None listed
Conditions
Brief summary
People with mental illness often have to accept medication and other treatments in the community through the use of community treatment orders (CTOs). Yet forced treatment remains one of the most contentious issues in mental health service delivery; its efficacy is unresolved, its usage is irregular and unequal, and it raises serious ethical and human rights concerns. Responses to these debates must be informed by valid and reliable data. This study will be the first to investigate the justifications for CTOs across Australia to allow greater understanding of the variance in rates of CTOs and enable appropriate action by stakeholders. The primary aim of this study is to understand differences in sociodemographic, clinical and health service use patterns (hospital and community) between individuals discharged onto CTOs compared to voluntary treatment.
Interventions
Community Treatment Orders (CTOs) enforce mental health treatment and have been signalled by some as a serious violation of human rights while others consider them as necessary protection. Australia has high rates by world standards, and variations in rates of use occur within jurisdictions that remain unexplained. This project aims to explain the drivers underpinning variations in the use of CTOs.
This is a retrospective case-control study of incidence using anonymous population-based linked a
Community Treatment Orders (CTOs) enforce mental health treatment and have been signalled by some as a serious violation of human rights while others consider them as necessary protection. Australia has high rates by world standards, and variations in rates of use occur within jurisdictions that remain unexplained. This project aims to explain the drivers underpinning variations in the use of CTOs. This is a retrospective case-control study of incidence using anonymous population-based linked administrative health data from Queensland, New South Wales, Victoria and South Australia. The cohort for linkage will include all individuals aged 18 years and older as of 01/01/2018 with any community mental health service use record between 01/01/2018 - 31/12/2022. These data will be linked to admitted patient data collection and community mental health service use records between 01/01/2016 - latest available, as well as death registration records from 01/01/2018 - latest available. Using a case-control cohort design, we will compare the incidence of admitted patient discharges onto CTOs (exposure group) between 01/01/2018 - 31/12/2022 compared to admitted patient discharges onto voluntary community treatment (comparator group) around the same time (plus or minus 6-months). The exposure group will be matched to comparator group 1:1 on sex and age (as far as possible). Patterns of mental health service use (community and admitted) will be examined in the two years prior to their first discharge onto CTO or voluntary community treatment (herein referred to as the "index date"), as well as 12-months after the index date. Patient deaths after the index date will also be counted.
Sponsors
NHMRC
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Exposure group: all patients aged 18 years or older (as of 01/01/2018) who were (i) discharged from inpatient psychiatric hospital stays (based on ICD-10-AM codes F00-F99) between 01/01/2018 – 31/12/2022; (ii) placed on a CTO at discharge (specifically, we are only interested in their first placement on CTO at discharge during this period i.e., the index date); and (iii) who continued their treatment in a community mental health service within 30 days of their hospital discharge. Comparator group: all patients aged 18 years or older (as of 01/01/2018) who were (i) discharged from inpatient psychiatric hospital stays (based on ICD-10-AM codes F00-F99) between 01/01/2018 - 31/12/2022; and (ii) who voluntarily continued their treatment in a community mental health service within 30 days of their hospital discharge.
Exclusion criteria
None.
Outcome results
None listed