ABSTRACT
This chapter addresses problems directly from the perspective of a treating clinician, and how the state of understanding of clinical and legal evidence may assist clinicians in the delivery of care in the community to people with serious mental illness. Involuntary outpatient treatment must be subject to the questions if it is to confer its initial hopes as being a less restrictive alternative to inpatient treatment. It must have evidence of efficacy, both when compared to inpatient and voluntary community treatment. Naturalistic studies have looked retrospectively at the effects of legislation enabling involuntary outpatient treatment. Prospective controlled studies are most valuable in defining the potential benefits of any treatment. People might be committed on the basis that the care offered is unacceptable to them, and thus the provision of involuntary community treatment excuses poor quality, consumer-insensitive services. Overruling the treatment decisions of a person with a serious mental illness to provide treatment non-consensually is ethically justified under certain circumstances.
