Assessing the New York City involuntary outpatient commitment pilot program

Objective: The study evaluated the effectiveness of a three-year outpatient commitment pilot program established in 1994 at Bellevue Hospital in New Y ork City. Methods: A total of 142 participants were randomly assigned; 78 r eceived court-ordered treatment, which included enhanced services, and 64 r eceived the enhanced-service package only. Between 57 and 68 percent of the subjects completed interviews at one, five, and 11 months after hospital d ischarge. Outcome measures included rehospitalization, arrest, quality of l ife, symptomatology, treatment noncompliance, and perceived level of coerci on. Results: On all major outcome measures, no statistically significant di fferences were found between the two groups. No subject was arrested for a violent crime. Eighteen percent of the court-ordered group and 16 percent o f the control group were arrested at least once. The percentage rehospitali zed during follow-up was about the same for both groups-51 percent and 42 p ercent, respectively The groups did not differ significantly in the total n umber of days hospitalized during the follow-up period. Participants' perce ptions of their quality of Life and level of coercion were about the same. From the community service providers' perspective, patients in the two grou ps were similarly adherent to their required treatments. Conclusions: All r esults must be qualified by the fact that no pick-up order procedures for n oncompliant subjects in the court-ordered group were implemented during the study, which compromised the differences between the conditions for the tw o groups, and that persons with a history of violence were excluded from th e program.