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Doubts over community treatment orders

Supervised Community Treatment Orders – introduced as a central plank of the amended Mental Health Act earlier this year – are ‘unlikely to help' the problem of revolving-door care, according to new research.

SCTOs were included by the Government as part of the Mental Health Act 2007 to encourage GPs and psychiatrists to treat psychiatric patients in the community after their release from hospital or offenders' units.

But despite the Government's insistence that the introduction of SCTOs will address the issue of revolving-door care, in fact they are unlikely to help.

In many cases they lead to an overall mean increase in bed days – indicative of earlier discharges.

Two recent epidemiological studies of more than 118,000 people in Australia, and a systematic review of all previous literature on SCTOs, suggest they have ‘failed to demonstrate a significant reduction in bed days between patients receiving compulsory community treatment and controls'.

Writing in the November issue of the British Journal of Psychiatry, Dr Stephen Kisely, a psychiatrist at Dalhousie University in Canada, accused the UK Government of pressing on with the introduction of SCTOs without evidence to back up their claims: ‘There is limited evidence that compulsory community treatment will address the revolving door issue even though this is the Department of Health's main justification for supervised community treatment.'

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