Does involuntary outpatient commitment lead to more intensive treatment?
Studies of involuntary outpatient commitment (OPC) among persons with severe mental illness have concluded that OPC is only effective in improving treatment outcomes when it is sustained for 6 months or longer and is combined with frequent outpatient services. This article explores factors that influence the delivery of outpatient services to subjects in a randomized trial of OPC and finds 2 general patterns. Outpatient visits were more frequent among all subjects with apparent clinical need, regardless of study assignment, and among subjects whose OPC was sustained beyond an initial court order. These results suggest that, in practice, sustained OPC represents a consensual agreement between clinicians and the court to more intensively address the complex needs of persons with severe and persistent mental illness.
Wagner
H Ryan
HR
Department of Psychiatry and Behavioral Sciences, Duke Univeristy Medical Center, Box 3173, Durham, NC 27710, USA.
Swartz
Marvin S
MS
swanson
Jeffrey W
JW
Burns
Barbara J
BJ
D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D036262:Empirical Research; D005069:Evaluation Studies as Topic; D006801:Humans; D007603:Jurisprudence; D028642:Persons with Psychiatric Disorders; D009657:North Carolina; D010349:Patient Compliance; D011618:Psychotic Disorders / Q000628:therapy; D016896:Treatment Outcome; D014481:United States