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Question: Are community treatment orders more effective than Section 17 leave in reducing hospital readmissions in people with psychosis?
Patients: In total, 336 adults (aged 18–65 years) involuntarily hospitalised for psychosis. Eligible participants were those who could give informed consent and were suitable for supervised outpatient care.
Setting: Thirty-two National Health Service Mental Health Trusts, UK; recruitment November 2008–February 2011.
Intervention: Hospital discharge on a community treatment order (CTO) or Section 17 leave. CTOs require patients to agree to clinical monitoring and patients can be recalled for up to 72 h for assessment without readmission procedures. Section 17 leave permits patients to leave hospital for hours, days or weeks subject to readmission without further legal procedures.
Outcomes: Hospital readmission over 12 months. Secondary outcomes: time to readmission, total number of readmissions, total days of hospitalisation and clinical symptoms measured with the Global Assessment of Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS).
Patient follow-up: At 12 months, 99% of participants were analysed for the primary outcome and 72% for secondary outcomes.
Design: Randomised controlled trial. …
Sources of funding: National Institute of Health Research
Competing interests: None.
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