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Cited by 83Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesSchizophrenia research and treatment

New directions in research on involuntary outpatient commitment

Marvin S. Swartz, B J Burns, Virginia Aldigé Hiday, Linda K. George, Jeffrey W. Swanson, Henry Ryan Wagner·1995·Psychiatric Services
DOI 10.1176/ps.46.4.381
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Abstract

OBJECTIVE: Involuntary outpatient commitment has been used as a method of improving tenure in community programs for individuals with severe and persistent mental illness. This paper reviews literature on research about involuntary outpatient commitment and suggests questions and methods for future research. METHODS: Literature describing research studies of involuntary outpatient commitment, located by searching MEDLINE and following up references cited in relevant articles, was reviewed with attention to patient characteristics and diagnostic, treatment, and outcomes measures. RESULTS: Involuntary outpatient commitment appears to provide limited but improved outcomes in rates of rehospitalization and lengths of hospital stay. Variability in community treatment makes interpretation of other types of outcome difficult. Few studies specifically identify results among patients with severe and persistent mental illness. CONCLUSIONS: No studies have examined the extent to which outpatient commitment affects compliance and treatment when essential community services such as case management are consistently and aggressively provided, nor have studies controlled for potentially confounding factors such as treatment and nontreatment effects, including informal coercion. A randomized trial of involuntary outpatient commitment should be useful in evaluating the effectiveness of this type of intervention.

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  • Even when studies have used control groups, it is difficult to know whether to attribute any improvement to compulsory community treatment or to the non-specific effects of increased contact with healthcare professionals.

    “However, even when studies have used control groups, it is difficult to know whether to attribute any improvement to CCT, or to the non-specific effects of increased contact with healthcare professionals (Swartz 1995; Torrey 1995; Geller 1998).”

    From Compulsory community and involuntary outpatient treatment for people with severe mental disorders. (2017) · cites this paper as Swartz 1995

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Authors
Swartz, M. S., Burns, B. J., Hiday, V. A., George, L. K., Swanson, J. W., & Wagner, H. R.
Affiliations
Duke Medical Center (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
1995-04-01
Volume
46
Issue
4
Pages
381-385
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.46.4.381
OpenAlex
W107390816
Cited by
83
References
26
Citations by year
2025: 1 · 2019: 2 · 2017: 2 · 2015: 1 · 2014: 1
FWCI
3.11
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
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 › Schizophrenia research and treatment
Keywords
involuntary outpatient commitment, severe and persistent mental illness, community mental health services, hospital readmission, length of hospital stay, medication adherence, case management, informal coercion, treatment effects
MeSH terms
Ambulatory Care, Mental Disorders, Commitment of Persons with Psychiatric Disorders, Commitment of Mentally Ill, Community Mental Health Services, Humans, Research Design, Treatment Outcome, Risk Assessment, Persons with Psychiatric Disorders, Mentally Ill Persons

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