@article{ref1,
title="Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness",
journal="British journal of psychiatry",
year="2000",
author="Swanson, Jeffrey W. and Swartz, M. S. and Borum, Randy and Hiday, V. A. and Wagner, H. Ryan and Burns, B. J.",
volume="176",
number="",
pages="324-331",
abstract="BACKGROUND: Violent behaviour among persons with severe mental illness (SMI) causes public concern and is associated with illness relapse, hospital recidivism and poor outcomes in community-based treatment. AIMS: To test whether involuntary out-patient commitment (OPC) may help to reduce the incidence of violence among persons with SMI. METHOD: One-year randomised trial of the effectiveness of OPC in 262 subjects with psychotic or major mood disorders and a history of hospital recidivism. Involuntarily hospitalised subjects awaiting OPC were randomly assigned to release or court-ordered treatment after discharge. Those with a recent history of serious assault remained under OPC until expiry of the court order (up to 90 days); then OPC orders were renewed at clinical/court discretion. Control subjects had no OPC. Four-monthly follow-up interviews with subject, case manager and collateral informant took place and service records were collected. RESULTS: A significantly lower incidence of violent behaviour occurred in subjects with > or = 6 months' OPC. Lowest risk of violence was associated with extended OPC combined with regular out-patient services, adherence to prescribed medications and no substance misuse. CONCLUSIONS: OPC may significantly reduce risk of violent behaviour in persons with SMI, in part by improving adherence to medications while diminishing substance misuse.<p /><p>Language: en</p>",
language="en",
issn="0007-1250",
doi="",
url="http://dx.doi.org/"
}