"What about the SPMI [severe and persistent mentally ill] patients who deny that they are ill, are hospitalized multiple times, and are potentially dangerous if not in treatment? Psychiatric care differs from general medical treatment due to the fact that psychiatrists treat some patients who are not able to appreciate that they need treatment. With the twin movements of de-institutionalization and managed care, there is less available funding for inpatient treatment. Involuntary hospitalizations occur in every state based on criteria that emphasize dangerous to self or others or grave disability. Sadly, involuntary hospitalization is often not available for patients who are not dangerous but who urgently need comprehensive evaluation and intensive treatment that is not possible outside a hospital. After patients are initially stabilized, they are often discharged and some are repeatedly noncompliant with outpatient care. Mandatory outpatient treatment is a useful tool and a preventive intervention for those who may not presently meet criteria for inpatient commitment but need treatment to prevent relapse or deterioration that would predictably and rapidly lead to their qualifying for admission. More than 40 states and the District of Columbia have commitment statutes permitting mandatory outpatient treatment, and studies of such treatment have been linked to improved patient outcomes such as reduced hospitalization rates and decreased violent behavior. Any humane and comprehensive quality mental health treatment system must make provision for both inpatient and outpatient involuntary treatment for those severely and/or persistently mentally ill who can benefit from such approaches."

Read the full report on the website of the American Psychiatric Association.