Impact of outpatient commitment on victimization of people with severe mental illness.
OBJECTIVE
The authors' goal was to evaluate the effectiveness of outpatient commitment in reducing victimization among people with severe mental illness.


METHODS
One hundred eighty-four involuntarily hospitalized patients were randomly assigned to be released (N=99) or to continue under outpatient commitment (N=85) after hospital discharge. An additional group of patients with a recent history of serious violent behavior (N=39) was nonrandomly assigned to at least a brief period of outpatient commitment following hospital disharge. All three groups were followed for 1 year, and case management services plus additional outpatient treatment were provided to all subjects. Outcome data were based on interviews with the patients and informants as well as service records.


RESULTS
Subjects who were ordered to outpatient commitment were less likely to be criminally victimized than those who were released without outpatient commitment. Multivariate analysis indicated that each additional day of outpatient commitment reduced the risk of criminal victimization and that outpatient commitment had its effect through improved medication adherence, reduced substance use or abuse, and fewer violent incidents.


CONCLUSIONS
Protection from criminal victimization appears to be a positive, unintended consequence of outpatient commitment.
Hiday
Virginia Aldigé
VA
Department of Sociology, North Carolina State University, Raleigh 27695, USA. ginny_hiday@ncsu.edu
Swartz
Marvin S
MS
Swanson
Jeffrey W
JW
Borum
Randy
R
Wagner
H Ryan
HR
D000293:Adolescent; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D010349:Patient Compliance / Q000523:psychology; D010351:Patient Discharge; D011336:Probability; D012720:Severity of Illness Index; D013997:Time Factors; D014754:Violence / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data