Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

364 IV. SPECIAL POPULATIONSStates have created laws that can be used to force those with either mentaldisorders or SUDs into treatment plans. Thomsen Hall and Appelbaum (2002)have commented on the valid legal basis for this approach. In Robinson v. California,the U.S. Supreme Court ruled in 1961 that “a state might establish aprogram of compulsory treatment for those addicted to narcotics. Such a programmight require periods of involuntary confinement and penal sanctionsmight be imposed for failure to comply with established treatment procedures.”As of 1997, 31 states and the District of Columbia had statutes specificallyallowing involuntary treatment or commitment for dependent individuals. Thiscan be inpatient or outpatient treatment, or partial hospitalization. The criteriaand processes for commitment vary by state but usually require a judicial hearingin which the individual’s or the community’s safety is seen to be endangeredby the refusal of the patient to be in treatment. The use of monitored disulfiramadministration has been shown to increase compliance (Brewer, 1993).CONCLUSIONIn 1939, Penrose accurately predicted an inverse relationship between the numberof individuals in a society who are psychiatrically hospitalized and those withpsychiatric disorders who are incarcerated. For patients released from state,municipal, Veterans Administration, and private hospitals, homelessness, comorbidaddiction, and incarceration have resulted. In this era of continued hospitaldeinstitutionalization and increased incarceration, psychiatrists are increasinglyessential in forensic, legal, and correctional settings. This will be true so longas long-term institutions for the mentally ill are absent and community resourcesare inadequate; the next-best alternative will be the implementation and expansionof procedures and practices of diversion from the justice system. Clinicianscould have the greatest impact on helping addicted and mentally ill offenders andreducing their placement in the justice system by advocating for effective diversionprograms that not only promote proper medical care and maintain libertyrights but also protect the public. Clinicians need also to know how best to usecoercion wisely and compassionately as a means to confront denial, engagepatients in treatment, and liberate them from the ravages and confinement oftheir addiction. Working with these addicted patients, who suffer more than mostof humanity, can be personally interesting and rewarding.REFERENCESAbram, K. M., & Teplin, L. A. (1991). Co-occurring disorders among mentally ill jaildetainees: implications for public policy. Am Psychol, 46, 1036–1045.Abram, K. M., Teplin, L. A., & McClelland, G. M. (2003). Comorbidity of severe psy-