The Effectiveness of Involuntary Outpatient Treatment: Empirical Evidence and the Experience of Eight States

In the last decade, many states have amended or interpreted their existing civil commitment statutes to allow for involuntary outpatient treatment. At the request of the California State Senate, the authors conducted a systematic literature review on involuntary outpatient commitment 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, could be effective in reducing the risk of negative outcomes. 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.