title: Outcomes associated with court-ordered treatment over objection in an acute psychiatric hospital.
abstract: The postdischarge outcomes of court-ordered treatment of acute psychiatric inpatients have not been adequately investigated. We reviewed the medical records of all patients who refused medication for whom a court order was sought during a recent three-year period, and compared this group to control patients who agreed to treatment and a group of patients who transiently refused medication. The principal outcome measures were successful linkage after discharge, readmission within six months of discharge, and transfer to a state hospital. The study group was less likely to link to an aftercare provider, and more likely to be transferred to a state hospital, had poorer insight on admission, had a longer average stay, and was more likely to utilize mandatory outpatient treatment and long-acting injectable medications after discharge. Patients who require court-ordered medication over objection constitute a group that is high risk for nonadherence after discharge and being refractive to treatment.
authors.affiliation: Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, USA. mruss@nshs.edu
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Russ
authors.forename: Majnu
authors.initials: M
authors.lastname: John
mesh_terms: D000208:Acute Disease; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D005260:Female; D006778:Hospitals, Psychiatric / Q000331:legislation & jurisprudence*; D006801:Humans; D008134:Long-Term Care / Q000331:legislation & jurisprudence; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009518:New York; D010351:Patient Discharge / Q000331:legislation & jurisprudence; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*