Brief Reports: Outcomes of Patients in a Low-Intensity, Short-Duration Involuntary Outpatient Commitment Program

Pollack, David A.; McFarland, Bentson H.; Mahler, Jo; Kovas, Anne E.

doi:10.1176/appi.ps.56.7.863

Cited by 17 publications

(20 citation statements)

References 10 publications

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“…In the present work, and in agreement with the medical literature, OPC is applied with greater frequency to persons with schizophrenia (73%). Like other authors, 6 , 21 , 22 , 27 - 29 we found no significant differences between the control and OPC groups in the use of healthcare services: number of emergency visits, number of hospital admissions and average length of hospital stay.…”

Section: Discussionsupporting

confidence: 78%

Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up

Castells-Aulet¹,

Hernández-Viadel

Jiménez-Martos

et al. 2015

BJPsych Bull

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Aims and method To evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared.Results No statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two.Clinical implications The findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital.

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Section: Discussionsupporting

confidence: 78%

Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up

Castells-Aulet¹,

Hernández-Viadel

Jiménez-Martos

et al. 2015

BJPsych Bull

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“…Involuntary re-admission was reported in both studies [34,35]. One randomised study [35] could not establish a difference in involuntary re-admission between advanced directives and usual care for in-patients about to be discharged from compulsory treatment (p=0.78).…”

Section: Effect On Involuntary Admissionmentioning

confidence: 90%

“…An overview of full text excluded studies in the update (N=4) are listed in Appendix II. Davidson and Campbell [26] 2007 Northern Ireland A) in community Wierdsma, et al [27] 2007 Netherlands A) in community Johnson, et al [28] 2005 England A) in community Henderson, et al [29] 2004 England A) in community Putkonen, et al [17] 2013 Finland B) in hospital Van De Sande, et al [30] 2011 Netherlands B) in hospital Ohlenschlaeger, et al [31] 2007 Denmark B) in hospital Abderhalden, et al [32] 2008 Switzerland B) in hospital Rosenman, et al [33] 2000 Australia B) in hospital Pollack, et al [34] 2005 USA C) at discharge Papageorgiou, et al [35] 2002 England C) at discharge…”

Section: Description Of Studiesmentioning

confidence: 99%

Interventions for Reducing Coercion in Mental Health for Adults: A Systematic Review and the Impact of Updating

Dahm

Jensen

Husum

et al. 2015

Journal of Brain Sciences

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Background: Reduction of use of coercive measures in Mental Health Care has been of increasing concern for patient organizations, governmental agents and health policy makers. Aim: To examine the effectiveness of psychosocial interventions intended to reduce coercion in mental health for adults. Methods: We conducted a systematic review in 2012 and update in 2013. Studies with control groups were included. Assessment of risk of bias and meta-analyses of randomized controlled studies was undertaken. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool for evaluating the overall quality of evidence was used and expressed in four categories: high, moderate, low and very low. Results: Fifteen studies met the inclusion criteria. For the intervention Joint crisis plan, a reduction in the number of patients admitted involuntarily could not be verified by meta-analyses (RR 0.71 (95% CI 0.38-1.33), P=0.28). Quality of evidence was assessed as low by GRADE and the results should be interpreted with caution. Risk assessment of aggressive behaviour in acute psychiatric wards and counselling towards staff in high security wards seemed to reduce seclusion and restraint, but for these interventions meta-analyses was not feasible. Conclusion: Joint crisis plans for reducing coercion is unclear. Risk assessment and counselling towards staff may reduce coercion.

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“…The AOT sample was identified by the mental health services board and consisted of all who had been receiving AOT for at least 6 months from 2000 through 2005. We excluded individuals who were receiving AOT for fewer than 6 months because prior research suggested this length of time was needed to achieve reductions in psychiatric hospitalizations (3,9). For the sample of 74 individuals, we examined changes in the number of days of psychiatric hospitalization before, during, and after AOT.…”

Section: Methodsmentioning

confidence: 99%

Association Between Hospitalization and Delivery of Assisted Outpatient Treatment With and Without Assertive Community Treatment

Munetz

Ritter

Teller

et al. 2019

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This study examined hospitalizations for individuals receiving assisted outpatient treatment (AOT), some of whom also received assertive community treatment (ACT). We examined whether participation in AOT, as well as in AOT paired with ACT services, was associated with reduced hospitalizations.Methods: Data were collected for 74 people who were receiving AOT for at least 6 months. Comparisons were made between those receiving AOT with ACT and those receiving AOT without ACT. Changes were examined in number and days of hospitalization before, during, and after AOT on an annualized basis.Results: AOT was associated with reduced hospitalizations and hospital days during and after the court order. Participating in AOT without ACT was associated with fewer hospitalizations during and after AOT and fewer days hospitalized after the court order ended.Conclusions: Individuals whose needs can be met with less intensive services while under an AOT order may not require ACT.

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Brief Reports: Outcomes of Patients in a Low-Intensity, Short-Duration Involuntary Outpatient Commitment Program

Cited by 17 publications

References 10 publications

Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up

Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up

Interventions for Reducing Coercion in Mental Health for Adults: A Systematic Review and the Impact of Updating

Association Between Hospitalization and Delivery of Assisted Outpatient Treatment With and Without Assertive Community Treatment

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