Observational studyBMJ open2020
Community treatment orders and associations with readmission rates and duration of psychiatric hospital admission: a controlled electronic case register study.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis 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
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- 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
- Availability and restrictiveness of community treatment orders across 33 European countries.BJPsych open · 2026Article
- Impact of community mental health center follow-up on psychiatric hospitalization burden in schizophrenia spectrum disorders: a retrospective mirror-image study.BMC psychiatry · 2026Article
- Understanding compulsory community treatment across Australian jurisdictions: insights from three different data sources.BJPsych open · 2026Article
- Immigrant, racialised and ethno-culturally diverse communities and community treatment orders: A scoping review.The International journal of social psychiatry · 2025Article
- Psychiatric Risk Governance Across Jurisdictions: A Comparative Analysis of Involuntary Treatment, Community Treatment Orders, and Forensic Mental Health Services.Healthcare (Basel, Switzerland) · 2025Review
- The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives.The British journal of psychiatry : the journal of mental science · 2024Article
- Long term outcomes and causal modelling of compulsory inpatient and outpatient mental health care using Norwegian registry data: Protocol for a controversies in psychiatry research project.International journal of methods in psychiatric research · 2023Article
- Improving mental healthcare access and experience for people from minority ethnic groups: an England-wide multisite experience-based codesign (EBCD) study.BMJ mental health · 2023Article
- The association between Compulsory Community Treatment Order status and mortality in New Zealand.BJPsych open · 2023Article
- Article
- Article
- Protecting Health and Safety with Needed-Treatment: the Effectiveness of Outpatient Commitment.The Psychiatric quarterly · 2022Review
- Use of compulsory community treatment in mental healthcare: An integrative review of stakeholders' opinions.Frontiers in psychiatry · 2022Review
- Compulsory Community Treatment Orders in New Zealand and the provision of care: An examination of national databases and predictors of outcome.The Lancet regional health. Western Pacific · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesLimited evidence is available regarding the effect of community treatment orders (CTOs) on mortality and readmission to psychiatric hospital. We compared clinical outcomes between patients placed on CTOs to a control group of patients discharged to voluntary community mental healthcare. DESIGN AND
settingAn observational study using deidentified electronic health record data from inpatients receiving mental healthcare in South London using the Clinical Record Interactive Search (CRIS) system. Data from patients discharged between November 2008 and May 2014 from compulsory inpatient treatment under the Mental Health Act were analysed.
participants830 participants discharged on a CTO (mean age 40 years; 63% male) and 3659 control participants discharged without a CTO (mean age 42 years; 53% male). OUTCOME MEASURES: The number of days spent in the community until readmission, the number of days spent in inpatient care in the 2 years prior to and the 2 years following the index admission and mortality.
resultsThe mean duration of a CTO was 3.2 years. Patients receiving care from forensic psychiatry services were five times more likely and patients receiving a long-acting injectable antipsychotic were twice as likely to be placed on a CTO. There was a significant association between CTO receipt and readmission in adjusted models (HR: 1.60, 95% CI 1.42 to 1.80, p<0.001). Compared with controls, patients on a CTO spent 17.3 additional days (95% CI 4.0 to 30.6, p=0.011) in a psychiatric hospital in the 2 years following index admission and had a lower mortality rate (HR: 0.66, 95% CI 0.50 to 0.88, p=0.004).
conclusionsMany patients spent longer on CTOs than initially anticipated by policymakers. Those on CTOs are readmitted sooner, spend more time in hospital and have a lower mortality rate. These findings merit consideration in future amendments to the UK Mental Health Act.
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Registered trials
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