Continuing medication and hospitalization outcomes after assisted outpatient treatment in New York.
OBJECTIVE
This study examined whether persons with mental illness who undergo a period of involuntary outpatient commitment continue to receive prescribed medications and avoid psychiatric hospitalization after outpatient commitment ends.


METHODS
Data on Medicaid pharmacy fills and inpatient treatment were used to describe patterns of medication possession and hospitalization for persons with mental illness after they received assisted outpatient treatment (AOT) in New York between 1999 and 2007 (N=3,576). Multivariable time-series analysis was used to compare post-AOT periods to pre-AOT periods.


RESULTS
For former AOT recipients, sustained improvements in rates of medication possession and hospitalization in the post-AOT period varied according to the length of time spent in court-ordered treatment. When the court order for AOT was for six months or less, improved medication possession rates and reduced hospitalization were sustained in the post-AOT period only when intensive case coordination services (assertive community treatment, intensive case management, or both) were kept in place. However, when the court order was for seven months or more, improved medication possession rates and reduced hospitalization outcomes were sustained even when the former AOT recipients were no longer receiving intensive case coordination services.


CONCLUSIONS
Benefits of involuntary outpatient commitment, as indicated by improved rates of medication possession and decreased hospitalizations, were more likely to persist after involuntary outpatient commitment ends if it is kept in place longer than six months.
Van Dorn
Richard A
RA
Department of Mental Health Law and Policy, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 2718, Tampa, FL 33612, USA. rvandorn@fmhi.usf.edu
Swanson
Jeffrey W
JW
Swartz
Marvin S
MS
Wilder
Christine M
CM
Moser
Lorna L
LL
Gilbert
Allison R
AR
Cislo
Andrew M
AM
Robbins
Pamela Clark
PC
D000328:Adult; D000553:Ambulatory Care; D003134:Commitment of Persons with Psychiatric Disorders; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008485:Medical Audit; D055118:Medication Adherence; D001523:Mental Disorders / Q000628:therapy*; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D009518:New York; D017063:Outcome Assessment, Health Care