American Journal of Public Health · 1999 · 610 citations · 10 references
Health ProfessionsBehavioral SciencesPsychologyBehavioral HealthMental Health LawSubstance Use DisordersMental HealthMental IllnessPsychiatric HarmCompetence To Consent To TreatmentCompetence To Make Treatment DecisionsInterview Data AnalysisLegitimate CoercionMajor Depression
The authors investigated how Americans judge the financial and treatment competence of people with mental health problems, their potential for self‑ or other‑harm, and the appropriateness of legal coercion. Using a 1996 General Social Survey nationally representative sample (n = 1,444), respondents were presented with vignettes depicting schizophrenia, major depression, alcohol dependence, drug dependence, or a control case. Americans’ reactions were driven primarily by the specific disorder: they viewed those with depression or “troubles” as competent to decide treatment and manage money, whereas those with alcohol or drug problems or schizophrenia were seen as likely violent and unable to manage finances, leading to a higher willingness to coerce treatment; respondent characteristics had little influence, highlighting a persistent need for public education on dangerousness and coercion.
OBJECTIVES: The authors examined Americans' opinions about financial and treatment competence of people with mental health problems, potential for harm to self or others, and the use of legal means to force treatment. METHODS: The 1996 General Social Survey provided interview data with a nationally representative sample (n = 1444). Respondents were given a vignette based on diagnostic criteria for schizophrenia, major depression, alcohol dependence, or drug dependence, or a "control" case. RESULTS: The specific nature of the problem was the most important factor shaping public reaction. Respondents viewed those with "troubles," alcohol dependence, or depression as able to make treatment decisions. Most reported that persons with alcohol or drug problems or schizophrenia cannot manage money and are likely to be violent toward others. Respondents indicated a willingness to coerce individuals into treatment. Respondent and other case characteristics rarely affected opinions. CONCLUSIONS: Americans report greater concern with individuals who have drug or alcohol problems than with persons who have other mental health problems. Evaluations of dangerousness and coercion indicate a continuing need for public education.
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Violence and mental disorder: developments in risk assessment
Choice Reviews Online · 1994 · 1.4K citations