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Commentary: Coerced Community Mental Health Treatment—An Added Burden on an Overstretched System

Dr. Dike is Principal Psychiatrist at Whiting Forensic Division of Connecticut Valley Hospital, and Assistant Clinical Professor at the Department of Psychiatry, Law and Psychiatry Division, Yale University School of Medicine, New Haven, CT. Address correspondence to: Charles C. Dike, MD, MRCPsych, MPH, Connecticut Mental Health Center, Law and Psychiatry Division, 34 Park Street, New Haven, CT 06519. E-mail: charles.dike{at}yale.edu

The sudden and massive depopulation of psychiatric institutions that occurred in the 60s and 70s overwhelmed a fragmented and undersourced community mental health system, leading, in part, to the high number of chronically mentally ill individuals currently residing in jails and prisons, a situation that has been described as reinstitutionalization or transinstitutionalization. Any process that forces more people out of jails into mental health treatment in the community without a sound, effective, available, and accessible community mental health system of care is potentially catastrophic.