Community treatment orders

Jethwa, Krishma; Galappathie, Nuwan

doi:10.1136/bmj.a613

Cited by 9 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Under a CTO, an individual is required to comply with a specified treatment plan, which may include medication, therapy, and other support services 2 . They may also be required to attend regular reviews with a mental health professional and/or comply with other conditions such as living at a specific address, abstaining from illicit substances, or not leaving a certain geographical area 2 . They are also subject to being recalled to hospital under a CTO 2 .…”

Section: Introductionmentioning

confidence: 99%

“…They may also be required to attend regular reviews with a mental health professional and/or comply with other conditions such as living at a specific address, abstaining from illicit substances, or not leaving a certain geographical area 2 . They are also subject to being recalled to hospital under a CTO 2 . CTOs are typically issued on the recommendation of the Responsible Clinician and an Approved Mental Health Professional and can be in place for up to six months, with the possibility of renewal 2 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of community treatment orders (CTOs) on readmission to hospital using electronic health records

Yang,

Thygesen,

Werbeloff

et al. 2023

Preprint

View full text Add to dashboard Cite

BackgroundCommunity treatment orders (CTOs) are used to manage community-based care for individuals with severe mental health conditions who have been discharged from inpatient care. Evidence examining whether CTOs are successful at reducing rehospitalisation has been mixed.MethodsUsing deidentified electronic health records from 2009-21, we compared patients who had ever been placed on a CTO (n=836) and two other groups of patients who had never been placed on CTO: patients admitted under Section 3 of the Mental Health Act (n=1,182) and outpatients with severe mental health issues (n=7,651). We examined the association between CTOs and rehospitalisation using within-individual stratified multivariable Cox regression.ResultsPatients on CTO were more likely to be male, single, of Black or Mixed ethnicity, and have a severe mental illness diagnosis than patients in the comparison groups. Time spent on CTO was associated with a lower risk of hospitalisation compared to time spent off CTO for the same individual (HR 0.60; 95% CI 0.56-0.64). This decreased risk of hospitalisation remained when we restricted analysis to individuals with a single CTO episode (HR 0.05; 95% CI 0.02-0.11) and when we restricted follow-up time to a patient’s first CTO episode (HR 0.20; 95% CI 0.17-0.25). However, there was no difference in re-hospitalisations when we observed patients starting from the first CTO (HR 1.07; 95% CI 1.00-1.16).ConclusionsWe found that patients on CTO were at lower risk of hospitalisation, though this pattern was not observed when we excluded time prior to the first CTO. Further research should consider whether CTOs provide genuine clinical benefit.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of community treatment orders (CTOs) on readmission to hospital using electronic health records

Yang,

Thygesen,

Werbeloff

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…More than 75 jurisdictions worldwide (including 9 Canadian provinces, most of the United States, Australia, England, Wales, New Zealand, Scotland, Sweden, Denmark, Norway, Switzerland) have enacted Community Treatment Order (CTO) legislation. 2 Although the specific legal frameworks for CTO enactment across Canadian provinces are not identical, most generally build upon the criteria for involuntary inpatient hospitalization (e.g., the individual is likely to cause harm to themselves or others or experience serious deterioration or physical impairment). 3 For example, in Ontario, a CTO can be implemented if the individual has been a patient in a psychiatric setting 2 or more times, equating to a 30 day or longer stay within the past 3 years, or if a previous CTO has been in effect.…”

mentioning

confidence: 99%

The Impact of Community Treatment Orders on Substitute Decision Makers

2020

View full text Add to dashboard Cite

“…Community treatment orders (CTOs) were introduced in England and Wales in 2008, in an attempt to reduce the use of in-patient services for patients with poor adherence to their treatment. [1][2][3] They require individuals with mental disorders who have been detained in hospital to adhere to treatment and supervision in the community. Non-compliance with CTOs may lead to revocation, where the patient is involuntarily admitted back into hospital for further treatment.…”

mentioning

confidence: 99%

Factors influencing use of community treatment orders and quality of care that people receive: results of a national survey in England and Wales

et al. 2019

View full text Add to dashboard Cite

Aims and methodWe conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive.ResultsBetween 1.1 and 20.2% of patients in each trust were being treated on a CTO. Male gender, younger age, greater use of in-patient services, coexisting substance misuse and problems with cognition predicted use of CTOs. Patients on CTOs were more likely to be screened for physical health, have a current care plan, be given contact details for crisis support, and be offered cognitive–behavioural therapy.Clinical implicationsCTOs appear to be used as a framework for delivering higher-quality care to people with more complex needs. High levels of variation in the use of CTOs indicate a need for better evidence about the effects of this approach to patient care.

show abstract

Community treatment orders

Abstract: Insufficient evidence exists to support the new legislation for England and Wales

Cited by 9 publications

References 5 publications

The effects of community treatment orders (CTOs) on readmission to hospital using electronic health records

The effects of community treatment orders (CTOs) on readmission to hospital using electronic health records

The Impact of Community Treatment Orders on Substitute Decision Makers

Factors influencing use of community treatment orders and quality of care that people receive: results of a national survey in England and Wales

Contact Info

Product

Resources

About