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Does compulsory or supervised community treatment reduce ‘revolving door’ care?: Legislation is inconsistent with recent evidence

  • Stephen Kisely (a1) and Leslie Anne Campbell (a2)

Summary

Supervised community treatment to address ‘revolving door’ care is part of the new Mental Health Act in England and Wales. Two recent epidemiological studies in Australia (n > 118 000), as well as a systematic review of all previous literature using appropriately matched or randomised controls (n = 1108), suggest that it is unlikely to help.

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Copyright

Corresponding author

Dr Stephen Kisely, Room 425, Centre for Clinical Research, 5790 University Avenue, Halifax, Nova Scotia B3H IV7, Canada. Tel: +1 902 494 7076; fax +1 902 494 1597; email: Stephen.Kisely@cdha.nshealth.ca

Footnotes

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Declaration of interest

None.

Footnotes

References

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Black, N. (2001) Evidence based policy, proceed with care. BMJ, 323, 275279.
Burgess, P., Bindman, J., Leese, M., et al (2006) Do community treatment orders for mental illness reduce readmission to hospital? An epidemiological study. Social Psychiatry and Psychiatric Epidemiology, 41, 574579.
Department of Health (2006) Mental Health Bill: Briefing Sheets on Key Policy Areas. Department of Health. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4134229 (accessed 4 July 2007).
Geller, J., Grudzinskas, A. J., McDermeit, M., et al (1998) The efficacy of involuntary outpatient treatment in Massachusetts. Administration and Policy in Mental Health, 25, 271285.
Kisely, S., Smith, M., Preston, N., et al (2005a) A comparison of health service use in two jurisdictions with and without compulsory community treatment. Psychological Medicine, 35, 111.
Kisely, S., Smith, M., Lawrence, D., et al (2005b) Mortality in individuals who have had psychiatric treatment: population-based study in Nova Scotia. British Journal of Psychiatry, 187, 552558.
Kisely, S., Campbell, L. A., Scott, A., et al (2007) Randomised and non-randomised evidence for the effect of compulsory community and involuntary outpatient treatment on health service use. Psychological Medicine, 37, 314.
Preston, N., Kisely, S. & Xiao, J. (2002) Assessing the outcome of compulsory psychiatry treatment in the community, epidemiological study in Western Australia. BMJ, 324, 12441246.
Segal, S. P. & Burgess, P. M. (2006a) Conditional release, a less restrictive alternative to hospitalization? Psychiatric Services, 57, 16001606.
Segal, S. P. & Burgess, P. M. (2006b) Factors in the selection of patients for conditional release from their first psychiatric hospitalization. Psychiatric Services, 57, 16141622.
Segal, S. P. & Burgess, P. M. (2006c) Effect of conditional release from hospitalization on mortality risk. Psychiatric Services, 57, 16071613.
Steadman, H. J., Gounis, K., Dennis, D., et al (2001) Assessing the New York City involuntary outpatient commitment pilot program. Psychiatric Services, 52, 330336.
Swartz, M. S., Swanson, J. W., Wagner, H. R., et al (1999) Can involuntary outpatient commitment reduce hospital recidivism? Findings from a randomised trial with severely mentally ill individuals. American Journal of Psychiatry, 156, 19681975.

Does compulsory or supervised community treatment reduce ‘revolving door’ care?: Legislation is inconsistent with recent evidence

  • Stephen Kisely (a1) and Leslie Anne Campbell (a2)

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