Scholars@Duke
Jeffrey W. Swanson

Jeffrey W. Swanson

Professor in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
jeffrey.swanson@duke.edu
Box 102505 Duke University Medical Center, Durham, NC 27705
Physical Address: 2400 Pratt Street, Room 6035, Postal Address: Box 102505 DUMC, Durham, NC 27705

Selected Publications

A Case Study of Maine's Risk-Based Firearm Removal Law.

Journal Article Milbank Q · November 2025 UNLABELLED: Policy Points Risk-based firearm removal laws are an effective policy tool to reduce firearm-related suicides. Unlike 21 other states with such laws, Maine's firearm removal statute applies only to persons who have been detained by law enforcem ... Full text Link to item Cite

Firearm Disqualification and Rights Restoration Among Adults with Mental Illness in Virginia.

Journal Article J Am Acad Psychiatry Law · September 3, 2025 This study evaluated legal prohibitions on firearm possession in a population of 128,090 adults in Virginia with a serious mental illness and record of at least one psychiatric hospitalization between 1998 and 2015. Approximately half the study population ... Full text Link to item Cite

Extreme risk protection order use in six US states: a descriptive study.

Journal Article Inj Epidemiol · June 3, 2025 OBJECTIVES: Extreme Risk Protection Orders (ERPOs) are civil court orders that temporarily prohibit firearm purchase and possession by someone ("respondent") at imminent risk of harming themselves or others. Despite ERPOs being currently available in 21 st ... Full text Link to item Cite

Do Children's Mental Health Symptoms Impact Their Access to Unlocked Guns at Home?

Journal Article J Am Acad Child Adolesc Psychiatry · April 23, 2025 OBJECTIVE: To test whether changes in children's and adolescents' mental health symptoms predict changes in their access to unlocked guns at home. METHOD: This study used data from a longitudinal cohort study of 1,420 youth and their parents in the southea ... Full text Link to item Cite

Clinical and Social Functioning Outcomes of Assisted Outpatient Treatment: Results From a Multisite Evaluation.

Journal Article Psychiatr Res Clin Pract · 2025 OBJECTIVE: This study used data from a multi-site evaluation of six assisted outpatient treatment (AOT) programs to assess the effectiveness of AOT on treatment adherence, clinical functioning, and social functioning outcomes. METHODS: Sites provided prima ... Full text Link to item Cite

Extreme Risk Protection Orders as Criminal Deflection and Diversion.

Journal Article Inquiry · 2025 The extreme risk protection order (ERPO) was conceived initially as a civil restraining order to temporarily suspend access to firearms for individuals behaving dangerously who are not otherwise legally barred from gun possession by a felony conviction or ... Full text Link to item Cite

A multi-state evaluation of extreme risk protection orders: a research protocol.

Journal Article Inj Epidemiol · September 9, 2024 BACKGROUND: Extreme Risk Protection Orders (ERPOs) are civil court orders that prohibit firearm purchase and possession when someone is behaving dangerously and is at risk of harming themselves and/or others. As of June 2024, ERPOs are available in 21 stat ... Full text Link to item Cite

Suicide Prevention Effects of Extreme Risk Protection Order Laws in Four States.

Journal Article J Am Acad Psychiatry Law · September 3, 2024 More than half of suicide deaths in the United States result from self-inflicted firearm injuries. Extreme risk protection order (ERPO) laws in 21 states and the District of Columbia temporarily limit access to firearms for individuals found in a civil cou ... Full text Link to item Cite

Extreme Risk Protection Orders in Connecticut, 2013-2020.

Journal Article J Am Acad Psychiatry Law · June 4, 2024 Twenty-one states and the District of Columbia have enacted Extreme Risk Protection Order (ERPO) statutes, which allow temporary removal of firearms from individuals who pose an imminent risk of harm to themselves or others. Connecticut was the first state ... Full text Link to item Cite

Mental and Substance Use Disorders Prevalence Study: Background and Methods

Journal Article International Journal of Methods in Psychiatric Research · March 1, 2024 Objective: The Mental and Substance Use Disorders Prevalence Study (MDPS) builds upon previous epidemiologic studies to provide estimates of prevalence and treatment rates of mental and substance use disorders among adults aged 18–65 in the U.S. The study ... Full text Cite

Extreme Risk Protection Orders in Older Adults in Six U.S. States: A Descriptive Study.

Journal Article Clin Gerontol · 2024 OBJECTIVES: Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide ... Full text Link to item Cite

Diversion to Treatment when Treatment is Scarce: Bioethical Implications of the U.S. Resource Gap for Criminal Diversion Programs.

Journal Article J Law Med Ethics · 2024 Despite significant scholarship, research, and funding dedicated to implementing criminal diversion programs over the past two decades, persons with serious mental illness and substance use disorders remain substantially overrepresented in United States ja ... Full text Link to item Cite

Violent Experiences and Patterns of Firearm Ownership From Childhood to Young Adulthood.

Journal Article JAMA Netw Open · October 2, 2023 IMPORTANCE: Young adults in their 20s are at high relative risk for self- and other-directed firearm injury, but little is known about gun access patterns for this group. OBJECTIVE: To describe the longitudinal patterns of firearm access from childhood to ... Full text Link to item Cite

American Gun Violence & Mental Illness: Reducing Risk, Restoring Health, Respecting Rights & Reviving Communities

Journal Article Daedalus · September 1, 2023 Intentional injuries claimed nearly two hundred lives every day in the United States in 2020, about two-thirds of them suicides, each a story of irretrievable human loss. This essay addresses the complex intersection of injurious behavior with mental illne ... Full text Cite

Adult criminal outcomes of juvenile justice involvement.

Journal Article Psychol Med · June 2023 BACKGROUND: The juvenile justice system in the USA adjudicates over seven hundred thousand youth in the USA annually with significant behavioral offenses. This study aimed to test the effect of juvenile justice involvement on adult criminal outcomes. METHO ... Full text Link to item Cite

Policing and Behavioral Health Conditions

Journal Article Law and Contemporary Problems · 2023 Link to item Cite

NORTH CAROLINA LAW ENFORCEMENT ASSISTED DIVERSION (LEAD): CONSIDERATIONS FOR OPTIMIZING ELIGIBILITY AND REFERRAL

Journal Article Law and Contemporary Problems · January 1, 2023 In 2011, a diverse group of stakeholders in Seattle, Washington, developed an alternative to repeated arrests and incarceration of people whose low-level unlawful conduct stemmed from unmet behavioral health needs, launching a new model called Law Enforcem ... Cite

Balancing the Roles of Clinicians and Police in Separating Firearms from People in a Dangerous Mental Health Crisis: Legal Rules, Policy Tools, and Ethical Considerations.

Conference J Law Med Ethics · 2023 In COVID's immediate wake, the 2020 death toll from a different enemy of the public's health - gun violence - ticked up by 15 percent in the United States from the previous year. Meanwhile, the U.S. Supreme Court issued an opinion in Caniglia v. Strom that ... Full text Link to item Cite

Gun violence among young adults with a juvenile crime record in North Carolina: Implications for firearm restrictions based on age and risk.

Journal Article Prev Med · December 2022 Youth who acquire a juvenile crime record may be at increased risk of perpetrating gun violence as adults. North Carolina and 22 other states permit young adults who were adjudicated by a juvenile court - even for some felony-equivalent offenses - to legal ... Full text Link to item Cite

Extreme risk protection orders in response to threats of multiple victim/mass shooting in six U.S. states: A descriptive study.

Journal Article Prev Med · December 2022 Extreme risk protection orders (ERPOs), also known as red flag laws, are a potential tool to prevent firearm violence, including mass shootings, but little is currently known about the extent of their use in cases of mass shooting threats or about the thre ... Full text Link to item Cite

Appropriateness of psychiatric advance directives facilitated by peer support specialists and clinicians on Assertive Community Treatment teams.

Journal Article J Ment Health · April 2022 BACKGROUND: Psychiatric advance directives (PADs) are used to document a person's treatment preferences for a future mental health crisis. Peer support specialists have been proposed to facilitate PADs, but little is known about the quality of peer versus ... Full text Link to item Cite

North Carolina Specialty Courts, Treatment Access, and the Substance Use Crisis: A Promising but Underfunded Model.

Journal Article Psychiatr Serv · December 1, 2021 Treatment courts aim to reduce criminal recidivism by addressing the behavioral health care needs of persons with psychiatric or substance use disorders that contribute to their offending. Stable funding and access to behavioral health providers are crucia ... Full text Link to item Cite

Impact of psychiatric advance directive facilitation on mental health consumers: empowerment, treatment attitudes and the role of peer support specialists.

Journal Article J Ment Health · October 2021 BACKGROUND: A psychiatric advance directive (PAD) is designed to prevent involuntary mental health interventions by enabling people with serious mental illnesses to plan ahead for their own treatment during a future incapacitating crisis. This study implem ... Full text Link to item Cite

Childhood Gun Access, Adult Suicidality, and Crime.

Journal Article Pediatrics · August 2021 OBJECTIVES: To test the associations of childhood domestic gun access with adult criminality and suicidality. METHODS: Analyses were based on a 20+ year prospective, community-representative study of 1420 children, who were assessed up to 8 times during ch ... Full text Link to item Cite

Preventing Suicide Through Better Firearm Safety Policy in the United States.

Journal Article Psychiatr Serv · February 1, 2021 The U.S. suicide rate continues to increase, despite federal investment in developing preventive behavioral health care interventions. Important determinants of suicide-social, economic, and circumstantial-have little or no connection to psychopathology. F ... Full text Link to item Cite

Implementing Psychiatric Advance Directives: The Transmitter and Receiver Problem and the Neglected Right to Be Deemed Incapable.

Journal Article Psychiatr Serv · February 1, 2021 Psychiatric advance directives (PADs) can help adults with serious mental illnesses preserve their autonomy and avoid involuntary interventions during an incapacitating mental health crisis. A PAD is a legal document prepared while mentally competent and s ... Full text Open Access Link to item Cite

Introduction: Violence and Mental Illness.

Journal Article Harv Rev Psychiatry · January 2021 Full text Link to item Cite

Gun-Related and Other Violent Crime After Involuntary Commitment and Short-Term Emergency Holds.

Journal Article J Am Acad Psychiatry Law · December 2020 This article presents a survival analysis of long-term risk of firearm-related and other violent crime in a large sample of adults with serious mental illness in Florida, comparing those who received a gun-disqualifying civil commitment after a short-term ... Full text Link to item Cite

The color of risk protection orders: gun violence, gun laws, and racial justice.

Journal Article Inj Epidemiol · August 10, 2020 BACKGROUND: Extreme risk protection order (ERPO) laws give municipal police officers new authority, through a civil restraining order, to remove firearms from people who are deemed to pose an imminent risk of causing serious harm to others or themselves. D ... Full text Link to item Cite

Gender-specific participation and outcomes among jail diversion clients with co-occurring substance use and mental health disorders.

Journal Article J Subst Abuse Treat · August 2020 Men and women with co-occurring substance use disorders and mental illness are at relatively high risk for becoming involved in the criminal justice system. Programs, such as post-booking jail diversion, aim to connect these individuals to community-based ... Full text Link to item Cite

Correlates of Future Violence in People Being Treated for Schizophrenia.

Journal Article Am J Psychiatry · September 1, 2019 OBJECTIVE: Violent behavior is infrequent among individuals with schizophrenia but is clinically important. The purpose of this study was to provide data on the correlates of violence, which may allow better risk assessment and care. METHODS: A total of 1, ... Full text Link to item Cite

Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law.

Journal Article J Am Acad Psychiatry Law · June 2019 This article examines the application and effectiveness of a 2006 Indiana law designed to prevent gun violence by authorizing police officers to separate firearms from persons who present imminent or future risk of injury to self or others, or display a pr ... Full text Link to item Cite

Simulating the Suicide Prevention Effects of Firearms Restrictions Based on Psychiatric Hospitalization and Treatment Records: Social Benefits and Unintended Adverse Consequences.

Journal Article Am J Public Health · June 2019 Objectives. To estimate the number of lives saved from firearms suicide with expansions of gun restrictions based on mental health compared with the number who would be unnecessarily restricted. Methods. Agent-based models simulated effects on suicide mort ... Full text Link to item Cite

Lawyers at the Peak of Their Careers: A 30-Year Longitudinal Study of Job and Life Satisfaction

Journal Article Journal of Empirical Legal Studies · March 1, 2019 A decade ago, we conducted a 20-year longitudinal study of career and life satisfaction among the class matriculating at the University of Virginia School of Law in 1987. Here, we extend our repeated measures follow-up from 20 to 30 years—from the time whe ... Full text Cite

Lawyers at the Peak of Their Careers: A 30-Year Longitudinal Study of Job and Life Satisfaction

Journal Article Virginia Public Law and Legal Theory Research Paper · October 1, 2018 Cite

Informing Federal Policy on Firearm Restrictions for Veterans with Fiduciaries: Risk Indicators in the Post-Deployment Mental Health Study.

Journal Article Adm Policy Ment Health · July 2018 This article examines the public safety rationale for a federal policy of prohibiting gun sales to veterans with psychiatric disabilities who are assigned a fiduciary to manage their benefits from the Department of Veterans Affairs. The policy was evaluate ... Full text Link to item Cite

Medication-Assisted Treatment for Alcohol-Dependent Adults With Serious Mental Illness and Criminal Justice Involvement: Effects on Treatment Utilization and Outcomes.

Journal Article Am J Psychiatry · July 1, 2018 OBJECTIVE: Adults with serious mental illness and comorbid alcohol dependence are at high risk for both high utilization of crisis-driven health care services and criminal justice involvement. Evidence-based medication-assisted treatment (MAT) for alcohol ... Full text Link to item Cite

Associations between pharmacotherapy for opioid dependence and clinical and criminal justice outcomes among adults with co-occurring serious mental illness.

Journal Article J Subst Abuse Treat · March 2018 Adults suffering from a serious mental illness (SMI) and a substance use disorder are at especially high risk for poor clinical outcomes and also arrest and incarceration. Pharmacotherapies for treating opioid dependence could be a particularly important m ... Full text Link to item Cite

Randomised controlled trials and outpatient commitment.

Journal Article Lancet Psychiatry · December 2017 Full text Link to item Cite

Prohibition of Persons With Mental Illness From Gun Ownership Under Tyler.

Journal Article J Am Acad Psychiatry Law · December 2017 The U.S. Supreme Court's Heller and McDonald decisions are the most important legal affirmations of the right of U.S. citizens to possess and bear firearms under the Second Amendment. Heller and McDonald are also significant in citing persons with mental i ... Link to item Cite

Facilitation of Psychiatric Advance Directives by Peers and Clinicians on Assertive Community Treatment Teams.

Journal Article Psychiatr Serv · July 1, 2017 OBJECTIVE: Psychiatric advance directives (PADs) provide a legal mechanism for competent adults to document care preferences and authorize a surrogate to make treatment decisions. In a controlled research setting, an evidence-based intervention, the facili ... Full text Open Access Link to item Cite

Involuntary Outpatient Commitment and the Elusive Pursuit of Violence Prevention.

Journal Article Can J Psychiatry · February 2017 OBJECTIVE: Involuntary outpatient commitment (OPC)-also referred to as 'assisted outpatient treatment' or 'community treatment orders'-are civil court orders whereby persons with serious mental illness and repeated hospitalisations are ordered to adhere to ... Full text Link to item Cite

A Randomized Clinical Trial of a Money Management Intervention for Veterans With Psychiatric Disabilities.

Journal Article Psychiatr Serv · October 1, 2016 OBJECTIVE: The study evaluated an intervention to help veterans with psychiatric disabilities, who face a unique set of challenges concerning money management. METHODS: A randomized clinical trial was conducted of a brief (one to three hours) psychoeducati ... Full text Link to item Cite

On Thoughts, Threats, and Throwing the Spear.

Journal Article Schizophr Bull · July 2016 Full text Link to item Cite

Gun Violence, Mental Illness, And Laws That Prohibit Gun Possession: Evidence From Two Florida Counties.

Journal Article Health Aff (Millwood) · June 1, 2016 Gun violence kills about ninety people every day in the United States, a toll measured in wasted and ruined lives and with an annual economic price tag exceeding $200 billion. Some policy makers suggest that reforming mental health care systems and improvi ... Full text Link to item Cite

State Laws on Emergency Holds for Mental Health Stabilization.

Journal Article Psychiatr Serv · May 1, 2016 OBJECTIVE: Psychiatric emergency hold laws permit involuntary admission to a health care facility of a person with an acute mental illness under certain circumstances. This study documented critical variation in state laws, identified important questions f ... Full text Link to item Cite

Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness.

Journal Article Psychiatr Serv · September 2015 The impact of criminal justice involvement and clinical characteristics on the cost of public treatment services for adults with serious mental illnesses is unknown. The authors examined differential effects of justice involvement on behavioral health trea ... Full text Link to item Cite

Guns, Impulsive Angry Behavior, and Mental Disorders: Results from the National Comorbidity Survey Replication (NCS-R).

Journal Article Behav Sci Law · June 2015 Analyses from the National Comorbidity Study Replication provide the first nationally representative estimates of the co-occurrence of impulsive angry behavior and possessing or carrying a gun among adults with and without certain mental disorders and demo ... Full text Link to item Cite

Guns, Mental Illness, and the Law: Introduction to This Issue.

Journal Article Behav Sci Law · June 2015 Firearm violence is a top-tier public health problem in the U.S., killing 33,563 and injuring an additional 81,396 people in 2012 (Centers for Disease Control and Prevention, CDC, ). Given constitutional protection and the cultural entrenchment of private ... Full text Link to item Cite

Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy.

Journal Article Ann Epidemiol · May 2015 Featured Publication PURPOSE: This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness ... Full text Link to item Cite

Mental illness and reduction of gun violence and suicide: Bringing epidemiologic research to policy

Journal Article Annals of Epidemiology · 2015 © 2015 The Authors.Purpose: This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and eval ... Full text Cite

Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations.

Journal Article Am J Public Health · November 2014 Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. T ... Full text Link to item Cite

Treatment participation and medication adherence: effects on criminal justice costs of persons with mental illness.

Journal Article Psychiatr Serv · October 2014 Featured Publication Little empirical research has directly examined the extent to which early and consistent participation in outpatient services and adherence to prescribed psychotropic medications after a psychiatric hospitalization can help people with serious mental illne ... Full text Link to item Cite

Patterns of justice involvement among adults with schizophrenia and bipolar disorder: key risk factors.

Journal Article Psychiatr Serv · July 2014 Featured Publication OBJECTIVE: Adults with serious mental illness have a relatively high risk of criminal justice involvement. Some risk factors for justice involvement are known, but the specific interaction of these risk factors has not been examined. This study explored th ... Full text Link to item Cite

Why the evidence for outpatient commitment is good enough.

Journal Article Psychiatr Serv · June 1, 2014 Featured Publication After nearly three decades of studies evaluating the legal practice of involuntary outpatient commitment, there is yet little consensus about its effectiveness and only limited implementation. Debate continues over how best to assist adults with serious me ... Full text Link to item Cite

Coercion and compulsion in mental healthcare-an international perspective.

Journal Article Asian J Psychiatr · April 2014 BACKGROUND: Coercion has always existed in psychiatry and is increasingly debated. The 'move into the community' in many countries over recent decades and the evolution of community services have substantially altered the locus of coercion. In many countri ... Full text Link to item Cite

Response to Burns.

Journal Article Am J Psychiatry · February 2014 Full text Link to item Cite

The cost of assisted outpatient treatment: can it save states money?

Journal Article Am J Psychiatry · December 2013 Featured Publication OBJECTIVE: The authors assessed a state's net costs for assisted outpatient treatment, a controversial court-ordered program of community-based mental health services designed to improve outcomes for persons with serious mental illness and a history of rep ... Full text Link to item Cite

Critical opportunities for public health law: a call for action.

Journal Article Am J Public Health · November 2013 Featured Publication Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key cr ... Full text Link to item Cite

Adverse impact of coercive treatments on psychiatric inpatients' satisfaction with care.

Journal Article Community Ment Health J · August 2013 Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient ca ... Full text Link to item Cite

Costs of criminal justice involvement among persons with serious mental illness in connecticut.

Journal Article Psychiatr Serv · July 1, 2013 Featured Publication OBJECTIVE: This study sought to describe patterns and costs of criminal justice involvement among adults with serious mental illness who received services across public agencies within a single state. Costs were examined from the perspective of state agenc ... Full text Link to item Cite

A survey of stakeholder knowledge, experience, and opinions of advance directives for mental health in Virginia.

Journal Article Adm Policy Ment Health · May 2013 Featured Publication An innovative Virginia health care law enables competent adults with serious mental illness to plan for treatment during incapacitating crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional ... Full text Link to item Cite

Preventing gun violence involving people with serious mental illness

Chapter · January 25, 2013 Featured Publication Cite

Economic grand rounds: Can states implement involuntary outpatient commitment within existing state budgets?

Journal Article Psychiatr Serv · January 2013 Featured Publication Many states have not implemented involuntary outpatient commitment, possibly believing that the program is too costly. A review of New York State's experience found that even though the state had appropriated funds for implementing outpatient commitment, o ... Full text Link to item Cite

Explaining rare acts of violence: the limits of evidence from population research.

Journal Article Psychiatr Serv · November 2011 Featured Publication After the tragic mass shooting in Tucson, experts struggled to explain why such horrific events occur, in order to prevent them in the future. The author argues that homicides perpetrated with firearms against strangers by individuals with mental disorders ... Full text Link to item Cite

Mental illness and firearm violence.

Journal Article JAMA · September 7, 2011 Featured Publication Full text Link to item Cite

Suicidality and acculturation in hispanic adolescents

Journal Article · January 1, 2011 Recent literature has suggested a significant acceleration in the rate of suicide amongst Latino youth, now approaching the higher rates traditionally seen amongst white youth. Acculturation into mainstream culture has been suggested as a significant facto ... Cite

A conceptually based scale to measure consumers' treatment motivation

Journal Article Research on Social Work Practice · January 1, 2011 Objectives: The objective of this work was to assess the reliability and validity of the Treatment Motivation Questionnaire- Revised (TMQ-R) in people with serious mental illness (SMI). Method: A large sample of consumers of mental health services (n = 469 ... Full text Cite

Reductions in arrest under assisted outpatient treatment in New York.

Journal Article Psychiatr Serv · October 2010 OBJECTIVE: Individuals with serious mental illness have a relatively high risk of criminal justice involvement. Assisted outpatient treatment (AOT) is a legal mechanism that mandates treatment for individuals with serious mental illness who are unlikely to ... Full text Link to item Cite

Assisted outpatient treatment in New York: regional differences in New York's assisted outpatient treatment program.

Journal Article Psychiatr Serv · October 2010 OBJECTIVE: This study sought to describe the implementation of "Kendra's Law" in New York State and examine regional differences in the application of the program. METHODS: Between February 2007 and April 2008, interviews were conducted with 50 key informa ... Full text Link to item Cite

Continuing medication and hospitalization outcomes after assisted outpatient treatment in New York.

Journal Article Psychiatr Serv · October 2010 OBJECTIVE: This study examined whether persons with mental illness who undergo a period of involuntary outpatient commitment continue to receive prescribed medications and avoid psychiatric hospitalization after outpatient commitment ends. METHODS: Data on ... Full text Link to item Cite

Robbing Peter to pay Paul: did New York State's outpatient commitment program crowd out voluntary service recipients?

Journal Article Psychiatr Serv · October 2010 Featured Publication OBJECTIVE: This study examined whether New York State's assisted outpatient treatment (AOT) program disadvantaged voluntary service recipients by directing services toward court-ordered individuals. METHODS: Administrative data from the New York State Offi ... Full text Link to item Cite

Changes in guideline-recommended medication possession after implementing Kendra's law in New York.

Journal Article Psychiatr Serv · October 2010 OBJECTIVE: This study examined changes in possession of guideline-recommended medication among three groups of New York State Medicaid enrollees with severe mental illness: those who received an involuntary outpatient commitment order, voluntary enhanced s ... Full text Link to item Cite

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

Journal Article Psychiatr Serv · October 2010 Featured Publication 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 ... Full text Link to item Cite

Violent behavior in mental illness: the role of substance abuse.

Journal Article JAMA · August 4, 2010 Featured Publication Full text Link to item Cite

Law & psychiatry: Gun laws and mental illness: how sensible are the current restrictions?

Journal Article Psychiatr Serv · July 2010 Featured Publication This column describes federal and state laws to restrict access to firearms among people with mental illness. The contribution to public safety of these laws is likely to be small because only 3%-5% of violent acts are attributable to serious mental illnes ... Full text Link to item Cite

What would Mary Douglas do? A commentary on Kahan et al., "Cultural cognition and public policy: the case of outpatient commitment laws".

Journal Article Law Hum Behav · June 2010 Featured Publication Involuntary outpatient commitment is a highly controversial issue in mental health law. Strong supporters of outpatient commitment see it as a form of access to community-based mental health care and a less restrictive alternative to hospitalization for pe ... Full text Link to item Cite

Making the case for laws that improve health: a framework for public health law research.

Journal Article Milbank Q · June 2010 Featured Publication CONTEXT: Public health law has received considerable attention in recent years and has become an essential field in public health. Public health law research, however, has received less attention. METHODS: Expert commentary. FINDINGS: This article explores ... Full text Link to item Cite

Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives.

Journal Article Psychiatr Serv · April 2010 OBJECTIVE: Psychiatric advance directives allow patients with severe mental illness to document their preferences for particular medications. This study investigated the role of psychiatric advance directives in treatment choice and medication adherence. M ... Full text Link to item Cite

Psychiatric advance directives and social workers: an integrative review.

Journal Article Soc Work · April 2010 Psychiatric advance directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed ... Full text Link to item Cite

Violence in schizophrenia: Prevalence, correlates, and treatment effectiveness

Chapter · January 1, 2010 Among the possible complications and adverse outcomes of schizophrenia, perhaps none is more troubling and tragic—albeit infrequent—than violence. Aside from causing physical harm to its victims, violent behavior is ruinous to its perpetrators and costly t ... Full text Cite

Preferences for psychiatric advance directives among Latinos: views on advance care planning for mental health.

Journal Article Psychiatr Serv · October 2009 OBJECTIVE: Psychiatric advance directives allow people to plan for future mental health care. Little is known about how minority groups, particularly Latinos, view these legal mechanisms. This study examined demand for, and attitudes toward, psychiatric ad ... Full text Link to item Cite

Autonomy and the use of directive intervention in the treatment of individuals with serious mental illnesses: A survey of social work practitioners

Journal Article Social Work in Mental Health · July 1, 2009 Social workers in mental health settings struggle to support the principle of autonomy while weighing the need to directively intervene when there is a risk of harm or when clients are nonadherent to treatment. However, our understanding of this tension is ... Full text Cite

Racial disparities in involuntary outpatient commitment: are they real?

Journal Article Health Aff (Millwood) · 2009 Featured Publication In this paper we explore racial disparities in outpatient civil commitment, using data from Kendra's Law in New York State. Overall, African Americans are more likely than whites to be involuntarily committed for outpatient psychiatric care in New York. Ho ... Full text Link to item Cite

Reducing barriers to completing psychiatric advance directives.

Journal Article Adm Policy Ment Health · November 2008 OBJECTIVE: Psychiatric advance directives (PADs) allow individuals to plan for future mental health treatment. However, little is known about barriers to PAD completion. This paper examines an intervention's effect in reducing barriers to PAD completion. M ... Full text Link to item Cite

Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia.

Journal Article Br J Psychiatry · July 2008 BACKGROUND: Violence is an uncommon but significant problem associated with schizophrenia. AIMS: To compare antipsychotic medications in reducing violence among patients with schizophrenia over 6 months, identify prospective predictors of violence and exam ... Full text Link to item Cite

A clinical trial comparing interviewer and computer-assisted assessment among clients with severe mental illness.

Journal Article Psychiatr Serv · July 2008 OBJECTIVE: Demographic, behavioral, and diagnostic information should routinely be collected from clients with severe mental illness, and data gathering should employ the most efficient techniques available. Surveys are increasingly conducted via Web-based ... Full text Link to item Cite

Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems.

Journal Article Law Hum Behav · June 2008 Featured Publication Violence in schizophrenia patients may result from many factors besides the symptoms of schizophrenia. This study examined the relationship between childhood antisocial behavior and adult violence using data from the NIMH CATIE study. The prevalence of vio ... Full text Link to item Cite

Social workers' familiarity with psychiatric advance directives: Implications for education, practice, and research

Journal Article Families in Society · April 1, 2008 Psychiatric advance directives (PADs) are legal documents that allow competent individuals to express wishes for psychiatric care during a future crisis when they may no longer be able to do so. PADs are intended to enhance client autonomy at a time when c ... Full text Cite

The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study.

Journal Article Schizophr Res · March 2008 OBJECTIVE: This double-blind study compared a second generation (atypical) antipsychotic drugs compared to a representative older agent for patients with schizophrenia who use or avoid illicit substances. METHODS: Schizophrenic subjects were recruited at 5 ... Full text Link to item Cite

Preventing the unpredicted: managing violence risk in mental health care.

Journal Article Psychiatr Serv · February 2008 Featured Publication Using clinical judgment alone, mental health professionals cannot predict individual patient violence much more accurately than chance. Clinicians could improve their prediction of violence if they routinely used structured risk assessment instruments, but ... Full text Link to item Cite

Assessing risk of violent behavior among veterans with severe mental illness.

Journal Article J Trauma Stress · February 2008 Although empirical research has examined factors associated with increased violence risk among individuals with severe mental illness (SMI) and among veterans without SMI, less attention has been devoted to identifying violence risk factors among veterans ... Full text Link to item Cite

Front line workers' attitudes towards psychiatric advance directives.

Journal Article Community Ment Health J · February 2008 Studies have begun to explore provider attitudes' toward psychiatric advance directives (PADs) and how those attitudes are related to provider characteristics. The study gathered attitudinal data from a sample of 193 social workers serving mentally ill adu ... Full text Link to item Cite

A typology of advance statements in mental health care.

Journal Article Psychiatr Serv · January 2008 Advance statements documenting mental health service consumers' preferences for treatment during a future mental health crisis or period of incapacity have gained currency in recent years in the United States and some European countries. Several kinds of a ... Full text Link to item Cite

Caregivers as money managers for adults with severe mental illness: how treatment providers can help.

Journal Article Acad Psychiatry · 2008 OBJECTIVE: To review the prevalence, benefits, and problems associated with families who, either informally or formally as representative payees, manage money for adults with severe mental illness. METHODS: Based on empirical research and clinical cases, s ... Full text Link to item Cite

Psychiatric advance directives and reduction of coercive crisis interventions.

Journal Article J Ment Health · January 1, 2008 BACKGROUND: Psychiatric advance directives are intended to enable self-determined treatment for patients who lose decisional capacity, and thus reduce the need for coercive interventions such as police transport, involuntary commitment, seclusion and restr ... Full text Link to item Cite

Characteristics of representative payeeship involving families of beneficiaries with psychiatric disabilities.

Journal Article Psychiatr Serv · November 2007 OBJECTIVE: Although the Social Security Administration frequently assigns family members to serve as representative payees for relatives with psychiatric disabilities, few studies have examined characteristics associated with these payee arrangements or th ... Full text Link to item Cite

EFFECTIVELY IMPLEMENTING PSYCHIATRIC ADVANCE DIRECTIVES TO PROMOTE SELF-DETERMINATION OF TREATMENT AMONG PEOPLE WITH MENTAL ILLNESS.

Journal Article Psychol Public Policy Law · November 2007 Statutes on psychiatric advance directives (PADs) allow competent individuals to document instructions for future mental health treatment in the event of an incapacitating crisis. PADs are aimed at promoting a stronger sense of patient self-determination, ... Full text Link to item Cite

Authors' reply:.

Journal Article The British journal of psychiatry : the journal of mental science · October 2007 Cite

Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives.

Journal Article Psychiatr Serv · October 2007 OBJECTIVE: Clinicians have raised concerns that psychiatric advance directives may be used to refuse all treatment. However, people writing psychiatric advance directives can explicitly state their reasoning underlying treatment decisions. This study exami ... Full text Link to item Cite

Effectiveness of atypical antipsychotics for substance use in schizophrenia patients.

Journal Article Schizophr Res · August 2007 Featured Publication OBJECTIVE: This study examined the influence of medication class (atypical antipsychotic, typical antipsychotic and no medication) and compliance on substance use outcomes for schizophrenia patients in the community. METHOD: N=362 adults with schizophrenia ... Full text Link to item Cite

Healthcare barriers among severely mentally ill homeless adults: evidence from the five-site health and risk study.

Journal Article Adm Policy Ment Health · July 2007 UNLABELLED: Few studies have examined barriers to physical and mental healthcare among homeless mentally adults. METHODS: This study examined physical and mental healthcare barriers reported by 154 recently homeless mentally ill persons. RESULTS: Practical ... Full text Link to item Cite

Competence to complete psychiatric advance directives: effects of facilitated decision making.

Journal Article Law Hum Behav · June 2007 Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological cor ... Full text Link to item Cite

Overriding psychiatric advance directives: factors associated with psychiatrists' decisions to preempt patients' advance refusal of hospitalization and medication.

Journal Article Law Hum Behav · February 2007 Featured Publication Psychiatric advance directives (PADs) are intended to support patients' treatment decisions during a crisis. However, PAD statutes give clinicians broad discretion over whether to carry out patients' advance instructions. This study uses data from a survey ... Full text Link to item Cite

The impact of perceived need for treatment on risk of arrest and violence among people with severe mental illness

Journal Article Criminal Justice and Behavior · February 1, 2007 One clinical strategy for managing risk of arrest and violence among people with severe mental illness (SMI) involves targeting potentially treatable factors related to these risks. The current study examines the association between individuals' perceived ... Full text Cite

Previous involuntary commitment is associated with current perceptions of coercion in voluntarily hospitalized patients

Journal Article International Journal of Forensic Mental Health · January 1, 2007 Involuntary psychiatric treatment is sometimes necessary and beneficial, but may also exert negative effects. The impact of involuntary commitment on subsequent mental health treatment experience is poorly understood. We examined whether history of involun ... Full text Cite

Understanding the personal and clinical utility of psychiatric advance directives: a qualitative perspective.

Journal Article Psychiatry · 2007 Psychiatric advance directives (PADs) are legal tools that allow competent individuals to declare preferences for future mental health treatment when they may not be capable of doing so as a result of a psychiatric crisis. PADs allow individuals to maintai ... Full text Link to item Cite

Psychiatric advance directives: a tool for consumer empowerment and recovery.

Journal Article Psychiatr Rehabil J · 2007 Individuals with psychiatric disabilities identify choice and self-direction as central elements of recovery. During times of psychiatric crisis people may experience a frightening loss of choice and self-direction, which can be damaging and traumatic. Psy ... Full text Link to item Cite

Dr. Swanson and colleagues reply [4]

Journal Article American Journal of Psychiatry · January 1, 2007 Full text Cite

Facilitated psychiatric advance directives: a randomized trial of an intervention to foster advance treatment planning among persons with severe mental illness.

Journal Article Am J Psychiatry · November 2006 Featured Publication OBJECTIVE: Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. METHO ... Full text Link to item Cite

Treatment engagement and violence risk in mental disorders.

Journal Article Br J Psychiatry · October 2006 BACKGROUND: Research has uncovered many characteristics related to violence committed by people with mental illness. However, relatively few studies have focused on understanding the connection between violence and dynamic, malleable variables such as a pa ... Full text Link to item Cite

Violence and leveraged community treatment for persons with mental disorders.

Journal Article Am J Psychiatry · August 2006 Featured Publication OBJECTIVE: This article explores the link between violence and the practice of legally mandating treatment in the community or leveraging benefits from the social welfare system, such as subsidized housing and disability income support, to ensure adherence ... Full text Link to item Cite

Substance use and psychosocial functioning in schizophrenia among new enrollees in the NIMH CATIE study.

Journal Article Psychiatr Serv · August 2006 OBJECTIVE: This study examined the relationship between substance use and psychosocial functioning in schizophrenia. METHODS: Participants were enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness. This study used baseline assessment ... Full text Link to item Cite

Clinicians' attitudes regarding barriers to the implementation of psychiatric advance directives.

Journal Article Adm Policy Ment Health · July 2006 OBJECTIVE: Psychiatric advance directives (PADs) may include documenting advance instructions (AIs) and/or designating health care agents (HCAs). Laws authorizing PADs have proliferated in the past decade, but there has been little research regarding perce ... Full text Link to item Cite

A national study of violent behavior in persons with schizophrenia.

Journal Article Arch Gen Psychiatry · May 2006 Featured Publication CONTEXT: Violent behavior is uncommon, yet problematic, among schizophrenia patients. The complex effects of clinical, interpersonal, and social-environmental risk factors for violence in this population are poorly understood. OBJECTIVE: To examine the pre ... Full text Link to item Cite

Clinical decision making and views about psychiatric advance directives.

Journal Article Psychiatr Serv · March 2006 OBJECTIVES: Psychiatric advance directives allow competent persons to document advance instructions or designate a health care agent to communicate their preferences for future mental health treatment in the event of an incapacitating crisis. Although laws ... Full text Link to item Cite

Use of outpatient commitment or related civil court treatment orders in five U.S. communities.

Journal Article Psychiatr Serv · March 2006 Featured Publication OBJECTIVE: Outpatient commitment and a number of related civil court mechanisms are used to attempt to improve adherence to mental health treatment in the community. This study examined lifetime use rates and correlates of outpatient commitment or related ... Full text Link to item Cite

Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care.

Journal Article J Clin Psychiatry · March 2006 BACKGROUND: Relatively little is known about the relationships between medication adherence and long-term functional outcomes in the treatment of schizophrenia. To extend previous research, we prospectively examined the relationships between adherence with ... Full text Link to item Cite

Substance use in persons with schizophrenia: baseline prevalence and correlates from the NIMH CATIE study.

Journal Article J Nerv Ment Dis · March 2006 This study examined baseline correlates of substance use in the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness project. Approximately 60% of the sample was found to use substances, including 37% with current evidence of substance use diso ... Full text Link to item Cite

Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia.

Journal Article BMC Psychiatry · February 21, 2006 BACKGROUND: There is an ongoing debate over whether atypical antipsychotics are more effective than typical antipsychotics in the treatment of schizophrenia. This naturalistic study compares atypical and typical antipsychotics on time to all-cause medicati ... Full text Link to item Cite

Patient preferences for psychiatric advance directives

Journal Article International Journal of Forensic Mental Health · January 1, 2006 Limited research has examined patients’ preferences for psychiatric advance directives (PADs). This study examines the preferences and interest in PADs among patients with severe mental illness. Participants in a randomized controlled trial of PAD facilita ... Full text Cite

Psychiatric advance directives among public mental health consumers in five U.S. cities: prevalence, demand, and correlates.

Journal Article J Am Acad Psychiatry Law · 2006 Featured Publication Psychiatric advance directives (PADs) are legal instruments that allow competent persons to document their preferences regarding future mental health treatment and to designate a surrogate decisionmaker in the event they lose capacity to make reliable trea ... Link to item Cite

Use of the criminal justice system to leverage mental health treatment: effects on treatment adherence and satisfaction.

Journal Article J Am Acad Psychiatry Law · 2006 In efforts to divert persons with mental illness from jails and prisons, the option of community mental health treatment in lieu of incarceration is sometimes offered. In addition, community treatment can be mandated, or "leveraged," as a condition of prob ... Link to item Cite

Superseding psychiatric advance directives: ethical and legal considerations.

Journal Article J Am Acad Psychiatry Law · 2006 Featured Publication Psychiatric advance directives (PADs) were introduced in the 1980s as legal instruments for psychiatric patients to retain some choice over their own mental health treatment during periods of decisional incapacity. However, PADs are nested in larger struct ... Link to item Cite

The relationship between mandated community treatment and perceived barriers to care in persons with severe mental illness.

Journal Article Int J Law Psychiatry · 2006 OBJECTIVE: In recent decades debate has intensified over both the ethics and effectiveness of mandated mental health treatment for persons residing in the community. Perceived barriers to care among persons subjected to mandated community treatment, and th ... Full text Link to item Cite

The effects of early sexual abuse on adult risky sexual behaviors among persons with severe mental illness.

Journal Article Child Abuse Negl · November 2005 OBJECTIVE: There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprot ... Full text Link to item Cite

Medication nonadherence and substance abuse in psychotic disorders: impact of depressive symptoms and social stability.

Journal Article J Nerv Ment Dis · October 2005 Although studies have consistently shown a strong relationship between medication nonadherence and substance abuse in psychotic disorders, less is understood about the mechanisms underlying this relationship. The purpose of this study was to examine whethe ... Full text Link to item Cite

Family representative payeeship and violence risk in severe mental illness.

Journal Article Law Hum Behav · October 2005 Featured Publication Although representative payeeship is prevalent among people with mental illness and shows promise to positively influence clinically relevant outcomes, research also suggests this legal mechanism could be implemented in ways that are problematic. The curre ... Full text Link to item Cite

Cost-sharing requirements and access to mental health care among medicare enrollees with schizophrenia.

Journal Article Psychiatr Serv · August 2005 OBJECTIVE: This study explored the association between Medicare cost-sharing requirements and the probability of use of various mental health outpatient services among Medicare enrollees with schizophrenia. METHODS: Multivariate logistic regression was use ... Full text Link to item Cite

The effects of race and criminal justice involvement on access to atypical antipsychotic medications among persons with schizophrenia.

Journal Article Ment Health Serv Res · June 2005 Featured Publication This study examined the impact of race and arrest history on the likelihood of being prescribed, and maintaining an atypical antipsychotic prescription for 90 or more days among patients with schizophrenia in the community. Participants were 224 adults wit ... Full text Link to item Cite

Perceived fairness and effectiveness of leveraged community treatment among public mental health consumers in five U.S. cities

Journal Article International Journal of Forensic Mental Health · January 1, 2005 Policies to leverage adherence with community-based mental health treatment have become widespread; however, little research exists on the attitudes of persons with psychiatric disorders regarding such leverage. This study examines the appraisals of 1, 011 ... Full text Cite

Psychiatrists’ views and attitudes about psychiatric advance directives

Journal Article International Journal of Forensic Mental Health · January 1, 2005 Psychiatric advance directives (PADs) document a patient’s advance instructions (AIs) for treatment and/or designation of a potential proxy decision maker. Approximately 50% of a total of N=167 U.S. psychiatrists who completed a mail survey of their attitu ... Full text Cite

Use of leverage to improve adherence to psychiatric treatment in the community.

Journal Article Psychiatr Serv · January 2005 Featured Publication OBJECTIVES: A variety of tools are being used as leverage to improve adherence to psychiatric treatment in the community. This study is the first to obtain data on the frequency with which these tools are used in the public mental health system. Patients' ... Full text Link to item Cite

Consumer views of representative payee use of disability funds to leverage treatment adherence.

Journal Article Psychiatr Serv · January 2005 OBJECTIVE: Although representative payee arrangements are common among people with psychiatric disabilities, only a small body of research has investigated how consumers feel about representative payees' use of disability funds to attempt to improve treatm ... Full text Link to item Cite

A comparison of stigmatizing attitudes toward persons with schizophrenia in four stakeholder groups: perceived likelihood of violence and desire for social distance.

Journal Article Psychiatry · 2005 Featured Publication This study compared four stakeholder groups regarding the presence of stigmatizing attitudes toward a hypothetical person diagnosed with schizophrenia. Participants included consumers with schizophrenia (n = 104), family members of those with schizophrenia ... Full text Link to item Cite

Reducing violence risk in persons with schizophrenia: olanzapine versus risperidone.

Journal Article J Clin Psychiatry · December 2004 Featured Publication OBJECTIVE: This study prospectively examined the effectiveness of treatment with olanzapine versus risperidone in reducing violent behavior among patients with schizophrenia under "usual care" conditions in the community. METHOD: Participants were 124 adul ... Full text Link to item Cite

Psychiatric advance directives: Practical, legal, and ethical issues

Journal Article Journal of Forensic Psychology Practice · December 1, 2004 Psychiatric Advance Directives are relatively new legal tools that allow competent persons to consent or refuse mental health treatment and designate a proxy decision maker in advance of a mental health crisis, during which they may lose capacity to make h ... Full text Cite

Involuntary outpatient commitment, community treatment orders, and assisted outpatient treatment: what's in the data?

Journal Article Can J Psychiatry · September 2004 OBJECTIVE: Involuntary outpatient commitment (OPC), also referred to as community treatment orders or assisted outpatient treatment, is a legal intervention intended to improve treatment adherence among persons with serious mental illness. This paper revie ... Full text Link to item Cite

Caregiving for persons with mental illness: the impact of outpatient commitment on caregiving strain.

Journal Article J Nerv Ment Dis · August 2004 This study examines factors that contribute to the subjective strain experienced by caregivers of persons with severe mental illness and addresses potential improvement in caregiver strain associated with involuntary outpatient commitment. Subjects from a ... Full text Link to item Cite

Consumers' perceptions of the fairness and effectiveness of mandated community treatment and related pressures.

Journal Article Psychiatr Serv · July 2004 Featured Publication OBJECTIVE: Little research has been conducted on the attitudes of persons with psychiatric disorders toward the potentially adverse or beneficial effects of involuntary outpatient commitment and other forms of mandated community treatment. This study exami ... Full text Link to item Cite

Effectiveness of atypical antipsychotic medications in reducing violent behavior among persons with schizophrenia in community-based treatment.

Journal Article Schizophr Bull · 2004 Featured Publication This study prospectively compared the effectiveness of atypical antipsychotic medications to that of conventional neuroleptics in reducing violent behavior among patients with schizophrenia under "usual care" conditions in the community. Participants (n = ... Full text Link to item Cite

Effects of legal mechanisms on perceived coercion and treatment adherence among persons with severe mental illness.

Journal Article J Nerv Ment Dis · October 2003 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 collec ... Full text Link to item Cite

Anxiolytic effects of acute morphine can be modulated by nitric oxide systems.

Journal Article Pharmacology · August 2003 This study was performed to investigate whether nitric oxide (NO) precursor (L-arginine), NO donor (S-nitroso-N-acetylpenicillamine, SNAP) and NO synthase inhibitors [N(G)-nitro-L-arginine-methylester (L-NAME) and N(G)-nitro-L-arginine (L-NOARG)] modulate ... Full text Link to item Cite

Characteristics of third-party money management for persons with psychiatric disabilities.

Journal Article Psychiatr Serv · August 2003 OBJECTIVE: The study examined different types of third-party money management arrangements for persons with psychiatric disabilities and consumers' perceptions of their finances in the context of these arrangements. METHODS: Clinical and demographic data w ... Full text Link to item Cite

The five-site health and risk study of blood-borne infections among persons with severe mental illness.

Journal Article Psychiatr Serv · June 2003 Featured Publication This article outlines the history and rationale of a multisite study of blood-borne infections among persons with severe mental illness reported in this special section of Psychiatric Services. The general problem of blood-borne diseases in the United Stat ... Full text Link to item Cite

Detection of illicit substance use among persons with schizophrenia by radioimmunoassay of hair.

Journal Article Psychiatr Serv · June 2003 OBJECTIVE: Illicit substance use is a potent risk factor for poor outcomes in schizophrenia, yet methods for detecting substance use consistently underestimate the problem. The purpose of this study was to assess whether use of a relatively new method of d ... Full text Link to item Cite

Regular sources of medical care among persons with severe mental illness at risk of hepatitis C infection.

Journal Article Psychiatr Serv · June 2003 Featured Publication OBJECTIVE: An estimated 19.6 percent of persons with severe mental illness are infected with the hepatitis C virus. Given the pressing need to identify and treat persons with severe mental illness who are at risk of hepatitis C infection and transmission, ... Full text Link to item Cite

Assessment of four stakeholder groups' preferences concerning outpatient commitment for persons with schizophrenia.

Journal Article Am J Psychiatry · June 2003 Featured Publication OBJECTIVE: Study findings indicating that involuntary outpatient commitment can improve treatment outcomes among persons with severe mental illness remain controversial. Opponents of outpatient commitment argue that its coerciveness is unacceptable even gi ... Full text Link to item Cite

Gender differences in hepatitis C infection and risks among persons with severe mental illness.

Journal Article Psychiatr Serv · June 2003 OBJECTIVES: The authors assessed gender differences in hepatitis C infection and associated risk behaviors among persons with severe mental illness. METHOD: S: The sample consisted of 777 patients (251 women and 526 men) from four sites. RESULTS: Across si ... Full text Link to item Cite

Effects of race and poverty on the process and outcome of inpatient rehabilitation services among stroke patients.

Journal Article Stroke · April 2003 BACKGROUND AND PURPOSE: The greater mortality and residual physical impairments among black stroke patients may be attributable to differential utilization of rehabilitation services. This report examines, within an equal-access healthcare system, racial d ... Full text Link to item Cite

Involuntary outpatient commitment and homelessness in persons with severe mental illness.

Journal Article Ment Health Serv Res · March 2003 This study took preliminary steps to explore the relationship between involuntary outpatient commitment (OPC) and the risk of homelessness among individuals with severe mental disorders. Involuntarily hospitalized patients were randomly assigned to be rele ... Full text Link to item Cite

Psychiatric disability, the use of financial leverage, and perceived coercion in mental health services

Journal Article International Journal of Forensic Mental Health · January 1, 2003 Although the use of representative payees has proliferated in the past decade, little is known about whether clinicians or family members of people with mental illness use their control of clients’ money to leverage treatment adherence or whether persons w ... Full text Cite

Psychiatric advance directives: A survey of persons with schizophrenia, family members, and treatment providers

Journal Article International Journal of Forensic Mental Health · January 1, 2003 Psychiatric advance directives (PADs) allow competent persons to request or refuse specific types of treatment and designate a proxy decisionmaker in advance of a mental health crisis when they may lose capacity to make reliable healthcare decisions. A sur ... Full text Cite

Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals.

Journal Article Behav Sci Law · 2003 Mental health consumer advocates have long argued that involuntary treatment frightens persons with mental disorder and thus deters them from voluntarily seeking help. We surveyed 85 mental health professionals and 104 individuals with schizophrenia spectr ... Full text Link to item Cite

Endorsement of personal benefit of outpatient commitment among persons with severe mental illness.

Journal Article Psychol Public Policy Law · 2003 This study examines whether individuals who experienced involuntary outpatient commitment (OPC) attribute benefit to this intervention. It was found that the majority of experimental subjects who underwent a period of OPC did not personally endorse OPC's b ... Full text Link to item Cite

Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness.

Journal Article Behav Sci Law · 2003 Featured Publication Recent evidence suggests that involuntary outpatient commitment (OPC), when appropriately applied, can improve adherence with psychiatric treatment, decrease hospital recidivism and arrests, and lower the risk of violent behavior in persons with severe men ... Full text Link to item Cite

Does involuntary outpatient commitment lead to more intensive treatment?

Journal Article Psychol Public Policy Law · 2003 Studies of involuntary outpatient commitment (OPC) among persons with severe mental illness have concluded that OPC is only effective in improving treatment outcomes when it is sustained for 6 months or longer and is combined with frequent outpatient servi ... Full text Link to item Cite

Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited.

Journal Article Soc Sci Med · October 2002 Featured Publication We examined the relationship between neighborhood structural characteristics and mental disorder using data from the National Institute of Mental Health's Epidemiological Catchment (ECA) surveys (n = 11,686). After controlling for individual-level characte ... Full text Link to item Cite

The social-environmental context of violent behavior in persons treated for severe mental illness.

Journal Article Am J Public Health · September 2002 Featured Publication OBJECTIVES: This study examined the prevalence and correlates of violent behavior by individuals with severe mental illness. METHODS: Participants (N = 802) were adults with psychotic or major mood disorders receiving inpatient or outpatient services in pu ... Full text Link to item Cite

Mediation of employment discrimination disputes involving persons with psychiatric disabilities.

Journal Article Psychiatr Serv · August 2002 Featured Publication OBJECTIVE: This study sought to determine whether persons with psychiatric disabilities who filed employment discrimination complaints with the Equal Employment Opportunity Commission (EEOC) under the Americans With Disabilities Act (ADA) were referred to ... Full text Link to item Cite

Impact of outpatient commitment on victimization of people with severe mental illness.

Journal Article Am J Psychiatry · August 2002 OBJECTIVE: The authors' goal was to evaluate the effectiveness of outpatient commitment in reducing victimization among people with severe mental illness. METHOD: One hundred eighty-four involuntarily hospitalized patients were randomly assigned to be rele ... Full text Link to item Cite

The perceived coerciveness of involuntary outpatient commitment: findings from an experimental study.

Journal Article J Am Acad Psychiatry Law · 2002 This study examines self-reported coercion in subjects with severe mental illness who were randomly assigned in an experimental study to continue under, or be released from, involuntary outpatient commitment (OPC) subsequent to hospital discharge. After re ... Link to item Cite

Recent victimization in women and men with severe mental illness: prevalence and correlates.

Journal Article J Trauma Stress · October 2001 The problem of violence against individuals with severe mental illness (SMI) has received relatively, little notice, despite several studies suggesting an exceptionally high prevalence of victimization in this population. This paper describes the results o ... Full text Link to item Cite

Effects of involuntary outpatient commitment and depot antipsychotics on treatment adherence in persons with severe mental illness.

Journal Article J Nerv Ment Dis · September 2001 This study examines potential improvement in treatment adherence during a study of involuntary outpatient commitment among individuals with severe mental illnesses. Involuntarily hospitalized subjects, awaiting discharge under outpatient commitment, were r ... Full text Link to item Cite

Consumer, provider, and informal caregiver opinions on psychiatric advance directives.

Journal Article Adm Policy Ment Health · July 2001 Psychiatric advance directives (PADs) are legal documents that permit competent adults to make choices in the present about their future psychiatric treatment if they lose their decision-making capacity. PADs may provide for the appointment of surrogate de ... Full text Link to item Cite

A randomized controlled trial of outpatient commitment in North Carolina.

Journal Article Psychiatr Serv · March 2001 Featured Publication OBJECTIVE: A randomized controlled trial of outpatient commitment was conducted in North Carolina to provide empirical data on involuntary outpatient commitment and to evaluate its effectiveness in improving outcomes among persons with severe mental illnes ... Full text Link to item Cite

Can involuntary outpatient commitment reduce arrests among persons with severe mental illness?

Journal Article Criminal Justice and Behavior · January 1, 2001 Involuntary outpatient commitment (OPC) is a promising but controversial legal intervention that may reduce criminal justice contact in persons with severe mental illness (SMI). This article examines arrest outcomes in a 1-year randomized study of OPC in 2 ... Full text Cite

Reliability and validity of the SF-12 health survey among people with severe mental illness.

Journal Article Med Care · November 2000 OBJECTIVE: The objective of this work was to assess the reliability and validity of the Medical Outcomes Study Short-Form 12-Item Health Survey (SF-12) in a large sample of people with severe mental illness (SMI). METHODS: We examined the internal factor s ... Full text Link to item Cite

Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness.

Journal Article Br J Psychiatry · April 2000 Featured Publication BACKGROUND: Violent behaviour among persons with severe mental illness (SMI) causes public concern and is associated with illness relapse, hospital recidivism and poor outcomes in community-based treatment. AIMS: To test whether involuntary out-patient com ... Full text Link to item Cite

Psychiatric advance directives: an alternative to coercive treatment?

Journal Article Psychiatry · 2000 Featured Publication Psychiatric Advance Directives (PADs) are a legal means by which persons with mental illness, while competent to make healthcare decisions, may specify their preferences for treatment and may designate a surrogate decision-maker to act on their behalf in t ... Full text Link to item Cite

Race, role responsibility, and relationship: understanding the experience of caring for the severely mentally ill

Journal Article Research in Community and Mental Health · January 1, 2000 The purpose of this study was to identify contextual factors that affect the ability of caregivers to provide necessary supports to mentally ill individuals. Context was defined here as the socially patterned arrangements of peoples' everyday lives and the ... Full text Cite

Can involuntary outpatient commitment reduce hospital recidivism?: Findings from a randomized trial with severely mentally ill individuals.

Journal Article Am J Psychiatry · December 1999 Featured Publication OBJECTIVE: The goal of this study was to evaluate the effectiveness of involuntary outpatient commitment in reducing rehospitalizations among individuals with severe mental illnesses. METHOD: Subjects who were hospitalized involuntarily were randomly assig ... Full text Link to item Cite

Consumer perceptions of involuntary outpatient commitment.

Journal Article Psychiatr Serv · November 1999 This study examined beliefs about the provisions of outpatient commitment and their effects among 306 people with severe and persistent mental illness who were awaiting a period of outpatient commitment. More than 80 percent of the respondents perceived th ... Full text Link to item Cite

Medication Compliance

Journal Article Psychiatric Services · April 1999 Full text Cite

Violent behavior preceding hospitalization among persons with severe mental illness.

Journal Article Law Hum Behav · April 1999 Featured Publication The need to better understand and manage risk of violent behavior among persons with severe mental illness (SMI) in community care is increasingly being recognized. Of particular concern is a subset of the SMI population characterized by a "revolving door" ... Full text Link to item Cite

Medication compliance.

Journal Article Psychiatr Serv · April 1999 Full text Link to item Cite

Physicians' legal defensiveness and knowledge of medical law: comparing Denmark and the USA.

Journal Article Scand J Public Health · March 1999 The impact of legal factors on medical treatment decisions for dying patients has been studied in the USA for years. However, it is unknown how legal factors may affect similar medical decisions in other countries. This exploratory study compared responses ... Full text Link to item Cite

Criminal victimization of persons with severe mental illness.

Journal Article Psychiatr Serv · January 1999 OBJECTIVE: The types and amounts of crime experienced by persons with severe mental illness were examined to better understand criminal victimization in this population. METHODS: Subjects were 331 involuntarily admitted psychiatric inpatients who were orde ... Full text Link to item Cite

Psychiatric impairment, social contact, and violent behavior: evidence from a study of outpatient-committed persons with severe mental disorder.

Journal Article Soc Psychiatry Psychiatr Epidemiol · December 1998 Featured Publication The need to better understand and manage risk of violent behavior among people with severe mental illness in community care settings is increasingly being recognized, as public-sector mental health systems face mandates to provide more cost-effective servi ... Full text Link to item Cite

Risk reconsidered: targets of violence in the social networks of people with serious psychiatric disorders.

Journal Article Soc Psychiatry Psychiatr Epidemiol · December 1998 Risk Reconsidered: Targets of violence in the Social Networks of People with Serious Mental illness. This exploratory analysis addresses the questions: 1) Who among the members of the social network of a person diagnosed with a major psychiatric disorder i ... Full text Link to item Cite

Taking the wrong drugs: the role of substance abuse and medication noncompliance in violence among severely mentally ill individuals.

Journal Article Soc Psychiatry Psychiatr Epidemiol · December 1998 Increasing numbers of severely mentally ill individuals are being treated in nonhospital, community-based settings and public concern about potential violence by these individuals has increased, often as a result of tragic, albeit uncommon events. The pres ... Full text Link to item Cite

Male-female differences in the setting and construction of violence among people with severe mental illness.

Journal Article Soc Psychiatry Psychiatr Epidemiol · December 1998 Data from a sample of severely and persistently mentally ill involuntary patients indicated that differences in violence between males and females in the 4 months prior to hospital admission depended on the measure. In the bivariate analysis, males had a g ... Full text Link to item Cite

Administrative update: utilization of services. I. Comparing use of public and private mental health services: the enduring barriers of race and age.

Journal Article Community Ment Health J · April 1998 Data from the NIMH-Epidemiologic Catchment Area Project were used to predict differential use of private versus public outpatient mental health services, a salient concern in integrating public and private services in market-based health care reform effort ... Full text Link to item Cite

Violence and severe mental illness: the effects of substance abuse and nonadherence to medication.

Journal Article Am J Psychiatry · February 1998 OBJECTIVE: Violent behavior among individuals with severe mental illness has become an important focus in community-based care. This study examines the joint effect of substance abuse and medication noncompliance on the greater risk of serious violence amo ... Full text Link to item Cite

Substance abuse, violent behavior, and police encounters among persons with severe mental disorder

Journal Article Journal of Contemporary Criminal Justice · December 1, 1997 In this sample of 331 people with severe mental disorders, 20% reported being arrested or picked up by police for a crime at some time in the 4-month period before their hospital admission, most commonly for alcohol or drug offenses or crimes of public dis ... Full text Cite

The ethical challenges of a randomized controlled trial of involuntary outpatient commitment

Journal Article Journal of Mental Health Administration · September 11, 1997 Involuntary outpatient commitment (OPC) is a civil justice procedure intended to enhance compliance with community mental health treatment, to improve functioning and to reduce recurrent dangerousness and hospital recidivism. The research literature on OPC ... Cite

Violence and severe mental disorder in clinical and community populations: the effects of psychotic symptoms, comorbidity, and lack of treatment.

Journal Article Psychiatry · 1997 Featured Publication This paper examines links between violent behavior, type and severity of psychopathology, substance abuse comorbidity, and community mental health treatment, using matched data from two surveys: the National Institute of Mental Health Epidemiologic Catchme ... Full text Link to item Cite

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

Journal Article J Am Acad Psychiatry Law · 1997 Featured Publication 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 e ... Link to item Cite

The ethical challenges of a randomized controlled trial of involuntary outpatient commitment.

Journal Article J Ment Health Adm · 1997 Involuntary outpatient commitment (OPC) is a civil justice procedure intended to enhance compliance with community mental health treatment, to improve functioning, and to reduce recurrent dangerousness and hospital recidivism. The research literature on OP ... Full text Link to item Cite

Psychotic symptoms and disorders and the risk of violent behaviour in the community

Journal Article Criminal Behaviour and Mental Health · December 1, 1996 This study uses data from the Epidemiologic Catchment Area (ECA) surveys to examine the strength of the association between psychotic symptoms and violent behaviour, controlling for underlying mental disorder, substance abuse, sociodemographic characterist ... Cite

Assessing and managing voilence risk in clinical practice

Journal Article Journal of Practical Psychiatry and Behavioral Health · July 1, 1996 The authors review the techniques for assessing and managing violence risk in clinical practice. They discuss how the concept of risk assessment has evolved and review the accuracy of mental health practitioners' predictions of violence, the relationship b ... Cite

Medical futility decisions and physicians' legal defensiveness: the impact of anticipated conflict on thresholds for end-of-life treatment.

Journal Article Soc Sci Med · January 1996 Featured Publication Does legal defensiveness significantly influence physicians' assessments of medical futility, in ways that may adversely affect the rights of patients and their family members to make their own health care decisions at the end of life? This exploratory stu ... Full text Link to item Cite

Psychotic symptoms and disorders and the risk of violent behaviour in the community

Journal Article Criminal Behaviour and Mental Health · January 1, 1996 This study uses data from the Epidemiologic Catchment Area (ECA) surveys to examine the strength of the association between psychotic symptoms and violent behaviour, controlling for underlying mental disorder, substance abuse, sociodemographic characterist ... Full text Cite

New directions in research on involuntary outpatient commitment.

Journal Article Psychiatr Serv · April 1995 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 an ... Full text Link to item Cite

Doing all they can: physicians who deny medical futility.

Journal Article J Law Med Ethics · 1994 Featured Publication Full text Link to item Cite

Hispanic Americans and the state mental hospitals in Texas: ethnic parity as a latent function of a fiscal incentive policy.

Journal Article Soc Sci Med · October 1993 Featured Publication This paper examines patterns of utilization of the state mental hospitals in Texas by Hispanics compared to Anglos over a 5-year period from FY 1984 to FY 1988. Historically, Hispanics have been underrepresented in public mental health client populations i ... Full text Link to item Cite

Demographic and diagnostic characteristics of inmates receiving mental health services in state adult correctional facilities: United States, 1988.

Journal Article Ment Health Stat Note · August 1993 Featured Publication The demographic and diagnostic characteristics of inmates in State adult correctional facilities who received 24-hour hospital mental health care, residential treatment care, and counseling/therapy in 1988 are reported by State and by type of administrativ ... Full text Link to item Cite

Funding, expenditures, and staffing of mental health services in state adult correctional facilities: United States, 1988.

Journal Article Ment Health Stat Note · July 1993 Featured Publication State-by-State data concerning the sources of funding, expenditures, and staffing for mental health services in State correctional facilities are reported for 1988 from the first national survey of prison mental health services conducted by the Center for ... Link to item Cite

Overview of mental health services provided by state adult correctional facilities: United States, 1988.

Journal Article Ment Health Stat Note · May 1993 State-by-State data concerning the administrative auspices, volume of use, and sources of funding and expenditures for mental health services in adult correctional facilities are reported for 1988 from the first national survey of prison mental health serv ... Link to item Cite

Treatment decisions for terminally ill patients: physicians' legal defensiveness and knowledge of medical law.

Journal Article Law, medicine & health care : a publication of the American Society of Law & Medicine · December 1, 1992 In this study, we investigated physicians' attitudes, knowledge, and reported practices regarding the effects of perceived legal constraints on the abatement of life-sustaining treatment from patients who are clearly dying. A factor in assessing these issu ... Cite

A binational school survey of depressive symptoms, drug use, and suicidal ideation.

Journal Article J Am Acad Child Adolesc Psychiatry · July 1992 Featured Publication New findings are presented from a survey of depressive symptoms, illicit drug use, and suicidality among 4,157 adolescents attending school in six border cities in Texas and neighboring Tamaulipas, Mexico. Among the Texas youth, 48.08% scored above 16 on t ... Full text Link to item Cite

Cultural context and substance abuse in Hispanic adolescents

Journal Article Journal of Child and Family Studies · March 1, 1992 Much emphasis has been placed on the significant substance abuse problem being faced by Hispanic as well as other minority youth in the United States. However, little research has focused on the relative importance of culturally determined factors in the d ... Full text Cite

Treatment decisions for terminally ill patients: physicians' legal defensiveness and knowledge of medical law.

Journal Article Law Med Health Care · 1992 In this study, we investigated physicians' attitudes, knowledge, and reported practices regarding the effects of perceived legal constraints on the abatement of life-sustaining treatment from patients who are clearly dying. A factor in assessing these issu ... Full text Link to item Cite

Violence and ECA data.

Journal Article Hosp Community Psychiatry · September 1991 Full text Link to item Cite

Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area surveys.

Journal Article Hosp Community Psychiatry · July 1990 Featured Publication Data from the Epidemiologic Catchment Area survey were used to examine the relationship between violence and psychiatric disorders among adults living in the community. Psychiatric assessment of survey respondents was based on the Diagnostic Interview Sche ... Full text Link to item Cite

Psychopathology and economic status in mother-only and mother-father families.

Journal Article Child Psychiatry Hum Dev · 1989 This paper reports evidence on the link between economic resources and psychiatric disorder in female-headed families with children. It has been assumed that a father's absence leads to augmented psychopathology in children and their mother through the dis ... Full text Link to item Cite