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Community treatment orders: current evidence and the implications.

Jorun Rugkåsa¹, John Dawson

¹Jorun Rugkåsa, PhD, Health Services Research Unit, Akershus University Hospital, Norway, and Department of Psychiatry, University of Oxford, UK; John Dawson, LLD, Faculty of Law, University of Otago, Dunedin, New Zealand.

The British Journal of Psychiatry : the Journal of Mental Science

|December 4, 2013

Summary

Community Treatment Orders (CTOs) did not reduce hospital readmissions over 12 months in a recent trial. This study questions the effectiveness of CTOs for

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Area of Science:

Mental health services research
Clinical psychiatry
Public health policy

Background:

Community Treatment Orders (CTOs) are implemented to manage 'revolving door' patients.
Existing evidence on CTO effectiveness is conflicting, with case-control studies yielding varied results.

Purpose of the Study:

To evaluate the effectiveness of Community Treatment Orders (CTOs) in reducing hospital readmissions.
To assess the impact of CTOs on patient autonomy.

Main Methods:

The Oxford Community Treatment Order Evaluation Trial (OCTET) was a randomized controlled trial (RCT).
The study followed patients for 12 months to track readmission rates.

Main Results:

CTOs did not significantly reduce 12-month readmission rates compared to standard care.
Patient autonomy was restricted under CTOs.

Conclusions:

The findings suggest that current practices involving CTOs may warrant re-evaluation.
Further high-quality randomized controlled trials are needed to definitively resolve the debate on CTO effectiveness.