The Effectiveness of Involuntary Outpatient Treatment

Empirical Evidence and the Experience of Eight States

by M. Susan Ridgely, John Borum, John Petrila


Download eBook for Free

FormatFile SizeNotes
PDF file 9 MB

Use Adobe Acrobat Reader version 7.0 or higher for the best experience.


Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback176 pages $15.00 $12.00 20% Web Discount

Many states use civil commitment — a statutorily created and court-ordered form of compulsory treatment — to compel people with mental illness who become gravely disabled or dangerous to themselves or others to undergo treatment. In the last decade, many states have amended or interpreted their existing civil commitment statutes to allow for involuntary outpatient treatment. Such a law has been proposed for California. At the request of the California State Senate, the authors conducted a systematic literature review on involuntary outpatient commitment; examined the experience of eight other states including statutory analysis and in-depth interviews with attorneys, public officials, and psychiatrists; and analyzed California administrative data for all persons served by California's county contract mental health agencies. They found that involuntary outpatient commitment, when combined with intensive mental health services, can be effective in reducing the risk of negative outcomes. But whether a court order in and of itself has any effect is an unanswered question. However, there is clear evidence that intensive community-based voluntary mental health treatment can produce good outcomes. There are no cost effectiveness studies that compare the relative return on investment in developing an involuntary outpatient treatment system or focusing all available resources on developing state-of-the-art treatment systems. Either approach would require a sustained commitment by California policymakers.

Related Products

The research described in this report was performed under the auspices of RAND's Institute for Civil Justice and RAND Health.

This report is part of the RAND Corporation monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.