Vine, R and Tibble, H and Pirkis, J and Judd, F and Spittal, MJ, Does legislative change affect the use and duration of compulsory treatment orders?, Australian and New Zealand Journal of Psychiatry pp. 1-8. ISSN 0004-8674 (2018) [Refereed Article]
© The Royal Australian and New Zealand College of Psychiatrists 2018
Methods: We obtained two distinct data sets of persons who had been on a community treatment order for at least 3 months and their subsequent treatment episodes over 2 years under the Mental Health Act and/or as an inpatient for the periods 2008-2010 (Mental Health Act 1986) and 2014-2016 (Mental Health Act 2014). The two sets were compared to assess the difference in use, duration and odds of having a further admission over 2 years. We also considered the mode of discharge - whether by the treating psychiatrist, external body or through expiry.
Results: Compared with the Mental Health Act 1986, under the Mental Health Act 2014, index community treatment orders were shorter (mean 227 days compared with 335 days); there was a reduction in the mean number of community treatment orders in the 2 years following the index discharge - 1.1 compared with 1.5 (incidence rate ratio (IRR) = 0.71, 95% confidence interval = [0.63, 0.80]) - and a 51% reduction in days on an order over 2 years. There was a reduction in the number of subsequent orders for those whose order expired or was revoked by the psychiatrist under the Mental Health Act 2014 compared to those under the Mental Health Act 1986. The number of orders which were varied to an inpatient order by the authorised psychiatrist was notably greater under the Mental Health Act 2014.
Conclusion: The reformed Mental Health Act has been successful in its intent to reduce the use and duration of compulsory orders in the community. The apparent increase in return to inpatient orders raises questions regarding the intensity and effectiveness of community treatment and context of service delivery.
|Item Type:||Refereed Article|
|Keywords:||community treatment order, Mental Health Act, service utilisation|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Psychiatry (incl. Psychotherapy)|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Mental Health|
|UTAS Author:||Judd, F (Professor Fiona Judd)|
|Web of Science® Times Cited:||2|
|Deposited By:||Menzies Institute for Medical Research|
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