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Conceptualizing services research on outpatient commitment

J Draine1

  • 1Center for Mental Health Policy and Services Research, University of Pennsylvania Medical Center, Philadelphia 19104, USA.

Journal of Mental Health Administration
|July 1, 1997
PubMed
Summary
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Research on involuntary outpatient commitment (OC) for serious mental illness needs better outcome measures. Studies should consider family roles, coercion, and conceptualization, viewing rehospitalization as an intermediate step, not the final outcome.

Area of Science:

  • Psychiatry
  • Mental Health Services Research
  • Health Outcomes Research

Background:

  • Involuntary outpatient commitment (OC) is a critical intervention for individuals with serious mental illness.
  • Current research on OC outcomes faces methodological and conceptual challenges.
  • Existing studies often rely on limited outcome measures, such as hospital recidivism.

Purpose of the Study:

  • To explore critical issues affecting the research of involuntary outpatient commitment outcomes.
  • To propose a conceptual framework for more robust OC outcome research.
  • To guide future research by identifying key variables and outcome conceptualizations.

Main Methods:

  • Literature review and critical analysis of existing OC outcome research.

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  • Development of a conceptual framework integrating various aspects of OC.
  • Identification of limitations in current study designs and outcome measures.

    • Main Results:

    • Reliance on hospital recidivism as a primary outcome measure is insufficient.
    • The role of family members and the nature of coercion require deeper investigation.
    • Conceptualization and study design need refinement to capture comprehensive outcomes.

    Conclusions:

    • Future OC research must adopt broader conceptual models.
    • Models should incorporate family role and burden, services provided, and diverse coercive mechanisms.
    • Rehospitalization should be viewed as an intermediate variable, not the ultimate client-level outcome.