Government's own research shows CTOs will be of no benefit
Posted Wednesday 7 March 2007
Dept of Health ploughs ahead with 'psychiatric Asbos' plan despite gaping hole in evidence base.
Review smashes Ministers' case for Community Treatment Orders.
"This review has found very little evidence of positive effects of CTOs in the areas where they might have been anticipated. None of the nine experimental studies found evidence suggesting that CTOs reduce either hospital readmission or length of stay, or that they improve compliance." - Research
Research released today (1) shows no clear evidence for the benefits of Community Treatment Orders (CTOs), which form a key part of the Government's Mental Health Bill. In an international comparison of countries with similar provisions, researchers commissioned by the Dept of Health concluded that it is impossible to say that supervised community treatment has any benefit. They go further and say that enhanced services, such as assertive community outreach teams, should be considered as a better way of achieving the goal of increasing compliance and reducing relapse.
Nine separate studies have shown that CTOs do not have any positive outcomes. They do not improve compliance with medication, reduce length of stays in hospital, or prevent re-admissions. They do not lower incidents of violence or arrest.
Paul Farmer, Chief Executive of mental health charity Mind, said:
"Community Treatment Orders won't help people at all. They do not improve compliance with medication. They do not lower incidents of violence or arrest. They do not reduce length of stays in hospital. They do not prevent re-admissions. But they will scare vulnerable people away from seeking help when they need it.
"The Government claims that there have been positive reports of CTOs in some countries are undermined by their own systematic review of all of the evidence world-wide. This is yet another review showing us that there is no sound evidence that CTOs are beneficial. It is clear that no amount of legislation can make up for the gaps in this country's over-stretched, under-resourced mental health services."
"The Government is trying to legislate on guesswork. They assumed that Community Treatment Orders would bring benefits, even though mental health service-users, the real experts, have long said that they will not. Now we have the clearest evidence yet that their plans are fundamentally flawed."
In their findings (1) , the researchers say:
"This review has found very little evidence of positive effects of CTOs in the areas where they might have been anticipated. None of the nine experimental studies found evidence suggesting that CTOs reduce either hospital readmission or length of stay, or that they improve compliance."
"There are genuine concerns that CTOs might be used as an alternative to providing a comprehensive package of effective community mental health services."
"Given the coercive nature of CTOs, there is a need to consider whether any potential therapeutic gains might be better delivered by enhancing the quality and assertiveness of community treatment for high risk patients through, for example, Assertive Community Treatment (ACT)."
1) International experiences of using community treatment orders, Churchill, R., Owen, G., Singh, S., Hotopf, M.