Outpatient commitment and coercion in New Zealand: a matched comparison study

Area of Science:

• Mental Health Law
• Forensic Psychiatry
• Clinical Psychology

Background:

• Coercion's role in outpatient commitment for therapeutic outcomes is hypothesized but poorly understood.
• Ambivalence, recognizing both positive and negative aspects of outpatient commitment, may signal adequate coercion levels.

Purpose of the Study:

• To assess perceived coercion levels among individuals under outpatient commitment in New Zealand.
• To explore the influence of ambivalence and procedural justice on patient perceptions of coercion.

Main Methods:

• A comparative cross-sectional study utilized the Perceived Coercion Scale.
• Compared 69 involuntary outpatients with 69 matched voluntary outpatients.
• Examined variables including patient knowledge and beliefs about outpatient commitment.

Main Results:

• Involuntary outpatients reported significantly higher perceived coercion than voluntary outpatients, though levels were relatively low.
• Involuntary outpatients were more likely to acknowledge the benefits of outpatient commitment.
• Procedural justice showed an inverse correlation with perceived coercion but was not a significant factor in regression analysis.

Conclusions:

• Ambivalence in involuntary outpatients regarding outpatient commitment suggests sufficient coercion for therapeutic benefit in New Zealand.
• Procedural justice may play a more critical role during initial hospital admission than during ongoing community care for perceived coercion.