Care and compulsion in community psychiatric treatment

Compulsory community and involuntary outpatient treatment for people with severe mental disorders

“…It would take 85 orders for compulsory community treatment to avoid one admission, or 238 to avoid one arrest. Even where changes in outcome have been shown such as decreased criminal victimisation (Hiday 2002), we still do not know whether these changes are due to the legislative framework or greater intensity of contact (McIvor 1998; McIvor 2001).…”

Impact of compulsory community treatment on admission rates

“…However, our findings suggest that compulsory community treatment remains unproved as a way of reducing hospital admission rates. Even where changes in outcome have been shown, such as lower out-patient attendance rates or a decrease in violent behaviour (Swartz et al , 1999; Swanson et al , 2000), we still do not know whether these are due to the legislative framework, use of depot medication or greater intensity of contact (McIvor, 1998, 2001). For example, Swartz et al (2001) in a post hoc analysis of their results suggested that compulsory community treatment had to be maintained for at least 180 days and combined with at least seven out-patient contacts a month to reduce admission rates.…”

Supervised community treatment and section 17 of the Mental Health Act 1983

“…Proponents argue that such treatment reduces hospital readmission, improves adherence to medication and permits better use of community resources (McIvor, 2001). Critics, however, argue that such treatments infringe civil liberties, extend unwanted…”