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Letter in response to Dr Segal's commentary
  1. Tom Burns
  1. Department of Psychiatry, University of Oxford, Oxford, UK
  1. Correspondence to Tom Burns, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; tom.burns{at}

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Reporting a complex randomised control trial (RCT) in 3000 words can lead to some misunderstandings, and Oxford Community Treatment Order Trial (OCTET)1 is being clarified in the Lancet correspondence columns. We restricted ourselves in this first paper to those outcomes for which the trial was designed and powered. Segal (EBMH on line 2013) confuses the time under compulsion of randomisation (median 183 days community treatment order (CTO) vs 8 days section 17) with total days under compulsion over the follow-up which includes readmissions. Section 17 leave is not an alternative community supervision order but a clinical mechanism to test stability by overnight and day leave before discharge (either to CTO or voluntary care) for involuntary inpatients. Protracted section 17 leave is considered poor practice and redundant now CTOs have been introduced; we recruited from clinicians who understood and followed the legislation. We adopted the same primary outcome (rate of readmission) used in the only two previous RCTs,2 ,3 both conducted in the USA, and we found exactly the same result—no difference. I am at a loss to see how our conclusions are ‘premature and potentially harmful’.



  • Competing interests None.

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