Coercion is hardly a panacea when a range of reforms is needed
The fundamental point of part 1 of the Globe Spotlight series on the mental health system — that the state failed to adequately replace closed mental hospitals with community-based services — is beyond reasonable dispute (“The desperate and the dead,” Page A1, June 26). But the article takes this truth in disappointing directions.
In addition to using statistical analysis — charitably described as flawed — to support the incorrect and stigmatizing suggestion that people with mental illness have a disproportionate propensity to commit acts of violence, the article posits that creating a program of coercion, known as involuntary outpatient commitment, is a solution for systemic problems. Since the authors place blame for the Legislature’s resistance to this idea on the advocacy of people such as a senior lawyer in this office, while simplifying our position to the point of misstatement, I am obliged to correct the record.
We do not apologize for defending constitutionally grounded rights that protect against arbitrariness in forced treatment. But the Spotlight piece ignores a central argument of the Mental Health Legal Advisors Committee and other advocacy groups: that involuntary outpatient commitment is bad public policy. Positive outcomes were generated in other states only when involuntary outpatient commitment was enacted as part of a package of reforms including significantly increased spending on services that are clearly beneficial without the element of coercion. Involuntary outpatient commitment diverts funds from such services toward enforcing court orders. It is hardly a panacea.