Use of outpatient commitment or related civil court treatment orders in five U.S. communities.
Use of outpatient commitment or related civil court treatment orders in five U.S. communities.
复制标题
在美国五个社区使用门诊承诺或相关民事法庭治疗令。
DOI：
10.1176/appi.ps.57.3.343
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Petrila,John
中科院分区：
文献类型：
--
作者：
Swartz,MarvinS;Swanson,JeffreyW;Kim,Mimi;Petrila,John
目的：利用门诊承诺和一些相关的民事法院机制，试图提高社区精神卫生治疗的依从性。本研究调查了美国五个社区的终身使用率和门诊承诺或相关民事法院命令门诊治疗的相关性。方法共从五个地点招募和访谈1,011名门诊患者：芝加哥；北卡罗来纳州的达勒姆；旧金山;坦帕;以及马萨诸塞州的伍斯特。结果12%至20%的消费者报告了门诊承诺或相关的民事法院命令治疗。在居住在有工作人员的住宿环境中、接受门诊治疗援助、报告社会支持差的参与者以及同时存在药物使用问题、心理社会功能差、最近有暴力行为史、终身住院率和非自愿住院率较高的参与者中，门诊承诺或相关法院命令的历史明显更为常见。以及最近警察在心理健康危机中遭遇的情况。近四分之三报告了门诊承诺或相关民事法庭命令的人也报告了其他形式的杠杆治疗，这些多重杠杆治疗经历与高感知强迫和低满意度治疗密切相关。结论在与多个精神卫生、社会福利和刑事司法机构接触的精神疾病患者中，民事法院命令门诊治疗史最为常见，许多机构采用各自形式的杠杆治疗，试图提高依从性。需要进一步的研究来指导决策者对治疗不依从采取协调和有效的应对措施。
OBJECTIVEOutpatient commitment and a number of related civil court mechanisms are used to attempt to improve adherence to mental health treatment in the community. This study examined lifetime use rates and correlates of outpatient commitment or related civil court-ordered outpatient treatment in five U.S. communities.METHODSA total of 1,011 outpatients were recruited and interviewed from five sites: Chicago; Durham, North Carolina; San Francisco; Tampa; and Worcester, Massachusetts.RESULTSBetween 12 and 20 percent of consumers reported outpatient commitment or related civil court-ordered treatment. A history of outpatient commitment or related court orders was significantly more common among participants who lived in staffed residential settings, received assistance with outpatient treatment, and reported poor social support as well as among those who had co-occurring substance use problems, poor psychosocial functioning, a recent history of violent behavior, higher rates of lifetime hospitalization and of involuntary hospitalization, and recent police encounters during mental health crises. Nearly three-quarters of persons who reported outpatient commitment or related civil court orders also reported experiencing other forms of leveraged treatment, and these multiple leveraged-treatment experiences were strongly associated with high perceived coercion and poor satisfaction with treatment.CONCLUSIONSA history of civil court-ordered outpatient treatment was most common among persons with mental illness who came into contact with multiple mental health, social welfare, and criminal justice agencies, many of which applied their own forms of leveraged treatment in attempts to improve adherence. Further research is needed to guide policy makers in implementing coordinated and effective responses to treatment nonadherence.