Outcomes of mandated treatment for women with histories of abuse and co-occurring disorders.
Although there is much momentum for behavioral health policies supporting mandated treatment, there is little evidence supporting its safety and effectiveness for individuals with complex issues. The authors used a national study of women with co-occurring psychiatric, substance use disorders and histories of trauma to compare mandated and voluntary treatment by examining psychiatric, substance use, and trauma-related outcomes following treatment. This quasi-experimental study included 2,726 women, with measures completed at baseline, 6-month, and 12-month follow-up. Two-way analyses of covariance examined the main and interactive effects of coercive status (mandated vs. voluntary) and condition (integrated treatment vs. services as usual) on psychiatric distress, trauma-related symptoms, and substance use outcomes. Women did better with integrated treatment and with mandated treatment regardless of treatment condition for psychiatric, trauma, and substance use outcomes at both follow-ups. Further research clarifying unintended side effects and change mechanisms of mandated treatment is needed to inform policy decisions.
Clark
Colleen
C
Department of Mental Health Law and Policy-MHC 2732, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL 33612, USA. cclark@fmhi.usf.edu
Young
M Scott
MS
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D000368:Aged; D000704:Analysis of Variance; D019548:Crime Victims / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D017579:Domestic Violence / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006291:Health Policy; D006801:Humans; D037141:Mandatory Programs; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome; D014836:Volition; D055815:Young Adult