Involuntary outpatient commitment, community treatment orders, and assisted outpatient treatment: what's in the data?

OBJECTIVE Involuntary outpatient commitment (OPC), also referred to as community treatment orders or assisted outpatient treatment, is a legal intervention intended to improve treatment adherence among persons with serious mental illness. This paper reviews the empirical literature on the procedure's effectiveness. METHODS We identified and reviewed all English-language studies of OPC and related procedures available in Medline and other bibliographic search services. RESULTS Existing naturalistic and quasi-experimental studies, taken as a whole, moderately support the view that the procedure is effective, although all do have methodological limitations. Two randomized controlled studies of OPC have conflicting findings and are reviewed in detail. CONCLUSIONS On balance, empirical studies support the view that OPC is effective under certain conditions, although some of the evidence has been contested and the policy remains controversial.