Walking a Tightrope: Case Management Services and Outpatient Commitment

Abstract

Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice.

KEYWORDS:

• case management services
• coercion
• community mental health
• community mental health practice
• mental health
• mental health recovery
• mental illness
• serious mental illness