Observational studySocial psychiatry and psychiatric epidemiology2017
What does being on a community treatment orders entail? A 3-year follow-up of the OCTET CTO cohort.
Observational study in Social psychiatry and psychiatric epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Availability and restrictiveness of community treatment orders across 33 European countries.BJPsych open · 2026Article
- 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
- Trust and Community Treatment Orders.Frontiers in psychiatry · 2019Article
- Community Treatment Orders and Supported Decision-Making.Frontiers in psychiatry · 2019Article
- Associations between compulsory community treatment and continuity of care in a three year follow-up of the Oxford Community Treatment Order Trial (OCTET) cohort.BMC psychiatry · 2017Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeCommunity Treatment Orders lack evidence of effectiveness. Very little is known about how they are used in practice and over time in terms of what it obliges patients to do and the judicial threshold for remaining on an order.
aimsTo investigate CTO implementation in England in terms of the use of specified conditions, and judicial hearings; whether these change over time, and; the level of continued coercion.
method36-month observational prospective study of patients on CTO in the OCTET follow-up study.
resultsThe number of CTO conditions remained stable over time but consolidated around medication adherence and remaining in contact with services. Ten percent of Mental Health Tribunal Hearings and only 1 percent of Hospital Managers Hearings resulted in discharge. Twenty-seven percent of patients experienced more than one CTO episode and eighteen percent remained under compulsion until the end of follow-up.
conclusionsCTOs seem to be used primarily to oblige patients to take medication and stay in contact with services. There is agreement between clinical and legal judgements about their appropriateness and threshold for use. A pattern of continuous coercion for a significant group of patients raises concerns. If CTOs are to be continued to be imposed, their use should be carefully monitored with further cohort studies with long-term follow-up.
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Registered trials
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