Outpatient Commitment as Both Social Control and Least Restrictive Alternative

Abstract

Outpatient commitment (OPC) permits compulsory outpatient treatment of the mentally ill. This study examines the wider institutional or normative purposes of OPC: greater social control of the mentally ill in the community and a less restrictive environment than inpatient commitment. OPC's ability to meet these contradictory institutional demands—social control and greater individual liberty—is explicated by the institutional theory of organizational activity and based on two data sources. First, case studies of four community mental health centers reveal the organizational beliefs that define OPC as social control and/or a least restrictive patient environment. Second, data collected in North Carolina from patients ordered to OPC and their primary therapists demonstrate that in practice OPC does provide both a least restrictive alternative as well as greater community social control.