Main description:

A compelling look at involuntary psychiatric care and psychiatry's role in preventing violence.

Battle lines have been drawn over involuntary treatment. On one side are those who oppose involuntary psychiatric treatments under any condition. Activists who take up this cause often don't acknowledge that psychiatric symptoms can render people dangerous to themselves or others, regardless of their civil rights. On the other side are groups pushing for increased use of involuntary treatment. These proponents are quick to point out that people with psychiatric illnesses often don't recognize that they are ill, which (from their perspective) makes the discussion of civil rights moot. They may gloss over the sometimes dangerous side effects of psychiatric medications, and they often don't admit that patients, even after their symptoms have abated, are sometimes unhappy that treatment was inflicted upon them.

In Committed, psychiatrists Dinah Miller and Annette Hanson offer a thought-provoking and engaging account of the controversy surrounding involuntary psychiatric care in the United States. They bring the issue to life with first-hand accounts from patients, clinicians, advocates, and opponents. Looking at practices such as seclusion and restraint, involuntary medication, and involuntary electroconvulsive therapy-all within the context of civil rights-Miller and Hanson illuminate the personal consequences of these controversial practices through voices of people who have been helped by the treatment they had as well as those who have been traumatized by it.

The authors explore the question of whether involuntary treatment has a role in preventing violence, suicide, and mass murder. They delve into the controversial use of court-ordered outpatient treatment at its best and at its worst. Finally, they examine innovative solutions-mental health court, crisis intervention training, and pretrial diversion-that are intended to expand access to care while diverting people who have serious mental illness out of the cycle of repeated hospitalization and incarceration. They also assess what psychiatry knows about the prediction of violence and the limitations of laws designed to protect the public.

Contents:

Before We Get Started
Part One: The Patients
Chapter 1: Eleanor and the Case against Involuntary Hospitalization
Chapter 2: Lily and the Case for Civil Commitment
Part Two: The Battleground
Chapter 3: Those in Favor of Involuntary Treatments
E. Fuller Torrey and the Treatment Advocacy Center
Ronald Honberg and NAMI
Paul Summergrad and the American Psychiatric Association
Chapter 4: Those against Involuntary Treatments
The Citizens Commission on Human Rights
Cecelia Brown and Janet Foner and MindFreedom International
Daniel Fisher and the National Empowerment Center
Ira Burnim and the Bazelon Center
Part Three: Civil Rights
Chapter 5: Eleanor and Lily and the Process of Civil Commitment
Chapter 6: Christina Schumacher and the History of Civil Commitment Laws
Part Four: Hospitalization
Chapter 7: Officer Scott Davis and Law Enforcement
Chapter 8: Dr. Leonard Skivorski and the Emergency Department
Chapter 9: Eleanor's Hospital Experience
Chapter 10: Dr. Ray DePaulo and Inpatient Psychiatry at a University Hospital
Chapter 11: Dr. Steven Sharfstein and Dr. Bruce Hershfield and Free-standing Psychiatric Hospitals
Chapter 12: Dr. Annette Hanson and the Use of Seclusion and Restraint
Chapter 13: Anthony Kelly and Involuntary Medications
Chapter 14: Jim and Involuntary Electroconvulsive Therapy
Part Five: Involuntary Outpatient Commitment
Chapter 15: Marsha and Involuntary Outpatient Commitment
Chapter 16: Outpatient Commitment by the Books
Chapter 17: The Honorable Jack Lesser and Mental Health Courts
Part Six: A Danger to Self or to Others
Chapter 18: Dan and Guns and Mental Illness
Chapter 19: Bryan Stanley and Violence and Psychiatric Illness
Chapter 20: Amy and Involuntary Treatment for Suicide Prevention
Chapter 21: Will Forcing Treatment on People with Psychiatric Disorders Prevent Mass Murders?
Part Seven: Future Directions
Chapter 22: Transforming the Battleground
References
Acknowledgments