Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb:56:97-104.
doi: 10.1016/j.eurpsy.2018.12.001. Epub 2019 Jan 14.

The utility of outpatient commitment: Reduced-risks of victimization and crime perpetration

Steven P Segal  1 , Lachlan Rimes  2 , Stephania L Hayes  3
Affiliations

The utility of outpatient commitment: Reduced-risks of victimization and crime perpetration

Steven P Segal et al. Eur Psychiatry. 2019 Feb.

Abstract

Background: Outpatient civil commitment (OCC) provisions, community treatment orders (CTOs) in Australia and Commonwealth nations, are part of mental health law worldwide. This study considers whether and by what means OCC provides statutorily required "needed-treatment" addressing two aspects of its legal mandate to protect the safety of self (exclusive of deliberate-self-harm) and others.

Method: Over a 12.4-year period, records of hospitalized-psychiatric-patients, 11,424 with CTO-assignment and 16,161 without CTO-assignment were linked to police-records. Imminent-safety-threats included perpetrations and victimizations by homicides, rapes, assaults/abductions, and robberies. "Need for treatment" determinations were validated independently by Health of the Nations Scale (HoNOS) severity-score-profiles. Logistic regressions, with propensity-score- adjustment and control for 46 potential confounding-factors, were used to evaluate the association of CTO-assignment with occurrence-risk of perpetrations and victimizations.

Results: CTO-assignment was associated with reduced safety-risk: 17% in initial-perpetrations, 11% in initial-victimizations, and 22% for repeat-perpetrations. Each ten-community-treatment-days in interaction with CTO-assignment was associated with a 3.4% reduced-perpetration-risk. CTO-initiated-re-hospitalization was associated with a 13% reduced-initial-perpetration-risk, a 17% reduced-initial-victimization-risk, and a 22% reduced-repeat-victimization-risk. All risk-estimates appear to be the unique contributions of the CTO, CTO-initiated-re-hospitalization, or the provision of ten-community-treatment-days-i.e. after accounting for the influence of prior crimes and victimizations, ethnic-bias, neighborhood disadvantage and other between-group differences in the analysis.

Conclusions: CTO assignment's association with reduced criminal-victimization and perpetration-risk, in conjunction with requiring participation in needed-treatment via re-hospitalization and community-service, adds support to the conclusion that OCC is to some extent fulfilling its legal objectives related to protecting safety of self (exclusive of deliberate-self-harm), and others.

Keywords: Community treatment orders; Forensic psychiatry; Outpatient civil commitment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

Authors Have No Conflicts Of Interest Associated With This Study.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bazelon center for mental health law. Washington D.C: Involuntary outpatient commitment: summary of state statutes; Bazelon Center for Mental Health Law; 2004. http://www.bazelon.org.
    1. Dennis H, 647 N.W.2d (Wis,2002) p. 863.
    1. Glover-Thomas NR. Reconstructing mental health law and policy. London: Lexis Nexis Butterworths Tolley; 2002.
    1. U.S. Civil Commitment Laws by State. Downloaded 30 December, 2017 from http://www.treatmentadvocacycenter.org/browse-by-state; Victoria Mental Health Act 1986, No. 59 of 1986, Version No. 098;Version incorporating amendments as at 24 August 2010 http://www.legislation.vic.gov.au/Domino/Web_Notes/LDMS/LTObject_Store/L... Mental Health Act 1996 (Tas) s 24. http://www.dhhs.tas.gov.au/mentalhealth/mental_health_act/mental_health_... Mental Health Act 2000 (NSW) s 14(1)(b). Mental Health Act 1998 (WA) s 26(2). Mental Health Act 2000 (Qld) s 14(1)(f). ttps://www.legislation.qld.gov.au/view/pdf/2002-07-19/act-2000–016 UK Mental Health Act 2007–8, www.legislation.gov.uk/ukpga/2007/12/pdfs/ukpga_20070012_en.pdf;.
    1. U.K. Parliament Health Committee. Post-legislative scrutiny of the mental health act 2007 - health committee contents, sec 5 supervised Community treatment, #80. 2013. Downloaded 24/2/18 https://publications.parliament.uk/pa/cm201314/cmselect/cmhealth/584/584....

MeSH terms