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ASSISTED OUTPATIENT TREATMENT
What is Assisted Outpatient Treatment?
- "Involuntary outpatient care is an innovative answer to
the deinstitutionalization of the severely mentally ill who cannot or will not care for
themselves."
(Meloy, Reid J., et al, Clinical Guidelines for Involuntary Outpatient Treatment,
Professional Resource Exchange, Inc. 1990, pg. 64)
Assisted Outpatient Treatment Saves Money by Reducing Revolving Door
Hospitalizations
- "Involuntary outpatient commitment (OPC) is a civil
justice procedure intended to enhance compliance with community mental health treatment,
to improve functioning, and to reduce recurrent dangerousness and hospital recidivism. The
research literature on OPC indicates that it appears to improve outcomes in rates of
rehospitalization and length of stay."
(Swartz, MS et al, The ethical challenges of a
randomized controlled trial of involuntary outpatient commitment, Journal of Mental Health
Adm., 24 (1):35-43, 1997 Winter)
Assisted Outpatient Treatment Increases Medication Compliance
- "Patients who were committed to outpatient treatment
were significantly more likely
to utilize aftercare services and to continue in
treatment."
(Hiday, Virginia; Scheid-Cook, Teresa, A Follow-up of Chronic Patients Committed to
Outpatient Treatment, Hospital and Community Psychiatry, January 1989, Vol. 40, No. 1)
- "Outpatient commitment appears to improve compliance
with treatment in about 80% of patients."
(Rohland, Barbara, The Role of Outpatient Commitment in the Management of Persons with
Schizophrenia, Report, Iowa Consortium for Mental Health Services, Training, and Research,
May 1998)
Assisted Outpatient Treatment Increases Treatment Compliance Even
After Court Order Expires
- "
outpatient commitment induces compliance and
leads to treatment maintenance even after the court order terminates."
(Hiday, Scheid-Cook, "Outpatient Commitment for "Revolving Door"
Patients: Compliance and Treatment, The Journal of Nervous and Mental Disease, 1991, Vol.
179, No. 2)
- "
the percentage of patients who voluntarily
maintained an active relationship with community treatment centers six months after
commitment increased significantly after outpatient commitment was instituted."
( Robert A. Van Putten, M.D.; Jose M. Santiago, M.D.; and Michael R. Berren, Ph.D.,
Hospital and Community Psychiatry (vol. 39, no. 9, pp. 953-958), September, 1988 )
Assisted Outpatient Treatment Reduces Violence
- "OPC works in terms of keeping patients in treatment
and on medication, increasing compliance, permitting residence outside an institution and
social interaction outside the home, and maintaining patients in the community with few
dangerous episodes."
(Hiday, V, Scheid-Cook, T, The North Carolina Experience with Outpatient Commitment: A
critical Appraisal, International Journal of Law and Psychiatry, Vol. 10, 215-231, 1987
Assisted Outpatient Treatment is more effective than Assertive Case
Management Alone
- "
the sustained use of OPC and aggressive services
provision act synergistically, especially in psychotically disordered individuals, to
improve these outcomes."
(Swartz, Marvin, et al, Can Involuntary Outpatient Commitment Reduce Hospital
Recidivism? Findings from a Randomized Trial With Severely Mentally Ill Individuals, Am J
Psychiatry 1566:12, Dec. 1999)
Assisted Outpatient Treatment Reduces Substance Abuse
- "Positive improvements were found in all areas of
functioning with the most consistent effects for medication compliance, substance abuse,
and violence."
(OKeefe, et al, Treatment Outcomes for Severely Mentally Ill Patients
Conditionally Discharged to Community Based Treatment, Journal of Nervous and Mental
Diseases, 185:409-411, 1997)
Assisted Outpatient Treatment Reduces Criticism of Mental Health
System
- "One criticism remained. The law was letting a needy
group slip through its cracks.
the state legislature designed the outpatient
commitment law (OPC) to fill the cracks in the statute through which this needy group had
fallen
The data indicate that OPC is successful."
(Hiday, V, Scheid-Cook, T, The North Carolina Experience with Outpatient Commitment: A
critical Appraisal, International Journal of Law and Psychiatry, Vol. 10, 215-231, 1987)
Assisted Outpatient Treatment Commits the System to the Patient
- "PRA found that the court orders provided a structure
around which providers and patients constantly negotiated the terms of
treatment
therefore assist in soliciting patient compliance in the community and
preventing relapse."
(Telson, H., et al, Report of the Bellevue Hospital Center Outpatient Commitment Pilot
Program, March 1, 1999)
- "According to this model, court-mandated outpatient
treatment may improve long-term outcomes both directly and indirectly in several ways: by
stimulating case management efforts, mobilizing supportive resources, improving individual
compliance with treatment in the community, reducing clients psychiatric symptoms
and dangerous behavior, improving clients social functioning, and finally be
reducing the chance of illness relapse and rehospitalization."
(Swanson, et al, Interpreting the effectiveness of involuntary outpatient commitment, a
conceptual model, Journal of American Academy of Psychiatry and the Law, 25 (1):5-16,
1997)
This document was complied by the California
Treatment Advocacy Coalition
For more information call Carla Jacobs at
562-438-4174
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