ReviewCanadian journal of psychiatry. Revue canadienne de psychiatrie2016
Effectiveness of Community Treatment Orders: The International Evidence.
Review in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review and meta-analysis of the effect of community treatment orders on aggression or criminal behaviour in people with a mental illness.Epidemiology and psychiatric sciences · 2025Pooled it
- The benefits and harms of community treatment orders for people diagnosed with psychiatric illnesses: A rapid umbrella review of systematic reviews and meta-analyses.The Australian and New Zealand journal of psychiatry · 2024Pooled it
- Compulsory community treatment to reduce readmission to hospital and increase engagement with community care in people with mental illness: a systematic review and meta-analysis.The lancet. Psychiatry · 2018Pooled it
- Article
- Perceiving Ethical Discomfort Triggered by Situations that Resist Meaning in Community Mental Health Settings: A Grounded Theory.Community mental health journal · 2025Article
- A hybrid fuzzy logic-Random Forest model to predict psychiatric treatment order outcomes: an interpretable tool for legal decision support.Frontiers in artificial intelligence · 2025Article
- Comparative analysis of characteristics among young people discharged from adolescent medium secure psychiatric hospital.Health care transitions · 2024Article
- Community Treatment Orders use Among Persons With a First Episode of Psychosis in Quebec.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2023Article
- Practitioner Perspectives About Managing Community Treatment Orders (CTOs) in England and the Importance of Social Influences.Community mental health journal · 2022Article
- Article
- Where the public health principles meet the individual: a framework for the ethics of compulsory outpatient treatment in psychiatry.BMC medical ethics · 2022Article
- Protecting Health and Safety with Needed-Treatment: the Effectiveness of Outpatient Commitment.The Psychiatric quarterly · 2022Review
- Hospital Utilization Outcomes Following Assignment to Outpatient Commitment.Administration and policy in mental health · 2021Review
- Community treatment orders and care planning: How is engagement and decision-making enacted?Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Measuring the level of compulsory hospitalisation in mental health care: The performance of different measures across areas and over time.International journal of methods in psychiatric research · 2021Article
- Cost and quality-of-life impacts of community treatment orders (CTOs) for patients with psychosis: economic evaluation of the OCTET trial.Social psychiatry and psychiatric epidemiology · 2021Article
- Observational
- Different Patient Group Responses To Community Treatment Orders Suggest Alternative Approaches.Professional development (Philadelphia, Pa.) · 2020Article
- Different forms of informal coercion in psychiatry: a qualitative study.BMC research notes · 2019Article
- Community Treatment Orders and Other Forms of Mandatory Outpatient Treatment.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCommunity treatment orders (CTOs) exist in more than 75 jurisdictions worldwide. This review outlines findings from the international literature on CTO effectiveness.
methodThe article draws on 2 comprehensive systematic reviews of the literature published before 2013, then uses the same search terms to identify studies published between 2013 and 2015. The focus is on what the literature as a whole tells us about CTO effectiveness, with particular emphasis on the strength and weaknesses of different methodologies.
resultsThe results from more than 50 nonrandomized studies show mixed results. Some show benefits from CTOs while others show none on the most frequently reported outcomes of readmission, time in hospital, and community service use. Results from the 3 existing randomized controlled trials (RCTs) show no effect of CTOs on a wider range of outcome measures except that patients on CTOs are less likely than controls to be a victim of crime. Patients on CTOs are, however, likely to have their liberty restricted for significantly longer periods of time. Meta-analyses pooling patient data from RCTs and high quality nonrandomized studies also find no evidence of patient benefit, and systematic reviews come to the same conclusion.
conclusionThere is no evidence of patient benefit from current CTO outcome studies. This casts doubt over the usefulness and ethics of CTOs. To remove uncertainty, future research must be designed as RCTs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.