title: Outcomes of mandated treatment for women with histories of abuse and co-occurring disorders.
abstract: 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.
authors.affiliation: 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
authors.forename: Colleen
authors.initials: C
authors.lastname: Clark
authors.forename: M Scott
authors.initials: MS
authors.lastname: Young
mesh_terms: 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