The University of Queensland School of Medicine, Woolloongabba, Queensland, Australia Metro South Health Service, Woolloongabba, Queensland, Australia Griffith Criminology Institute (GCI), Griffith University, Mount Gravatt, Queensland, Australia Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
Tessa Zirnsak
Social Work and Social Policy, Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
Chris Maylea
Law School, La Trobe University, Melbourne, Victoria, Australia
Social Work and Social Policy, Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
Community treatment orders (CTOs) have been introduced in many jurisdictions with evidence of increasing use over time as well as a disproportionate use in marginalised populations. Rates of CTOs also vary widely, both internationally and within the same country, for reasons that are poorly understood. This is despite evidence for effectiveness being mixed and, as a result, there have been calls for a reappraisal of this type of legislation. In the UK, a parliamentary committee on reforming the existing Mental Health Act recommended abolishing CTOs other than for people in the criminal justice system. Two recent Australian papers based on large state-wide administrative data-sets give conflicting results and came to markedly different conclusions regarding the desirability of reducing CTO rates. The debate about the effectiveness of CTOs therefore remains unresolved. This is of concern beyond Australia, as other jurisdictions such as England, Scotland and Canada have similar clinician-initiated orders.
