Outpatient commitment: What, why, and for whom

The authors describe studies showing the effectiveness of involuntary outpa tient commitment in improving treatment compliance, reducing hospital readm ission, and reducing episodes of violence among persons with severe psychia tric illnesses. They point out that because of its role in enhancing compli ance with treatment, outpatient commitment can be regarded as a form of ass isted treatment, such as assertive case management, representative payeeshi p, and mental health courts. The authors argue that such assisted treatment is necessary for persons with severe psychiatric illnesses who are noncomp liant with their medication regimens because many lack awareness of their i llnesses because of biologically based cognitive deficits. They recommend o utpatient commitment for any individual with a severe psychiatric disorder who has impaired awareness of his or her illness and is at risk of becoming homeless, incarcerated, or violent or of committing suicide, and they prov ide case examples. The authors conclude by addressing eight of the most com mon objections to outpatient commitment by mental health professionals and civil liberties groups that oppose outpatient commitment.