Compulsory Hospitalization Does Not Improve Outcomes


Researchers in Israel followed 320 patients who had been admitted involuntarily with schizophrenia diagnoses.  157 (49%) left the hospital against medical advice (AMA), and 163 (51%) agreed to stay. There were no differences in baseline clinical characteristics between compliant and non-compliant patients.  Outcome measures in terms of rate of readmission, legal status of next admission, or length of stay in the next admission did not differ between the two groups. The study will appear in Comprehensive Psychiatry.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Interesting article. A better headline might be “Voluntary Hospitalization Does Not Improve Outcomes” or perhaps “Heeding Medical Advice Does Not Improve Outcomes” since none of the study subjects differed in terms of the compulsory period of hospitalization.

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  2. This is a REALLY important finding! So much energy is spent trying to force or manipulate or cajole clients into complying with their medical regimes – to find a clear study saying it doesn’t matter one way or the other if you ignore your psychiatrist’s advice is very powerful!

    —- Steve

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