This study examines factors that contribute to the subjective strain experienced by caregivers of persons with severe mental illness and addresses potential improvement in caregiver strain associated with involuntary outpatient commitment. Subjects from a population of involuntarily hospitalized people awaiting discharge under outpatient commitment were randomly assigned to be released or continue under outpatient commitment after hospital discharge. A nonrandomized group with a recent history of serious violence was also studied under outpatient commitment. Randomized control and outpatient commitment groups did not differ significantly in caregiver strain. However, analyses of all subjects, including the nonrandomized violent group, showed that among subjects who underwent sustained periods of outpatient commitment, caregivers reported significantly decreased subjective strain compared with caregivers of those who underwent only brief outpatient commitment or none. Improved treatment adherence also reduced caregiver strain independently of the effect of sustained outpatient commitment.