Use of involuntary outpatient commitment in community care of the seriously and persistently mentally ill patient.

Involuntary outpatient commitment (IOC) in some form has been adopted by all states as an alternative to hospital commitment. Regulations for IOC vary among the states. Although some studies have shown that IOC reduces hospital admission rates, research findings have not clearly determined the effectiveness of IOC or the type of concurrent care measures indicated. The limited community care available for IOC patients, the legalities, and the ethical issues surrounding the restriction of a client's autonomy and self-determination are rarely addressed. Nurses need to be prepared to advocate for patients who may be at risk for violation of their basic rights. More research is needed to validate the effectiveness of IOC and to determine when IOC is justified to support an individualized treatment program.