title: A randomized trial of a mental health consumer-managed alternative to civil commitment for acute psychiatric crisis.
abstract: This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.
authors.affiliation: Alcohol Research Group, Public Health Institute, 6475 Christie Ave., Suite 400, Emeryville, CA 94608, USA. tgreenfield@arg.org
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Greenfield
authors.forename: Beth C
authors.initials: BC
authors.lastname: Stoneking
authors.forename: Keith
authors.initials: K
authors.lastname: Humphreys
authors.forename: Evan
authors.initials: E
authors.lastname: Sundby
authors.forename: Jason
authors.initials: J
authors.lastname: Bond
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002140:California; D003134:Commitment of Persons with Psychiatric Disorders; D003255:Consumer Organizations / Q000191:economics; D003419:Crisis Intervention; D004637:Emergency Services, Psychiatric / Q000191:economics; D005260:Female; D016352:Group Homes / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010359:Patient Readmission; D017060:Patient Satisfaction; D012649:Self Concept