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Federal Document

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An apparent shortage of psychiatric beds in many areas has created a situation in which involuntary commitment may be seen as a virtual entitlement—a way to prioritize intensive mental health services for individuals who would have difficulty accessing these services otherwise. Constraints on access greatly influence involuntary commitment practice and policy. Outpatient commitment, commonly termed “Assisted Outpatient Treatment” (AOT), may serve as a portal to services in some communities, using the legal leverage of commitment law.

To meet these challenges in a shifting policy landscape, some guidance is needed to assist state policymakers and practitioners in reforming, implementing, and appropriately targeting commitment law and practice—both inpatient and outpatient—to the small proportion of adults who require and may benefit from its use. Part I of this report reviews the history and current status of involuntary commitment in the United States. Part II sets forth expert consensus principles to guide the optimal, ethical use of commitment. Part III provides practical tools— briefly stated guidelines and a checklist of requirements—to assist policy makers and others responsible for reforming or implementing civil commitment laws or systems.

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