Skip to main content

The Efficacy of Involuntary Outpatient Treatment in Massachusetts

Abstract

One means to address some of the unintended consequences of the shift of treatment for individuals with serious mental illness from hospitals to communities has been involuntary outpatient treatment (IOT). Using Massachusetts data, 19 patients with court orders for IOT were matched to all and to best fits on demographic and clinical variables, and then to individuals with the closest fit on utilization before the IOT date. Outcomes indicated the IOT group had significantly fewer admissions and hospital days after the court order. The full impact of IOT requires more study, particularly directed toward IOT's effects on insight and quality of life.

This is a preview of subscription content, access via your institution.

REFERENCES

  • Addington v. Texas, 441 U.S. 426 (1979)

  • Addington v. Texas, 429.

  • Cook, T.D. & Campbell, D.T. (1979). Quasi-experimentation: Design and analysis issues for field settings. Skokie, IL: Rand McNally.

    Google Scholar 

  • Fernandez, G.A. (1992). Evaluation of involuntary outpatient commitment in North Carolina. Raleigh, NC: North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.

    Google Scholar 

  • Fernandez, G.A., & Nygard, S. (1990). Impact of involuntary outpatient commitment on the revolving-door syndrome in North Carolina. Hospital & Community Psychiatry,41, 1001–1004.

    Google Scholar 

  • Geller, J.L. (1986). In again, out again: A preliminary evaluation of a state hospital's worst recidivists. Hospital & Community Psychiatry,37, 386–390.

    Google Scholar 

  • Geller, J.L. (1986). The quandaries of enforced community treatment and unenforceable outpatient commitment statutes. The Journal of Psychiatry and the Law,14, 149–158.

    Google Scholar 

  • Geller, J.L. (1990). Clinical guidelines for the use of involuntary outpatient treatment. Hospital & Community Psychiatry,41, 749–755.

    Google Scholar 

  • Geller, J.L. (1993). On being “committed” to treatment in the community. Innovations and Research,2, 23–27.

    Google Scholar 

  • Geller, J.L. (1996). Make 'em do it. Psychiatric Services,47, 1157.

    Google Scholar 

  • Haycock, J., Finkelman, D., & Presskreischer, H. (1994). Mediating the gap: Thinking about alternatives to the current practice of civil commitment. New England Journal on Criminal and Civil Confinement,20, 265–289.

    Google Scholar 

  • Hiday, V.A. (1996). Outpatient commitment: Official coercion in the community. In D.L. Dennis & J. Monahan (Eds.),Coercion and aggressive community treatment. A new frontier in mental health law. New York: Plenum Press.

    Google Scholar 

  • Hiday, V.A., & Goodman, R.R. (1982). The least restrictive alternative to involuntary hospitalization, outpatient commitment: Its use and effectiveness. Journal of Psychiatry and Law, 10, 81–96.

    Google Scholar 

  • Hiday, V.A., & Scheid-Cook, T.L. (1987). The North Carolina experience with outpatient commitment: A critical appraisal. International Journal of Law and Psychiatry, 10, 215–232.

    Google Scholar 

  • Hiday, V.A., & Scheid-Cook, T.L. (1989). A follow-up of chronic patients committed to outpatient treatment. Hospital & Community Psychiatry, 40, 52–58.

    Google Scholar 

  • Lamb, H.R., & Weinberger, L.E. (1992). Conservatorship for gravely disabled psychiatric patients: A four-year follow-up study. American Journal of Psychiatry, 149, 909–913.

    Google Scholar 

  • Lamb, H.R., & Weinberger, L.E. (1993). Therapeutic use of conservatorship in the treatment of gravely disabled psychiatric patients. Hospital & Community Psychiatry, 44, 147–150.

    Google Scholar 

  • Luckstead, A., Coursey, R.D. (1995). Consumer perceptions of pressure and force in psychiatric treatments. Psychiatric Services, 46, 146–152.

    Google Scholar 

  • Mill, J.S. (1859). On liberty. London: J.W. Parker and Son.

    Google Scholar 

  • Mulvey, E.P., Geller, J.L., & Roth, L.H. (1987). Balancing the promises and perils of involuntary outpatient commitment. American Psychologist, 42, 571–584.

    Google Scholar 

  • Schneider-Braus, K. (1986). Civil commitment to outpatient psychotherapy: A case study. Bulletin of the American Academy of Psychiatry and the Law, 14, 273–279.

    Google Scholar 

  • Schwartz, S.J., & Costanzo, C.L. (1987). Compelling treatment in the community: Distorted doctrines and violated values. Loyola of Los Angeles Law Review, 20, 1239–1429.

    Google Scholar 

  • Siegal, S., & Castellan, N.J. (1988). Non-parametric statistics for the behavioral sciences. New York: McGraw-Hill.

    Google Scholar 

  • Stefan, S. (1987). Preventive commitment: The concept and its pitfalls. Mental and Physician Disability Law Reporter II, 288–302.

  • Stone, A.A. (1982). Psychiatric abuse and legal reform: Two ways to make a bad situation worse. International Journal of Law and Psychiatry, 5, 9–28.

    Google Scholar 

  • Torrey, E.F., & Kaplan, R.J. (1995). A national survey of the use of outpatient commitment. Psychiatric Services, 46, 778–784.

    Google Scholar 

  • Treffert, D. (1973). Dying with their rights on. American Journal of Psychiatry, 130, 1041.

    Google Scholar 

  • Van Putten, R.A., Santiago, J.M., & Berren, M.R. (1988). Involuntary outpatient commitment in Arizona: A retrospective study. Hospital & Community Psychiatry, 39, 953–958.

    Google Scholar 

  • Zanni, G., & deVeau, L. (1986). Inpatient stays before and after outpatient commitment. Hospital & Community Psychiatry, 37, 941–942.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Geller, J., Grudzinskas, A.J., McDermeit, M. et al. The Efficacy of Involuntary Outpatient Treatment in Massachusetts. Adm Policy Ment Health 25, 271–285 (1998). https://doi.org/10.1023/A:1022239322212

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022239322212

Keywords

  • Public Health
  • Mental Illness
  • Clinical Variable
  • Unintended Consequence
  • Outpatient Treatment