Efficacy of continuing advocacy in involuntary treatment

Objective: The effectiveness of an experimental model of personal advocacy for involuntarily hospitalized psychiatric patients was examined. In the mo del, a personal advocate represented the needs and best interests of patien ts throughout the period of involuntary hospital treatment. Methods: The sa mple consisted of 105 involuntarily hospitalized psychiatric inpatients in Canberra, Australia, Fifty-three consecutive patients received personal adv ocacy, which started soon after they entered the hospital and lasted throug h the commitment process to the time of discharge front involuntary care. T he outcome of this group was compared with that of 52 consecutive patients in a control group who received routine lights advocacy from hospital entry through the commitment hearing only. Results: The experimental and control groups were similar in demographic characteristics, diagnosis, and severit y of illness. nt the start of hospital care, satisfaction with care was sim ilar in both groups; however, it improved significantly in the experimental group while it declined in the control group. Aftercare attendance was sig nificantly better in the experimental group. The experimental subjects' ris k of involuntary rehospitalization was less than half the risk of control s ubjects, and community tenure was significantly increased. Clinical staff r eported that the experimental advocacy facilitated management of patients. Conclusions: Compared with routine rights advocacy the experimental advocac y based on patients' needs and best interests, which was maintained through out the patients' involuntary hospitalization, significantly improved patie nts' and staff members' experience of involuntary treatment. Better complia nce with aftercare among patients receiving personal advocacy led to a stat istically and economically significant reduction in rehospitalization.