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

The authors' goal was to evaluate the effectiveness of outpatient commitment in reducing victimization among people with severe mental illness.

One hundred eighty-four involuntarily hospitalized patients were randomly assigned to be released (N=99) or to continue under outpatient commitment (N=85) after hospital discharge. An additional group of patients with a recent history of serious violent behavior (N=39) was nonrandomly assigned to at least a brief period of outpatient commitment following hospital disharge. All three groups were followed for 1 year, and case management services plus additional outpatient treatment were provided to all subjects. Outcome data were based on interviews with the patients and informants as well as service records.

Subjects who were ordered to outpatient commitment were less likely to be criminally victimized than those who were released without outpatient commitment. Multivariate analysis indicated that each additional day of outpatient commitment reduced the risk of criminal victimization and that outpatient commitment had its effect through improved medication adherence, reduced substance use or abuse, and fewer violent incidents.

Protection from criminal victimization appears to be a positive, unintended consequence of outpatient commitment.