You can now read 5 articles in a month for free on Read as much as you want anywhere and anytime for just 99¢.


In rare cases, outpatient commitment for mentally ill can be crucial tool

In response to the letter by Daniel B. Fisher (“Outpatient commitment would harm patients in need,” Jan. 1), I disagree with his assessment that outpatient commitment for psychiatric patients should be considered as harmful. In my training as a psychiatrist, I saw outpatient commitment being used in a helpful, thoughtful way. It was used rarely — only for those patients or clients for whom there was a clearly documented history of violence when off their medication, and a clear positive response to their medication when they were taking it regularly (in these cases, by injection once or twice a month).

The patients and clients were aware that if they slipped off their medicines when taking them by daily oral doses, as a result of carelessness or ambivalence, their mental illness would soon impair their judgment enough that they would refuse to restart their medicines, and they would end up in a downward spiral that was likely to end in aggression. They wanted neither to perpetrate violence on others, nor to end up incarcerated themselves.

Continue reading below

In my opinion, having this tool available enhanced these patients’ civil rights in that they were able to live in the community rather than being imprisoned, as so many of the severely mentally ill now find themselves.

Other approaches that are voluntary, such as the emotional CPR program Dr. Fisher refers to, are necessary and helpful, but there are rare cases in which voluntary programs are insufficient.

Dr. Naomi Dworkin


Loading comments...
Want each day's news headlines delivered fresh to your
inbox every morning? Just connect with us
in one of the following ways:
Please enter a valid email will never post anything without asking.
Privacy Policy
Subscriber Log In

You have reached the limit of 5 free articles in a month

Stay informed with unlimited access to Boston’s trusted news source.

  • High-quality journalism from the region’s largest newsroom
  • Convenient access across all of your devices
  • Today’s Headlines daily newsletter
  • Subscriber-only access to exclusive offers, events, contests, eBooks, and more
  • Less than 25¢ a week
Marketing image of
Marketing image of