Health Law and Ethics



Effectiveness of compulsory treatment orders for patients with mental illness

The lectures have covered the use of compulsory treatment orders (e.g. inpatient treatment orders [ITOs] or community treatment orders [CTOs]) for people with mental illness. In Victoria, these orders are made according to the requirements of the Mental Health Act 2014 (Vic). Other Australian (and international) jurisdictions have similar legislation and orders (generically termed “compulsory treatment orders”).

While the issues of autonomy and justification of orders have been discussed in the course, effectiveness has not been mentioned. Your presentation will consider the effectiveness of compulsory treatment orders in terms of patient or system outcomes. Issues of autonomy aside, do these orders actually have benefits?

As a starting point, a selection of international and Australian research on compulsory treatment orders is provided below. You may also wish to review other compulsory treatment order studies published more recently.

Along with a general description of compulsory treatment orders and overview of these effectiveness studies/reviews, please consider the following questions in your presentation:

– To what extent does this research relate to the system in Victoria?

Starting points:

Please note that you may need to access some of these journals

Kisely S, et al (2011), “Compulsory community and involuntary outpatient treatment for people with severe mental disorders,” Cochrane Database of Systematic Reviews,Issue 2. Art. No.: CD004408.

Ingram G, et al (2009), “Effectiveness of Community Treatment Orders for Treatment of Schizophrenia with Oral or Depot Antipsychotic Medication: Changes in Problem Behaviours and Social Functioning” Australian and New Zealand Journal of Psychiatry 43(11): 1077-1083.
Preston N, et al (2002), “Assessing the outcome of compulsory psychiatric treatment in the community: epidemiological study in Western Australia,” British Medical Journal 324:1244
Kisely S, et al (2013), “An eleven-year evaluation of the effect of community treatment orders on changes in mental health service use” Journal of Psychiatric Research 47(5): 650-656.