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Biomedical subjects

P B Fiddleman

Publications and source records attributed to P B Fiddleman.

6 recordsLinked to original sources
PubMed1984

Outpatient commitment: treatment in the least restrictive environment?

Despite the growing emphasis on treatment in the least restrictive environment, states rarely use commitment to outpatient treatment as an alternative to involuntary hospitalization. The authors studied the effects of changes in North Carolina commitment laws that were made in 1979 and designed to facilitate the appropriate use of outpatient commitment. The changes resulted in some increase in the appropriate use of outpatient commitment; nevertheless, clinicians who work at hospitals and community treatment facilities continue to doubt its efficacy. The authors discuss possible reasons for the clinicians' reluctance to use outpatient commitment and attitudinal shifts needed on the part of the general public, professionals, and the judiciary if outpatient commitment is to become a viable alternative.

Ambulatory Care↗
PubMed1983

Emergency involuntary commitment: a look at the decision-making process.

Emergency involuntary commitment is provided in a majority of states to allow for rapid response to patients who are acutely violent and must be hospitalized quickly. The authors investigated the use of emergency hospitalization in North Carolina and found that the majority of petitions executed by law-enforcement officers did not provide adequate evidence for the required criteria. In fact, in many cases the authors noted a marked absence of such criteria. The authors discuss these results and possible reasons for the misuse of the emergency commitment provisions. They stress the importance of cooperation between community mental health professionals and law-enforcement officials in the evaluation of disruptive individuals who may be mentally disordered.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

The effect of witnesses, attorneys, and judges on civil commitment in North Carolina: a prospective study.

A total of 388 commitment hearings were observed and analyzed for demographic information on patients, name of judge, duration of hearing, identities of those present and those actually testifying, outcome of any procedural challenges, and concurrence of the judges with attorney and physician recommendations. Age, race, and gender of the patient were found to have no significant effect on the outcome of the cases. Disposition of the cases correlated with recommendations by physicians, witnesses, and state attorneys in an overwhelming number of cases. Possible harmful influences of plea-bargaining in commitment hearings are discussed.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

Judicial oversight of release of patients committed after being found not competent to stand trial or not guilty by reason of insanity in violent crimes.

In 1981, North Carolina joined a growing number of states in passing legislation requiring judicial concurrence with discharge decisions for civilly committed patients who had been found either not competent to proceed to trial or not guilty by reason of insanity. The authors studied all such patients at one of North Carolina's four state mental hospitals during the first year of the new law's operation, and found that there were only 16 of them. These patients were compared to a control sample of civilly committed patients without criminal charges; it was found that the forensic patients spent longer in the hospital than the controls, but still significantly less time than reported in studies from other states. The authors discuss possible reasons for these differences and comment on the effectiveness of such legislation.

Adult↗