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Methods We empirically examine two perspectives on need for and consequences of coercion in the context of outpatient commitment. The "Mandated Treatment Engagement Hypothesis" tests whether treatment engagement when coerced aides in symptom reduction and leads to improvements in perceived stigma and its consequences. In this hypothesis symptoms drive consequences. The "Coercion to Stigma Hypothesis" examines whether coercion has negative effects on stigmatization, quality of life, social functioning, disengagement from treatment and symptoms. In this hypothesis, coercion drives consequences. We use longitudinal data on 184 people with severe mental illnesses.

Implications of outpatient commitment and perceived coercion for stigma, quality of life and social functioning