Effects of Legal Mechanisms on Perceived Coercion and Treatment Adherence Among Persons with Severe Mental Illness
Abstract
This study takes preliminary steps to examine the effects of 2 legal mechanisms-outpatient commitment (OPC) and representative payeeship (rep payee)-on perceived coercion and treatment adherence in persons with severe mental illness (SMI). Data were collected in structured interviews from 258 involuntarily-admitted inpatients with SMI who were followed for 1 year after discharge. Subjects' clinicians and family members were also interviewed. The analyses show that subjects with both OPC and a rep payee perceived their mental health treatment to be significantly more coercive than subjects who did not receive these legal interventions. Duration of OPC and having a newly-appointed rep payee were both significantly associated with increased treatment adherence over the course of 1 year. For treatment-adherent subjects, neither form of legal mechanism was associated with perceived coercion in treatment, whereas subjects who were nonadherent perceived legal mechanisms as significantly more coercive. The data suggest that these legal tools both affect adherence to treatment, but when used together significantly increase the perceived coerciveness of treatment. Questions remain concerning the underlying mechanism of these effects.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Two studies found no difference in perceived coercion between patients subjected to outpatient commitment and others.
“though two studies found no difference [56,69].”
From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [56]
Cites
The brief symptom inventory: an introductory report.
Derogatis, L. R., & Melisaratos, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700048017 · Cited by 6,650 · see citing works
The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
Endicott, J. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770060086012 · Cited by 4,982 · see citing works
Violence and Severe Mental Illness: The Effects of Substance Abuse and Nonadherence to Medication
Swartz, M. S., Swanson, J. W., Hiday, V. A., Borum, R., Wagner, H. R., & Burns, B. J. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.2.226 · Cited by 628 · see citing works
Self-citationTwo scales for measuring patients’ perceptions for coercion during mental hospital admission
Gardner, W., Hoge, S. K., Bennett, N., Roth, L. H., Lidz, C. W., Monahan, J., & Mulvey, E. P. (1993) · Behavioral Sciences & the Law · doi:10.1002/bsl.2370110308 · Cited by 342 · see citing works
Swartz, M. S., Swanson, J. W., Wagner, H. R., Burns, B. J., Hiday, V. A., & Borum, R. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.12.1968 · Cited by 337 · see citing works
Self-citationAssessing the New York City involuntary outpatient commitment pilot program
Steadman, H. J., Gounis, K., Dennis, D., Hopper, K., Roche, B., Swartz, M., & Robbins, P. C. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.3.330 · Cited by 312 · see citing works
Self-citationSwanson, J. W., Swartz, M. S., Wagner, H. R., Burns, B. J., Borum, R., & Hiday, V. A. (2000) · The British Journal of Psychiatry · doi:10.1192/bjp.176.4.324 · Cited by 266 · see citing works
Self-citationMonahan, J. T., Hoge, S. K., Lidz, C. W., Roth, L. H., Bennett, N. S., Gardner, W. P., & Mulvey, E. P. (1995) · International Journal of Law and Psychiatry · doi:10.1016/0160-2527(95)00010-f · Cited by 247 · see citing works
Mandated Community Treatment: Beyond Outpatient Commitment
Monahan, J. T., Bonnie, R. J., Appelbaum, P. S., Hyde, P. S., Steadman, H. J., & Swartz, M. S. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.9.1198 · Cited by 199 · see citing works
Self-citationCan Involuntary Outpatient Commitment Reduce Arrests among Persons with Severe Mental Illness?
Swanson, J. W., Borum, R., Swartz, M. S., Hiday, V. A., Wagner, H. R., & Burns, B. J. (2001) · Criminal Justice and Behavior · doi:10.1177/0093854801028002002 · Cited by 158 · see citing works
Self-citationShaner, A., Eckman, T., Roberts, L. J., Wilkins, J. N., Tucker, D., Tsuang, J., & Mintz, J. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509213331207 · Cited by 155 · see citing works
Law & Psychiatry: Mental Health Courts: Their Promise and Unanswered Questions
Steadman, H. J., Davidson, S. K., & Brown, C. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.4.457 · Cited by 154 · see citing works
Psychiatric Advance Directives: An Alternative to Coercive Treatment?
Swanson, J. W., Tepper, M. C., Backlar, P., & Swartz, M. S. (2000) · Psychiatry · doi:10.1080/00332747.2000.11024908 · Cited by 106 · see citing works
Self-citationA national survey of the use of outpatient commitment
(1995) · Psychiatric Services · doi:10.1176/ps.46.8.778 · Cited by 98 · see citing works
Shaner, A. L., Roberts, L. J., Eckman, T. A., Tucker, D. E., TSUANG, J. W., WILKINS, J. N., & Mintz, J. (1997) · Psychiatric Services · doi:10.1176/ps.48.6.807 · Cited by 98 · see citing works
Impact of Involuntary Outpatient Commitment on the Revolving-Door Syndrome in North Carolina
Fernandez, G. A., & Nygard, S. (1990) · Psychiatric Services · doi:10.1176/ps.41.9.1001 · Cited by 96 · see citing works
The South African truth and reconciliation commission as a therapeutic tool
Allan, A., & Allan, M. M. (2000) · Behavioral Sciences & the Law · doi:10.1002/1099-0798(2000)18:4 · Cited by 86 · see citing works
Swartz, M. S., Swanson, J. W., Wagner, H. R., Burns, B. J., & Hiday, V. A. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200109000-00003 · Cited by 84 · see citing works
Self-citationAdvance Directives for Psychiatric Treatment
Appelbaum, P. S. (1991) · Psychiatric Services · doi:10.1176/ps.42.10.983 · Cited by 78 · see citing works
The efficacy of involuntary outpatient treatment in Massachusetts
Geller, J., Grudzinskas, A. J., McDermeit, M., Fisher, W. H., & Lawlor, T. (1998) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1023/a:1022239322212 · Cited by 61 · see citing works
Impact of representative payees on substance use by homeless persons with serious mental illness
Rosenheck, R. A., Lam, J., & Randolph, F. (1997) · Psychiatric Services · doi:10.1176/ps.48.6.800 · Cited by 59 · see citing works
Representative payee practices of community mental health centers in Washington State
Ries, R. K., & Dyck, D. G. (1997) · Psychiatric Services · doi:10.1176/ps.48.6.811 · Cited by 55 · see citing works
Luchins, D. J., Hanrahan, P. A., Conrad, K. J., Savage, C., Matters, M. D., & Shinderman, M. S. (1998) · Psychiatric Services · doi:10.1176/ps.49.9.1218 · Cited by 53 · see citing works
When Disability Benefits Make Patients Sicker
Satel, S. L. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509213331210 · Cited by 51 · see citing works
Case Managers' and Clients' Perspectives on a Representative Payee Program
Dixon, L. B., Turner, J., Krauss, N., Scott, J. R., & McNary, S. W. (1999) · Psychiatric Services · doi:10.1176/ps.50.6.781 · Cited by 45 · see citing works
Frisman, L. K., & Rosenheck, R. (1997) · Psychiatric Services · doi:10.1176/ps.48.6.792 · Cited by 44 · see citing works
Substance Use and Assignment of Representative Payees
Rosen, M. I., & Rosenheck, R. (1999) · Psychiatric Services · doi:10.1176/ps.50.1.95 · Cited by 39 · see citing works
Ries, R. K., & Comtois, K. A. (1997) · American Journal on Addictions · doi:10.3109/10550499709005064 · Cited by 37 · see citing works
Ries, R. K., & Comtois, K. A. (1997) · American Journal on Addictions · doi:10.1111/j.1521-0391.1997.tb00414.x · Cited by 37 · see citing works
The Therapist as Representative Payee
Brotman, A. W., & Muller, J. J. (1990) · Psychiatric Services · doi:10.1176/ps.41.2.167 · Cited by 33 · see citing works
Characteristics of Third-Party Money Management for Persons With Psychiatric Disabilities
Elbogen, E. B., Swanson, J. W., Swartz, M. S., et al. (2003) · Psychiatric Services · doi:10.1176/appi.ps.54.8.1136 · Cited by 33 · see citing works
Self-citationDisability patterns among SSI recipients.
Kochhar, S., & Scott, C. G. (1995) · PubMed · Cited by 32 · see citing works
Money Management Services for the Homeless Mentally Ill
Stoner, M. R. (1989) · Psychiatric Services · doi:10.1176/ps.40.7.751 · Cited by 28 · see citing works
Mental health court: promises and limitations.
Watson, A. C., Luchins, D. J., Hanrahan, P. A., et al. (2000) · PubMed · Cited by 26 · see citing works
Preventive Commitment: The Concept and Its Pitfalls
Stefan, S. (2016) · DigitalGeorgetown (Georgetown University Library) · Cited by 19 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Stanhope, V., Marcus, S., & Solomon, P. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.2.183 · Cited by 36 · see citing works
Leverage, the Treatment Relationship, and Treatment Participation
McNiel, D. E., Gormley, B., & Binder, R. L. (2013) · Psychiatric Services · doi:10.1176/appi.ps.201200368 · Cited by 21 · see citing works
Coercion in Outpatients under Community Treatment Orders: A Matched Comparison Study
Nakhost, A., Sirotich, F., Pridham, K. M. F., Stergiopoulos, V., & Simpson, A. I. F. (2018) · The Canadian Journal of Psychiatry · doi:10.1177/0706743718766053 · Cited by 19 · see citing works
Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review
Lessard-Deschênes, C., Pariseau-Legault, P., Billé, V., Sergerie-Richard, S., Hudson, E., Silva, B., Drouin, J.-S., Désilets, M., & Goulet, M.-H. (2025) · Healthcare · doi:10.3390/healthcare13151868 · Cited by 10 · see citing works
- Authors
- Elbogen, E. B., Swanson, J. W., & Swartz, M. S.
- Affiliations
- Duke Medical Center (US)
- Duke University (US)
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2003-10
- Volume
- 191
- Issue
- 10
- Pages
- 629-637
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2041496862
- Cited by
- 56
- References
- 35
- Citations by year
- 2025: 2 · 2024: 2 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 1 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 6.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh048103-08, 5p50mh051410-05)
- National Institute of Mental Health (MH48103, MH51410)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- outpatient commitment, perceived coercion, medication adherence, severe mental illness, involuntary psychiatric admission, legal mechanisms, family involvement in treatment
- MeSH terms
- Adolescent, Adult, Mental Disorders, Coercion, Commitment of Persons with Psychiatric Disorders, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Perception, Confidence Intervals, Chi-Square Distribution, Logistic Models, Odds Ratio
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
