Court-mandated treatment: dilemmas for hospital psychiatry

The authors present clinical material to illustrate the special treatment and management problems posed by different types of mentally ill offenders; they suggest that court-mandated hospital treatment is often destructive and unrelated to the needs of the patient, the community, and the mental institution. The failure to create new kinds of institutions, combining modalities derived from the hospital and correctional systems, is traced to poor communication among the disciplines involved. The "mentally ill offender" is caught in the interplay of these systems and is consequently both their victim and victimizer.