Abstract
Objective: To determine best practice management strategies in the clinical application of civil commitment.
Method: All relevant literature on the topics of ‘civil commitment', ‘coercion’ and ‘procedural justice’ were located on MEDLINE and PsychUT databases and reviewed. Literature on the use of Ulysses contracts and advance directives in mental health treatment was integrated into the findings.
Results: Best practice evidence that guides management strategies is limited to the time of enactment of civil commitment. Management strategies involve enhancing the principles of procedural justice as a means of limiting negative patient perception of commitment. In the absence of evidence-based research beyond this point of enactment, grounds for the application of the principles of procedural justice are supported by reference to ethical considerations. Ulysses contracts provide an additional method for strengthening procedural justice.
Conclusions: Procedural justice principles should be routinely applied throughout the processes of civil commitment in order to enhance longer term therapeutic outcomes and to blunt paternalism.