A biopsychosocial rationale for coerced community treatment in the management of schizophrenia
Geller, Jeffrey L.
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Student Authors
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UMass Chan Affiliations
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Keywords
Antipsychotic Agents
Brain Diseases
Combined Modality Therapy
Commitment of Mentally Ill
Community Mental Health Services
Health Resources
Humans
*Mentally Ill Persons
Patient Selection
Practice Guidelines as Topic
Rehabilitation, Vocational
Risk Assessment
Schizophrenia
*Schizophrenic Psychology
Social Adjustment
Treatment Outcome
Health Services Research
Mental and Social Health
Psychiatric and Mental Health
Psychiatry
Psychiatry and Psychology
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Abstract
Coerced community treatment in its various forms is receiving increasing attention and generating considerable controversy. Few attempts, however, have been made to articulate a rationale for its use. The author presents material in support of the concept that schizophrenia can be viewed as a set of biopsychosocial deficits and that some of the deficits can be efficaciously addressed using coerced community treatment. The biological, psychological, and social deficits are each examined and then a biopsychosocial-coerced intervention hypothesis is generated. The underpinning of the use of coerced community treatment in this model is its ability to affect structure and motivation and thereby to alter the customary community living equation. The charge that one can just treat the deficits and then coercion becomes superfluous is answered. The concerns that the employment of coercion could become too widespread or be used in lieu of adequate community resources for mental health services are also considered. The conclusion is that coerced community treatment is a logical component of the treatment of schizophrenia in outpatient settings.
Source
Psychiatr Q. 1995 Fall;66(3):219-35.