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No evidence to back mental health orders

Controversial Government plans to force treatment onto the mentally ill are totally lacking in supportive evidence, a major new analysis concludes.

The report, prepared for the Department of Health, examined all other countries where community treatment orders had been introduced and found no evidence of benefits for patient care. There was also a lack of any evidence that use of the orders would reduce hospitalisations and prove less coercive than imprisonment initiatives.

The report will fuel GPs' concerns over introduction of the reforms and comes a blow to the department, which remains determined to push through its Mental Health Bill.

Last week, health minister Rosie Winterton attacked peers for amending key sections of the legislation during a recent House of Lords debate.

Study leader Dr Rachel Churchill, lecturer at the Institute of Psychiatry, King's College London, said there was 'very little evidence to suggest community treatment orders are associated with any positive outcomes'.

She added: 'Proponents of the orders argue they will lead to a decrease in hospital admissions and that they are less coercive than the hospitalisation

or imprisonment alternatives. There is, so far, no evidence to support this.'

The review found no evidence community treatment orders kept patients out of hospital, as well as evidence 238 people would need to receive one to avoid a single arrest. It concluded it was 'not possible to state whether community treatments orders are beneficial or harmful to patients'.

Dr Ian Walton, a GPSI in mental health in Tipton in

the West Midlands and chair of Primary Care Mental Health and Education, said: 'I'm not surprised there is no evidence to show they work because with mental health disorders you have to have co-operation from the patient. This legislation is

a bit of a knee-jerk reaction.'

Dr Tony Calland, chair of the BMA medical ethics committee and a recently retired GP, said: 'I don't quite see how this system is going to benefit anybody. This report says there's no evidence. So why are we doing it?'

dcressey@cmpmedica.com

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