title: Involuntary outpatient commitment and homelessness in persons with severe mental illness.
abstract: This study took preliminary steps to explore the relationship between involuntary outpatient commitment (OPC) and the risk of homelessness among individuals with severe mental disorders. Involuntarily hospitalized patients were randomly assigned to be released or maintained under OPC following hospital discharge. Multivariate analyses demonstrated that involuntary OPC was associated with a significant decrease in the risk of homelessness during the first 4 months following hospital discharge for participants with severe functional impairment at baseline. OPC did not appear to affect risk of homelessness among participants with mild-to-moderate functional impairment. Co-occurring substance abuse, treatment nonadherence, and outpatient services intensity were found to be strongly associated with episodes of homelessness. This study suggests that involuntary OPC may provide a short-term reduction in the risk of homelessness among a subgroup of treatment-reluctant individuals with severe mental disorders combined with severe functional impairment.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. scompton@duke.edu
authors.forename: Scott N
authors.initials: SN
authors.lastname: Compton
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Swanson
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.forename: Marvin S
authors.initials: MS
authors.lastname: Swartz
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Burns
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
mesh_terms: D000328:Adult; D019090:Case Management; D003134:Commitment of Persons with Psychiatric Disorders; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D010349:Patient Compliance; D010351:Patient Discharge; D011336:Probability; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016896:Treatment Outcome