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Substance Abuse and Mental Health Services Administration
Impact of Outpatient Commitment on Victimization of People with Severe Mental Illness
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Objective: The authors’ goal was to evaluate
the effectiveness of outpatient commitment
in reducing victimization among people with severe mental illness. Method: One hundred eighty-four involuntarily hospitalized patients were randomly assigned to be released (N=99) or
to continue under outpatient commitment (N=85) after hospital discharge. An additional group of patients with a recent history of serious violent behavior (N=39) was nonrandomly assigned to at least a brief period of outpatient commitment following hospital discharge. All three groups were followed for 1 year, and case management services plus additional outpatient treatment were provided to all subjects. Outcome data were based on interviews with the patients and informants
as well as service records. Results: Subjects who were ordered to outpatient commitment were less likely to be criminally victimized than those who were released without outpatient
commitment. Multivariate analysis indicated
that each additional day of outpatient
commitment reduced the risk of criminal victimization and that outpatient commitment had its effect through improved medication adherence, reduced substance use or abuse, and fewer violent incidents. Conclusions: Protection from criminal victimization appears to be a positive, unintended consequence of outpatient commitment. (Authors)
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