Economic grand rounds: Can states implement involuntary outpatient commitment within existing state budgets?

Psychiatr Serv. 2013 Jan;64(1):7-9. doi: 10.1176/


Many states have not implemented involuntary outpatient commitment, possibly believing that the program is too costly. A review of New York State's experience found that even though the state had appropriated funds for implementing outpatient commitment, overall cost savings were realized. This column presents an analysis in which net costs of outpatient commitment were calculated by using data from a randomized controlled study in North Carolina, where court-ordered treatment was implemented without additional appropriations. The analysis found that outpatient commitment in North Carolina was relatively cost-neutral when relevant costs for persons on outpatient commitment were compared with costs for persons not on outpatient commitment, regardless of commitment duration. Outpatient commitment of six months or more, combined with provision of outpatient services, appeared to result in cost savings of 40%. Findings suggest that states with adequate services to provide consumers on outpatient commitment may implement a program without new funding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care / economics*
  • Budgets*
  • Commitment of Mentally Ill / economics
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Community Mental Health Services / economics
  • Community Mental Health Services / statistics & numerical data
  • Costs and Cost Analysis / methods
  • Criminal Law
  • Humans
  • New York
  • North Carolina
  • Program Evaluation
  • Randomized Controlled Trials as Topic