legal advocacy enters the second generation. American Journal of Psychiatry, 143, 1264–1269.PubMedGoogle Scholar
  24. Susser, E. (1990). Working with people who are homeless and mentally ill: The role of a psychiatrist. In R. Jahiel (Ed.), Homelessness: A preventive approach (pp. 207–217 ). Baltimore: Johns Hopkins Press.Google Scholar
  25. Susser, E., Goldfinger, S., & White, A. (1990). Some clinical approaches to the homeless mentally ill. Community Mental Health Journal, 26, 459–476.Google Scholar
  26. Susser, E., Valencia, E., & Goldfinger, S. (1992). Clinical care of the homeless mentally ill: Strategies and adaptations. In H. R. Lamb, L. Bachrach, & F. Kass (Eds.), Treating the homeless mentally ill (pp. 127–140 ). Washington, DC: American Psychiatric Press.Google Scholar
  27. Valencia, E., Susser, E., & McQuiston, H. L. (in press). Critical time points in the clinical care of homeless mentally ill individuals. In J. Vaccaro & G. Clurke (Eds.), Community psychiatry: A practitioner’s manual. Washington, DC: American Psychiatric Press.Google Scholar
  28. Wertheimer, A. (1993). A philosophical examination of coercion for mental health issues. Behavioral Sciences and the Law, 11, 239–258.CrossRefGoogle Scholar
  29. Witheridge, T. F. (1991). The active ingredients of assertive outreach. New Directions For Mental Health Services, 52, 47–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Ezra Susser
    • 1
  • Brenda Roche
    • 1
  1. 1.Division of Epidemiology and Community PsychiatryNew York State Psychiatric Institute, Columbia Presbyterian Medical CenterNew YorkUSA

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