Challenge:

Involuntary Outpatient Commitment (IOC) is receiving increased attention and at least forty-five states have some type of IOC statute. In evaluating whether IOC should be used for any individual, one should consider the complex balance of forced treatment, patient autonomy, collaboration, treatment outcomes and public safety.

Critics of IOC argue that any loss of personal autonomy or coercion is not acceptable. With sufficient resources and infrastructure to support appropriately robust outpatient services, IOC can be a realistic compromise between involuntary hospitalization and no care. IOC can help people with serious behavioral health needs safely experience life in the community, with enhanced services.

Position:

AACP believes that people with severe mental illness, including those with co-occurring substance use disorders, who are not consistently engaged in behavioral health treatment, have repeated hospitalizations and episodes of violence, and who would benefit from enhanced services, should have access to IOC. By incorporating recovery-oriented principle in all aspects of treatment, IOC can be a tool towards recovery and a tool for improving consumer and public safety.

The AACP accepts and agrees with the position statement and principles established by the American Psychiatric Association on Involuntary Outpatient Commitment. In addition the AACP has added the following positions and principles:

• The benefits of IOC to the consumer, family, and community should be thoughtfully weighed against IOC’s infringement upon the human and constitutional rights of the consumer.

• IOC is not intended to be a permanent level of treatment. As part of IOC initiatives, states and localities should establish a means for evaluating criteria for IOC removal or completion.

• IOC mandates treatment adherence for the individual, and it is equally important that treatment providers act on their responsibility to provide appropriately enhanced treatment and services for these individuals.

Please reference the attached position paper for more information about implementing this position.