Involuntary outpatient commitment: ethics and problems.

The 1991 Israeli Mental Patients Law permits involuntary outpatient commitment (IOC) in an attempt to lessen the problem of recidivism of chronic patients who do not comply with medical treatment after discharge, relapse and are readmitted. The history of IOC in its different forms in several states in the United States is reviewed, with emphasis placed on indications and enforcement. Research assessment of the efficacy of IOC is discussed. The Israeli law is compared with the American law. Three case reports are presented.