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Cited by 120Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesSchizophrenia research and treatment

Assessing outcomes for consumers in New York's assisted outpatient treatment program

Swartz, Marvin S., Wilder, Christine M., Swanson, Jeffrey W., Van Dorn, Richard A., Robbins, Pamela Clark, Steadman, Henry J., Moser, Lorna L., Gilbert, Allison R. +1 more·2010·Psychiatric Services
DOI 10.1176/ps.2010.61.10.976
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Abstract

OBJECTIVE: This study examined whether New York State's assisted outpatient treatment (AOT) program, a form of involuntary outpatient commitment, improves a range of policy-relevant outcomes for court-ordered individuals. METHODS: Administrative data from New York State's Office of Mental Health and Medicaid claims between 1999 and 2007 were linked to examine whether consumers under a court order for AOT experienced reduced rates of hospitalization, shorter hospital stays, and improvements in other outcomes. Multivariable analyses controlling for relevant covariates were used to examine the likelihood that AOT produced these effects. RESULTS: On the basis of Medicaid claims and state reports for 3,576 AOT consumers, the likelihood of psychiatric hospital admission was significantly reduced by approximately 25% during the initial six-month court order (odds ratio [OR]=.77, 95% confidence interval [CI]=.72-.82) and by over one-third during a subsequent six-month renewal of the order (OR=.59, CI=.54-.65) compared with the period before initiation of the court order. Similar significant reductions in days of hospitalization were evident during initial court orders and subsequent renewals (OR=.80, CI=.78-.82, and OR=.84, CI=.81-.86, respectively). Improvements were also evident in receipt of psychotropic medications and intensive case management services. Analysis of data from case manager reports showed similar reductions in hospital admissions and improved engagement in services. CONCLUSIONS: Consumers who received court orders for AOT appeared to experience a number of improved outcomes: reduced hospitalization and length of stay, increased receipt of psychotropic medication and intensive case management services, and greater engagement in outpatient services.

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  • Mirror-image studies use people as their own controls and consistently report reduced use of admission and other improved outcomes after placement on a community treatment order.

    “Mirror-image studies use people as their own controls and consistently report reduced use of admission and other improved outcomes after placement on a CTO.”

    From Compulsory community and involuntary outpatient treatment for people with severe mental disorders. (2017) · cites this paper as Swartz 2010

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Authors
Swartz, M. S., Wilder, C. M., Swanson, J. W., Van Dorn, R. A., Robbins, P. C., Steadman, H. J., Moser, L. L., Gilbert, A. R., & Monahan, J.
Affiliations
  • Duke University (US)
  • Policy Research Associates (US)
  • University of Virginia (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2010-10
Volume
61
Issue
10
Pages
976-981
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.2010.61.10.976
OpenAlex
W2142903819
Cited by
120
References
25
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 10 · 2019: 6 · 2018: 11 · 2017: 10 · 2016: 9 · 2015: 14 · 2014: 16 · 2013: 14 · 2012: 5
FWCI
9.81
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
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 › Schizophrenia research and treatment
Keywords
assisted outpatient treatment, involuntary outpatient commitment, court-ordered treatment, psychiatric hospitalization, length of hospital stay, psychotropic drugs, intensive case management, service engagement, Medicaid claims, New York State
MeSH terms
Adult, Ambulatory Care, Mental Disorders, Commitment of Persons with Psychiatric Disorders, Female, Hospitalization, Hospitals, Psychiatric, Humans, Insurance Claim Review, Length of Stay, Male, Middle Aged, New York, Multivariate Analysis, Outcome Assessment, Health Care, Persons with Psychiatric Disorders

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