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

Publication ,  Journal Article
Swanson, JW; Swartz, MS; Elbogen, EB; Wagner, HR; Burns, BJ
Published in: Behav Sci Law
2003

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 mental illness. Presumably these are benefits that improve quality of life (QOL); however, insofar as OPC involves legal coercion, the undesirable aspects of OPC could also exert a negative effect on quality of life, thus offsetting clinical benefits. Involuntarily hospitalized subjects, awaiting discharge under outpatient commitment, were randomly assigned to be released or continue under outpatient commitment in the community after hospital discharge, and were followed for one year. Quality of life was measured at baseline and 12 months follow-up. Treatment characteristics and clinical outcomes were also measured. Subjects who underwent longer periods of outpatient commitment had significantly greater quality of life as measured at the end of the 1 year study. Multivariable analysis showed that the effect of OPC on QOL was mediated by greater treatment adherence and lower symptom scores. However, perceived coercion moderated the effect of OPC on QOL. Involuntary outpatient commitment, when sustained over time, indirectly exerts a positive effect on subjective quality of life for persons with SMI, at least in part by improving treatment adherence and lowering symptomatology.

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Published In

Behav Sci Law

DOI

ISSN

0735-3936

Publication Date

2003

Volume

21

Issue

4

Start / End Page

473 / 491

Location

United States

Related Subject Headings

  • Violence
  • United States
  • Severity of Illness Index
  • Quality of Life
  • Patient Compliance
  • Mental Disorders
  • Male
  • Ill-Housed Persons
  • Humans
  • Female
 

Citation

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Swanson, J. W., Swartz, M. S., Elbogen, E. B., Wagner, H. R., & Burns, B. J. (2003). Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness. Behav Sci Law, 21(4), 473–491. https://doi.org/10.1002/bsl.548
Swanson, Jeffrey W., Marvin S. Swartz, Eric B. Elbogen, H Ryan Wagner, and Barbara J. Burns. “Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness.Behav Sci Law 21, no. 4 (2003): 473–91. https://doi.org/10.1002/bsl.548.
Swanson JW, Swartz MS, Elbogen EB, Wagner HR, Burns BJ. Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness. Behav Sci Law. 2003;21(4):473–91.
Swanson, Jeffrey W., et al. “Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness.Behav Sci Law, vol. 21, no. 4, 2003, pp. 473–91. Pubmed, doi:10.1002/bsl.548.
Swanson JW, Swartz MS, Elbogen EB, Wagner HR, Burns BJ. Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness. Behav Sci Law. 2003;21(4):473–491.
Journal cover image

Published In

Behav Sci Law

DOI

ISSN

0735-3936

Publication Date

2003

Volume

21

Issue

4

Start / End Page

473 / 491

Location

United States

Related Subject Headings

  • Violence
  • United States
  • Severity of Illness Index
  • Quality of Life
  • Patient Compliance
  • Mental Disorders
  • Male
  • Ill-Housed Persons
  • Humans
  • Female