SynthesisThe lancet. Psychiatry2018
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.
Synthesis in The lancet. Psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 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
42 citing papers in PubMed, 4 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- 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 impact of maternal depression during pregnancy on the risk of gestational diabetes mellitus: a meta-analysis.Frontiers in endocrinology · 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
- Experiences with legally mandated treatment in patients with schizophrenia: A systematic review of qualitative studies.European psychiatry : the journal of the Association of European Psychiatrists · 2020Pooled it
- Feasibility testing and preliminary trial of a crisis planning and monitoring intervention to reduce compulsory readmissions: the FINCH Study.BMC medicine · 2025Trial
- Can primary mental health services impact levels of involuntary admissions? A cluster-RCT of the ReCoN intervention.Social psychiatry and psychiatric epidemiology · 2025Trial
- Availability and restrictiveness of community treatment orders across 33 European countries.BJPsych open · 2026Article
- Factors influencing the outcomes of Community Treatment Orders: state-wide study using linked administrative health data from New South Wales, Australia.BJPsych open · 2026Article
- Restricting community treatment orders to people with non-affective psychosis is needed to reduce use and improve subsequent outcomes: Queensland-wide cohort study.The British journal of psychiatry : the journal of mental science · 2025Article
- Psychiatric Risk Governance Across Jurisdictions: A Comparative Analysis of Involuntary Treatment, Community Treatment Orders, and Forensic Mental Health Services.Healthcare (Basel, Switzerland) · 2025Review
- Community Treatment Orders in Australia in the Context of International Literature: A Narrative Review of Consumers, Families and Health Professionals' Perspectives.International journal of mental health nursing · 2025Review
- Changes in inpatient mental health treatment and related costs before and after flexible assertive community treatment: a naturalistic observational cohort study.BMC psychiatry · 2025Observational
- Text mining of outpatient narrative notes to predict the risk of psychiatric hospitalization.Translational psychiatry · 2025Article
- Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020.BJPsych open · 2024Article
- Compulsory treatment at home: an interview study exploring the experiences of an early group of patients, relatives and mental-health workers.BMC health services research · 2024Article
- The Power of Thought: The Role of Psychological Attentiveness and Emotional Support in Patient Trajectories.The Yale journal of biology and medicine · 2024Review
- Latest findings highlight the continuing uncertainty over the utility of compulsory psychiatric treatment in the community.BJPsych open · 2024Article
- A crisis planning and monitoring intervention to reduce compulsory hospital readmissions (FINCH study): protocol for a randomised controlled feasibility study.Pilot and feasibility studies · 2024Article
- Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review.Healthcare (Basel, Switzerland) · 2024Article
- [Compulsory community treatment orders (CTOs): recent research and future directions].BJPsych open · 2023Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCompulsory community treatment (CCT) aims to reduce hospital readmissions among people with mental illness. However, research examining the usefulness of CCT is inconclusive. We aimed to assess the effectiveness of CCT in reducing readmission and length of stay in hospital and increasing community service use and treatment adherence.
methodsFor this systematic review and meta-analysis, we searched three databases (PsycINFO, MEDLINE and Embase) for quantitative studies on CCT published in English between Jan 1, 1806, and Jan 4, 2018. We included both randomised and non-randomised designs that compared CCT with no CCT, and pre-post designs that compared patients before and after CCT. Studies were eligible if they had been peer-reviewed, if 50% or more of patients had severe mental illness, and if CCT was the intervention. Trials in which CCT was used in response to a criminal offence were excluded. We extracted data on study characteristics and length of follow-up, patient-level data on diagnosis, age, sex, race, and admission history, and outcomes of interest (readmission to hospital, inpatient bed-days, community service use, and treatment adherence) for meta-analysis, for which we extracted summary estimates. We used a random-effects model to compare disparate outcome measures and convert effect size statistics into standardised mean differences. This systematic review is registered with PROSPERO, number CRD42018086232.
findingsOf 1931 studies identified, 41 (2%) met inclusion criteria and had sufficient data for analysis. Before and after CCT comparisons showed significant large effects on readmission to hospital (standardised mean difference 0·80, 95% CI 0·53-1·08; I
interpretationWe found no consistent evidence that CCT reduces readmission or length of inpatient stay, although it might have some benefit in enforcing use of outpatient treatment or increasing service provision, or both. Future research should focus on why some people do not engage with treatment offered and on enhancing quality of the community care available. Shortcomings of this study include high levels of variability between studies and variation in study quality.
fundingNational Institute for Health Research.
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.