An ethnographic evaluation of outpatient commitment

This project is an ethnographic examination of clinical decision-making in involuntary outpatient commitment. I confront the longstanding ethical dilemma on whether and how coercion can be justified to achieve medication compliance in psychiatric services. To do so, I performed participant-observations of service delivery in clinical services over a 2-year period. In addition, I interviewed providers and their clients with serious mental illness to understand how their moral reasonings shaped medication use.

In my dissertation, I demonstrate that contemporary rationales for coercion in psychiatric services are to protect vulnerable patient populations from increasing social inequities. By situating this ethical dilemma within the contemporary sociopolitical landscape of social welfare policy, I demonstrate how social work can foster patient autonomy through addressing broader structural determinants of health and vulnerability. My findings will be disseminated in peer-reviewed publications.

The project will also result in additional publications related to community psychiatry, community violence and victimization, and social welfare policy and ethics. 
This project, housed at the UCLA Center for Social Medicine and Humanities and directed by Drs. Joel Braslow and Philippe Bourgois, is a mixed methods evaluation of involuntary outpatient psychiatric services in Los Angeles County.

Upcoming publications

Dougherty, R. J., Kelly, E., Erickson, B., Bourgois, P., & Braslow, J. (In preparation). Violence perpetration and victimization in involuntary outpatient commitment: Social ecological perspectives from an ethnography of Assisted Outpatient Treatment-Los Angeles.

Video presentations


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