91172.pdf

176 7 Court and the Legal System—-Civil Forensics

often left to state mental hospitals. Thus, mental health professionals are the primary
figures in LRA decisions. It is, however, unlikely that such professionals would opt
against drug treatment or confinement in psychiatric hospitals when questions arise
concerning treatment. Doing so would essentially require mental health profes-
sionals to admit that their current methods of treatment are, perhaps, ineffective or
only marginally effective. Thus, it seems unlikely that recommendations by the very
people in charge of the decisions would include options other than the conventional
restrictive settings and treatment methods.
In general, then, much of the disagreement concerning the LRA doctrine can
be regarded as a fundamental difference in perspective. The legal goal is to minimize
intrusions of liberty, while the clinical goal is to determine the most effective treat-
ment available for the mentally ill individual and, subsequently, to implement that
treatment plan (Munetz & Geller, 1993). Thus, the goals of the legal system and
the mental health system may often be in conflict with one another. The concept
of LRA requires involvement by the mental health field, ascertaining what the least
invasive and most effective psychiatric intervention is, as well as deciding what the
least restrictive environment is for that treatment. Thus, effective policy analysis and
implementation of new policy requires the insight of both psychological, medical,
and legal scholars. Forensic psychology, perhaps, provides this insight by addressing
both mental health and legal issues from within one framework.

Suggestions for Future Research

Based on the literature concerning the LRA doctrine, several important consid-
erations are apparent when questioning its future status. First, it is necessary to
determine exactly what "restrictive" implies. As discussed earlier, there has been
considerable debate questioning what settings and treatments (and combinations
thereof) are, in fact, less restrictive. The answer depends on the needs of the in-
dividual in question. Thus, methods of relating "least restrictive" to the specific
necessities of the individual become crucial in the future employment of the LRA
doctrine. In this sense, psychology and law must realize that the resolution of the
issue requires joint cooperation. Future research must explore the differences in-
herent in each of these disciplines and calculate ways to reach mutual agreement on
what the LRA doctrine implies for given individuals.
Second, and related to the first issue, is the need for more empirical research
concerning individuals who have been affected by the doctrine. In other words,
what are the experiences of individuals who have been subjected to commitment
(both hospitalization and outpatient) compared to those in community facilities
and the like? Are there fundamental differences in individual well-being, treatment
effectiveness, and feelings of self-determination? While legal and mental health
scholars continue to debate the issue, the input of the very persons affected by the
doctrine have been somewhat neglected. Additional research in these two areas may