RT Journal Article SR Electronic T1 Interpreting the effectiveness of involuntary outpatient commitment: a conceptual model JF Journal of the American Academy of Psychiatry and the Law Online JO J Am Acad Psychiatry Law FD American Academy of Psychiatry and the Law SP 5 OP 16 VO 25 IS 1 A1 JW Swanson A1 MS Swartz A1 LK George A1 BJ Burns A1 VA Hiday A1 R Borum A1 HR Wagner YR 1997 UL http://jaapl.org/content/25/1/5.abstract AB Many experimental trials of community mental health interventions fail to develop testable conceptual models of the specific mechanisms and pathways by which relevant outcomes may occur, thus falling short of usefully interpreting what happens inside the experimental "black box." This paper describes a conceptual model of involuntary outpatient commitment (OPC) for persons with severe and persistent mental disorders. The model represents an attempt to "unpack" the effects of OPC by incorporating several interacting variables at various stages. According to this model, court-mandated outpatient treatment may improve long-term outcomes both directly and indirectly in several ways: by stimulating case management efforts, mobilizing supportive resources, improving individual compliance with treatment in the community, reducing clients' psychiatric symptoms and dangerous behavior, improving clients' social functioning, and finally by reducing the chance of illness relapse and rehospitalization. A randomized clinical trial of OPC is underway in North Carolina that will test the direct and indirect effects suggested by this model, using longitudinal data from the multiple perspectives of mental health clients, family members, and case managers.