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A randomized controlled trial of outpatient commitment in North Carolina.

Publication ,  Journal Article
Swartz, MS; Swanson, JW; Hiday, VA; Wagner, HR; Burns, BJ; Borum, R
Published in: Psychiatr Serv
March 2001

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 illnesses. METHODS: A total of 331 involuntarily hospitalized patients awaiting discharge under outpatient commitment were randomly assigned to be released or to undergo outpatient commitment. Each received case management services and outpatient treatment. Participants in both groups were monitored for one year. After the initial 90-day outpatient commitment order, a patient could receive a renewable 180-day extension. Patients in the control group were immune from outpatient commitment for one year. Information was obtained from self-reports and reports of several informants as well as from outpatient treatment, hospital, and arrest records. RESULTS: In most bivariate analyses, outcomes for the outpatient commitment group and the control group did not differ significantly when the duration of outpatient commitment was not taken into account. However, patients who underwent sustained outpatient commitment and who received relatively intensive outpatient treatment had fewer hospital admissions and fewer days in the hospital, were more likely to adhere to community treatment, and were less likely to be violent or to be victimized. Extended outpatient commitment was also associated with fewer arrests of participants with a combined history of multiple rehospitalizations and previous arrests. The intervention was particularly effective among individuals with psychotic disorders. CONCLUSIONS: Outpatient commitment can improve treatment outcomes when the court order is sustained and combined with relatively intensive community treatment. A court order alone cannot substitute for effective treatment in improving outcomes.

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Published In

Psychiatr Serv

DOI

ISSN

1075-2730

Publication Date

March 2001

Volume

52

Issue

3

Start / End Page

325 / 329

Location

United States

Related Subject Headings

  • Violence
  • Psychotic Disorders
  • Psychiatry
  • Patient Readmission
  • Patient Compliance
  • Outcome Assessment, Health Care
  • North Carolina
  • Mood Disorders
  • Humans
  • Deinstitutionalization
 

Citation

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Swartz, M. S., Swanson, J. W., Hiday, V. A., Wagner, H. R., Burns, B. J., & Borum, R. (2001). A randomized controlled trial of outpatient commitment in North Carolina. Psychiatr Serv, 52(3), 325–329. https://doi.org/10.1176/appi.ps.52.3.325
Swartz, M. S., J. W. Swanson, V. A. Hiday, H. R. Wagner, B. J. Burns, and R. Borum. “A randomized controlled trial of outpatient commitment in North Carolina.Psychiatr Serv 52, no. 3 (March 2001): 325–29. https://doi.org/10.1176/appi.ps.52.3.325.
Swartz MS, Swanson JW, Hiday VA, Wagner HR, Burns BJ, Borum R. A randomized controlled trial of outpatient commitment in North Carolina. Psychiatr Serv. 2001 Mar;52(3):325–9.
Swartz, M. S., et al. “A randomized controlled trial of outpatient commitment in North Carolina.Psychiatr Serv, vol. 52, no. 3, Mar. 2001, pp. 325–29. Pubmed, doi:10.1176/appi.ps.52.3.325.
Swartz MS, Swanson JW, Hiday VA, Wagner HR, Burns BJ, Borum R. A randomized controlled trial of outpatient commitment in North Carolina. Psychiatr Serv. 2001 Mar;52(3):325–329.
Journal cover image

Published In

Psychiatr Serv

DOI

ISSN

1075-2730

Publication Date

March 2001

Volume

52

Issue

3

Start / End Page

325 / 329

Location

United States

Related Subject Headings

  • Violence
  • Psychotic Disorders
  • Psychiatry
  • Patient Readmission
  • Patient Compliance
  • Outcome Assessment, Health Care
  • North Carolina
  • Mood Disorders
  • Humans
  • Deinstitutionalization