Alternatives to outpatient commitment.

The killing of 26 students and teachers in Newtown, Connecticut last year was committed by a young man, Adam Lanza, who took his own life before police could apprehend him. Investigative news reports and articles have stated that Lanza had received a diagnosis of Asperger’s syndrome with sensory integration disorder. Even before significant investigation into Lanza’s past was conducted, however, the tragedy at Newtown rekindled the debate on legal commitment to outpatient treatment (outpatient commitment) for persons with disabling psychiatric disorders who refuse voluntary treatment. In this editorial, I review both pro and con arguments regarding outpatient commitment and the research conducted on it and discuss alternative approaches to addressing the objectives of assuring public safety and providing care for persons at risk of violence to self or others who are not engaged in mental health treatment.