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Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model.

Publication ,  Journal Article
Swanson, JW; Swartz, MS; George, LK; Burns, BJ; Hiday, VA; Borum, R; Wagner, HR
Published in: J Am Acad Psychiatry Law
1997

Many experimental trials of community mental health interventions fail to develop testable conceptual models of the specific mechanisms and pathways by which relevant outcomes may occur, thus falling short of usefully interpreting what happens inside the experimental "black box." This paper describes a conceptual model of involuntary outpatient commitment (OPC) for persons with severe and persistent mental disorders. The model represents an attempt to "unpack" the effects of OPC by incorporating several interacting variables at various stages. According to this model, court-mandated outpatient treatment may improve long-term outcomes both directly and indirectly in several ways: by stimulating case management efforts, mobilizing supportive resources, improving individual compliance with treatment in the community, reducing clients' psychiatric symptoms and dangerous behavior, improving clients' social functioning, and finally by reducing the chance of illness relapse and rehospitalization. A randomized clinical trial of OPC is underway in North Carolina that will test the direct and indirect effects suggested by this model, using longitudinal data from the multiple perspectives of mental health clients, family members, and case managers.

Duke Scholars

Published In

J Am Acad Psychiatry Law

ISSN

1093-6793

Publication Date

1997

Volume

25

Issue

1

Start / End Page

5 / 16

Location

United States

Related Subject Headings

  • Recurrence
  • Personal Autonomy
  • Paternalism
  • Outcome and Process Assessment, Health Care
  • North Carolina
  • Mentally Ill Persons
  • Mental Disorders
  • Longitudinal Studies
  • Humans
  • Follow-Up Studies
 

Citation

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Swanson, J. W., Swartz, M. S., George, L. K., Burns, B. J., Hiday, V. A., Borum, R., & Wagner, H. R. (1997). Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model. J Am Acad Psychiatry Law, 25(1), 5–16.
Swanson, J. W., M. S. Swartz, L. K. George, B. J. Burns, V. A. Hiday, R. Borum, and H. R. Wagner. “Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model.J Am Acad Psychiatry Law 25, no. 1 (1997): 5–16.
Swanson JW, Swartz MS, George LK, Burns BJ, Hiday VA, Borum R, et al. Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model. J Am Acad Psychiatry Law. 1997;25(1):5–16.
Swanson, J. W., et al. “Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model.J Am Acad Psychiatry Law, vol. 25, no. 1, 1997, pp. 5–16.
Swanson JW, Swartz MS, George LK, Burns BJ, Hiday VA, Borum R, Wagner HR. Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model. J Am Acad Psychiatry Law. 1997;25(1):5–16.

Published In

J Am Acad Psychiatry Law

ISSN

1093-6793

Publication Date

1997

Volume

25

Issue

1

Start / End Page

5 / 16

Location

United States

Related Subject Headings

  • Recurrence
  • Personal Autonomy
  • Paternalism
  • Outcome and Process Assessment, Health Care
  • North Carolina
  • Mentally Ill Persons
  • Mental Disorders
  • Longitudinal Studies
  • Humans
  • Follow-Up Studies