The utility of extended outpatient civil commitment

Area of Science:

• Psychiatry
• Public Health
• Health Services Research

Background:

• Involuntary outpatient commitment (IOC) is a legal mechanism used to mandate mental health treatment in the community.
• The impact of extended IOC orders on service utilization remains an area requiring further investigation.

Purpose of the Study:

• To examine the effects of extended involuntary outpatient commitment (IOC) orders on mental health service utilization.
• To compare service utilization between patients under extended IOC and a diagnostically matched, voluntarily treated group.

Main Methods:

• A comparative study using the Victorian Psychiatric Case Register (VPCR).
• Service utilization data for patients with extended (> or =180 day) IOC orders were compared to a voluntarily treated, matched group (N=1182).
• Statistical analyses included paired t tests, logistic and OLS regression, and repeated measures ANOVA.

Main Results:

• Both extended IOC and voluntary treatment were associated with reduced hospitalization and increased community treatment days.
• Extended IOC orders increased community treatment days to levels comparable to the voluntary group.
• Approximately six community treatment days were needed to achieve a one-day reduction in hospital utilization post-episode.

Conclusions:

• Extended IOC orders in Victoria facilitated community-based treatment, offering an alternative to hospitalization.
• IOC can enable a level of community treatment provision not otherwise achievable.
• The findings suggest IOC is an effective tool for managing long-term community care.