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Am J Community Psychol. 2008 Sep;42(1-2):135-44. doi: 10.1007/s10464-008-9180-1.

A randomized trial of a mental health consumer-managed alternative to civil commitment for acute psychiatric crisis.

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Alcohol Research Group, Public Health Institute, 6475 Christie Ave., Suite 400, Emeryville, CA 94608, USA.


This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.

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