“Framed for State Interest”: Professional Perspectives on Forced Medication in Outpatient Competency Restoration

Abstract

This research will examine the opinions of professionals working within systems related to involuntary medication, community behavioral health, and/or competency to stand trial on Sell procedures in outpatient competency restoration in Washington State. Qualitative interviews were conducted (n = 20) with participants and resulting themes were coded and analyzed by the lead researcher. Participants were recruited within Washington State beginning with convenient, key referrals that led to some snowball referrals of their colleagues. Potential participants whose primary, relevant employment was a private practice were excluded. Major findings include 1.) most participants would further explore involuntary medication in Outpatient Competency Restoration, 2.) participants' reflection of individuals who have received involuntary medication showed that their client/patient had a co-occurring Substance Use Disorder (SUD) and/or limited insight into their mental health situation, and 3.) legislative effort and program development in this field should include attention to person-centered assessment and intervention planning and further development of comprehensive, accessible mental health care in jails. A significant relationship was found between a participant’s personal history of themself or a family member being diagnosed with a Serious Mental Illness (SMI) or detained for psychiatric reasons and the decision outcome to remove involuntary medication in OCRP. Participants reported that their personal background with SMI had a neutral or positive affect on their career or approach to working with individuals with an SMI.