One criticism was that the 12-month follow-up failed to capture a trueclinical picture, and that more time was necessary to demonstrate theirworth. The team that carried out this original work have now published3-year data on 330 individuals detained under section of the Mental Health Act,1 randomised on discharge to CTO or voluntary status viaSection 17 leave. No improvements in readmission rates, time to firstreadmission, or duration of readmissions were found for those placed onCTOs. The findings are even more powerful than the original results; CTOsnow exist in various forms in over 75 jurisdictions, but no solid scientificevidence has yet been produced to support them. If there are subpopulationsfor whom (or specific circumstances in which) they work, suchcharacteristics have yet to be delineated. A ‘least restrictive’ principleunderpins the Mental Health Act, and a strong rebuttal is needed to justifyongoing CTO use – so-called ‘revolving-door patients' should not be replacedby revolving-door policy.