Community treatment orders 'do little to help'

Community treatment orders (CTOs) do little to reduce arrests, hospital readmission rates or bed days in patients with mental illness, research has shown.

But the government is still pushing ahead with its plans to include CTOs - or supervised community treatment - in the Mental Health Bill despite the fears of mental health organisations that this move could affect patients' human rights.

Amendments to the bill an-nounced this month mean CTOs can only be put in place to ensure a patient receives treatment to prevent risk of harm to themselves or to protect others.

However, results of a review and meta-analysis presented at the Royal College of Psychiatrists' annual meeting in Edinburgh this week showed limited evidence that CTOs worked.

Only two randomised controlled trials were identified and neither showed any significant fall in readmission rates, bed days or arrests from CTOs compared with controls.

Dr Stephen Kisely, from Dal-housie University in Canada, told the conference it would take 500 CTOs to prevent one arrest, 100 to prevent one readmission, and 25 to prevent one episode of homelessness.

There is little evidence, therefore, that CTOs will prevent 'revolving door' care, the main justification for CTOs given by the DoH, added Dr Kisely.

North Shields GP Dr Dave Tomson, who has an interest in mental health, said the reforms were unlikely to increase public safety and likely to reduce personal freedoms.

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