In this large population-based study, community treatment orders increase community care and delay rehospitalisation while they are in operation. Some negative findings in this field may reflect the use of observation periods longer than the period of active intervention.

Outcomes of students with behavioural and emotional difficulties attending a specialised educational programme, delivered in a tertiary education and health facility, were evaluated and compared with Australian normative data. A total of 45 students (5-10 years old) attending the school in Sydney, New South Wales, were identified. At enrolment, parent ratings on the Strengths and Difficulties Questionnaire (SDQ) significantly deviated from Australian normative data on all scales for males and on the overall score, conduct and hyperactivity scales for females. Clinically significant levels of hyperactivity, peer problems and conduct symptoms were identified. After an average attendance at the school of 8.82 months, ratings on the Children's Global Assessment Scale (CGAS) indicated improved overall functioning, alongside specific improvements on SDQ rated emotion, conduct and social symptoms, and in Health of the Nation Outcomes Scales Child and Adolescent (HoNOSCA) rated social impairment and parents' reported need for information about their child's condition. Male students' emotional symptoms no longer differed from those of typical Australian students. The findings provide initial evidence for the effectiveness of a multimodal, flexible and targeted school programme in remediating key student mental health symptoms. It is suggested that major concepts from attachment theory and explicitly taught behavioural skills are key elements of this unique programme that contribute to its apparent effectiveness.