Comparison between two legal indications for compulsory outpatient treatment in Israel

The aim of the present study was to compare the outcome of two legal indications for Compulsory Outpatient Treatment (COT) in Israel (a) as an alternative to compulsory hospitalization (CH) and (b) as a follow-up to CH. Demographic, clinical and legal measurements based on 326 COT orders issued in the Jerusalem and Southern district of Israel were compared according to the two legal provisions for COT contained in the Treatment of Mental Patients Law (1991). The COT order was found to be more effective when used as an alternative to CH (53.1%) than when it was used following CH (38.8%), p = 0.002. In the former case, there were fewer schizophrenic patients, fewer hospitalizations, fewer visits to psychiatric emergency services and longer remissions. Our results point to the influence of the legal indications on the efficacy of the COT order and help define the target population.