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Involuntary outpatient commitment, community treatment orders, and assisted outpatient treatment: what's in the data?
Marvin S Swartz1, Jeffrey W Swanson
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. swart001@mc.duke.edu
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 reviews the empirical literature on the procedure's effectiveness.
Methods:
We identified and reviewed all English-language studies of OPC and related procedures available in Medline and other bibliographic search services.
Results:
Existing naturalistic and quasi-experimental studies, taken as a whole, moderately support the view that the procedure is effective, although all do have methodological limitations. Two randomized controlled studies of OPC have conflicting findings and are reviewed in detail.
Conclusions:
On balance, empirical studies support the view that OPC is effective under certain conditions, although some of the evidence has been contested and the policy remains controversial.
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