There is controversy as to whether compulsory community treatment for people with severe mental illnesses reduces health service use, or improves clinical outcome and social functioning. Given the introduction of widespread use of such powers in the 2007 Mental Health Act this report purports it is important to assess the effects of this type of legislation.
This report indicates that based on current evidence, community treatment orders may not be an effective alternative to standard care. Authors conclude that It appears that compulsory community treatment results in no significant difference in service use, social functioning or quality of life compared with standard care. They also indicate that there is currently no evidence of cost effectiveness. The report highlights that It is, difficult to conceive of another group in society that would be subjectto measures that curtail the freedom of 85 people to avoid one admission to hospital or of 238 to avoid one arrest.
Authors conclude there is an urgently need for further, good quality randomised controlled studies to consolidate findings and establish whether it is the intensity of treatment in compulsory community treatment or its compulsory nature that affects outcome. The report recommends an evaluation of a wide range of outcomes should be included if this type of legislation is introduced.
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