Effectiveness of involuntary outpatient commitment.

To the Editor: Having observed patient progress during conditional release (a form of involuntary outpatient commitment) and found the policy useful in protecting some individuals with serious mental illness, I anticipated positive results from the randomized clinical trial by Dr. Swartz et al. The investigators randomly assigned patients released from a mental hospital to one of two conditions: involuntary outpatient commitment (analogous to parole) or unconditional release. All patients were followed for 12 months. The finding of no difference between the involuntary outpatient commitment and control groups in the number and duration of rehospitalizations at follow-up was instructive regarding the limitations of clinical judgment.