A follow-up of chronic patients committed to outpatient treatment.
ABSTRACT Data collected in a statewide study of psychiatric patients involved in civil commitment hearings in North Carolina were used to evaluate the effectiveness of outpatient commitment as a less restrictive alternative to involuntary hospitalization. Six months after the commitment hearings, outcome data for patients who were committed to outpatient treatment were compared with outcome data for patients who were released and patients who were involuntarily hospitalized. All three groups comprised patients who were chronically mentally ill, had previously been hospitalized, and had histories of medication refusal and dangerousness. Patients who were committed to outpatient treatment were significantly more likely than patients with the other two dispositions to utilize aftercare services and to continue in treatment.
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ABSTRACT: There is little objective evidence to support the use of community treatment orders (CTOs) from randomized controlled trials. Qualitative research indicates more negative than positive responses to the use of CTOs. Nonetheless, the use of CTOs is growing internationally. There is no research to identify for whom CTOs may be a positive experience. To assess patients' perspectives of CTOs, assessing for correlates with clinical and demographic variables. Patients currently or previously subject to a CTO were assessed quantitatively to identify their experience. Demographic data, the experience of coercion, views of detention, satisfaction with care, social functioning and psychopathology were correlated using SPSS. Fifty-three per cent of patients felt that they were, on balance, better off when treated informally in the community. Patients described greater coercion and less satisfaction with care when subject to a CTO. These factors, and being in employment, identified patients whom felt harmed by CTOs 61% of the time. This paper highlights that more than half of patients under a CTO consider it negatively. This group is identified by patients who work, experience coercion and are unsatisfied with care. This has implications for the application of CTOs.International Journal of Social Psychiatry 08/2013; 60(5). DOI:10.1177/0020764013498870 · 1.15 Impact Factor
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ABSTRACT: There is an urgent need for pertinent outcome information. Relevance for decision makers must take priority over scientific rigor. However, a review of computer-identified outcome evaluation reports from community service settings, during the past 5 years, suggests that much more has been said than has been done. Although relatively heterogeneous in scope, these studies focused on the effects of community support services for adults with persistent and severe mental illness; traditional outpatient services have been neglected. Studies are characterized by multidimensional, standardized outcome assessment, and nonequivalent comparison group and single cohort designs. Randomized designs, with usual services as the control condition, were feasible in some situations. Inadequate sample size and attrition continue to be method problems.Clinical Psychology Science and Practice 01/2006; 3(2):105 - 129. DOI:10.1111/j.1468-2850.1996.tb00061.x · 2.92 Impact Factor
- International Journal of Law and Psychiatry 02/1992; 15(4):359-77. DOI:10.1016/0160-2527(92)90017-U · 1.19 Impact Factor