Patients on outpatient commitment orders in Northern Norway

Area of Science:

• Mental health services research
• Forensic psychiatry
• Public health policy

Background:

• Outpatient commitment (OC) orders mandate community-based compulsory treatment for patients.
• Increasing global adoption of OC orders contrasts with limited research on their practical implementation.
• Understanding OC practices is crucial for evaluating mental healthcare delivery.

Purpose of the Study:

• To investigate the utilization of inpatient services among patients subjected to outpatient commitment (OC) orders.
• To analyze changes in inpatient service use before and after the implementation of a first-ever OC order.
• To identify factors influencing the duration of OC orders.

Main Methods:

• Retrospective case register study analyzing medical files of patients with OC orders between 2008-2012.
• Pre/post design comparing inpatient service use in the three years preceding and following the first OC order.
• Data collected for patients receiving their first OC order in 2008 and 2009.

Main Results:

• A total of 345 OC orders for 286 individuals were identified; rates remained stable but declined later in the study.
• For 54 patients with their first OC order, need for treatment was the primary reason, with all receiving psychotropic medication.
• Inpatient admissions and days increased, while individual admission length decreased post-OC. 76% of first OC orders lasted under a year.
• Psychiatrist follow-up and depot medication predicted longer OC durations.

Conclusions:

• Patients receiving their first outpatient commitment (OC) order in Northern Norway demonstrated increased inpatient service utilization post-order.
• The study highlights a potential increase in inpatient care following OC, warranting further investigation.
• Further research is essential to determine if this increased inpatient service use signifies a benefit or a deficiency in OC effectiveness.