Involuntary Outpatient Commitment in Florida: Case Information and Provider Experience and Opinions

Abstract

The use of involuntary outpatient commitment (IOC) is a significant international issue. Variations can be found in Australia, New Zealand, Scotland, Ontario (Canada), Switzerland, and the United States. Its use varies considerably by country and in the United States, between states. In Florida, the IOC statute has been used sparingly. This paper first presents information about the first fifty IOC cases in Florida including a description of the pre- and post-IOC order emergency commitments and state hospital admissions of these individuals. It then provides results from a survey of mental health professionals about their experience with and opinions about IOC. The majority of the individuals with IOC orders had at least one emergency commitment in the two years pre-IOC order (n = 46; range 1–7) and in the two years post-IOC order (n = 41; range 1–13). While 41 individuals experienced 68 total emergency commitments in the 180 days prior to the IOC order, 18 individuals had 24 emergency commitments in the 180 days after the order. Eleven had at least one state hospital admission pre-IOC order, with eight having such an admission post-IOC order. Results from the survey suggest that a number of issues have reduced the use of IOC, including difficulties in applying the statute, inadequate clinical resources, and skepticism regarding the practical effect of an IOC order on positive clinical outcomes. The implications of these results for policy development are discussed.