Opposing arguments are heard from two extremes. On one side are civil libertarian legal advocates and representatives for mental health consumer groups who see outpatient commitment as an infringement on constitutionally protected personal freedom. There is ample room for consensus in the middle ground, where the real issue is not whether one favors or opposes any use of legal coercion in community mental health treatment, but for which subgroups it may be beneficial and appropriate, and how should it be applied.
Outpatient commitment offers a less-restrictive alternative to hospitalization.
Our recent study in North Carolina addressed this question with a one-year experiment among 331 people with severe mental illness. A Rand report has interpreted our results to mean that if a court order and intensive treatment work together, it is difficult to tell if there is any net benefit to outpatient commitment per se. In fact, our study tested the net effect of outpatient commitment as well as the complementary role of intensive services delivery. We found that subjects who were high-intensity service users without outpatient commitment had no better outcomes than their counterparts who received infrequent services or no services at all. Admittedly, outpatient commitment presents thorny dilemmas.