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Community compulsion in Scotland: a descriptive analysis

  • Rachel Brown (a1), Mark Taylor (a2), Kirsty Mackay (a1), Callum Macleod (a3) and Donald Lyons (a3)...
Abstract
Aims and method

Community compulsion via community compulsory treatment orders is used routinely in Scotland. We aimed to describe the common characteristics of individuals subject to community compulsion. We collected standardised information from a national database about individuals subject to community compulsion and compared them with people subject to hospital detention.

Results

Analysis of 499 cases revealed that the majority of individuals subject to community compulsion had a psychotic illness, had a history of non-adherence to services and treatment, and were more likely than not to be in receipt of a long-acting injection of antipsychotic medication. Patients subject to community compulsion were clinically similar to patients subject to hospital-based treatment orders and usually were considered to pose a risk to other people.

Clinical implications

Community compulsion has been widely adopted despite a relative lack of supporting scientific evidence. Our findings are similar to those of other related studies and highlight that individuals with a psychotic illness who are ambivalent about treatment and who pose a risk to self or others are likely to be considered for community compulsion.

Copyright
Corresponding author
Mark Taylor (mark.taylor2@nhs.net)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Mental Welfare Commission for Scotland. Total Number of Orders in Existence. Mental Welfare Commission for Scotland, 2008.
2 Kisely, S, Campbell, LA, Preston, N. Compulsory community and involuntary outpatient treatment for people with severe mental disorders. Cochrane Database Syst Rev 2005; 3: CD004408.
3 Pinfold, V, Bindman, J. Is compulsory community treatment ever justified? Psychiatrist 2001; 25: 268–70.
4 Lambert, TJ, Singh, BS, Patel, MX. Community treatment orders and antipsychotic long-acting injections. Br J Psychiatry 2009; 95 (suppl 52): s5762.
5 Churchill, R, Owen, G, Singh, S, Hotopf, M. International Experiences of Using Community Treatment Orders. UK Department of Health and Institute of Psychiatry, 2007.
6 Taylor, M. Community treatment orders and their use in the UK. Adv Psychiatr Treat 2010; 16: 260–2.
7 Evans, R, Makala, J, Humphreys, M, Mohan, CRN. Supervised community treatment in Birmingham and Solihull: first 6 months. Psychiatrist 2010; 34: 330–3.
8 Swanson, JW, Swartz, MS, Wagner, HR, Burns, BJ, Borum, R, Hiday, VA. Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness. Br J Psychiatry 2000; 176: 324–31.
9 Dawson, J, Romans, S. Uses of community treatment orders in New Zealand: early findings. Aust N Z J Psychiatry 2001; 35: 190–5.
10 O'Reilly, R, Keegan, DL, Corring, D, Shrikhande, S, Natarajan, D. A qualitative analysis of the use of community treatment orders in Saskatchewan. Int J Law Psychiatry 2006; 29: 516–24.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Community compulsion in Scotland: a descriptive analysis

  • Rachel Brown (a1), Mark Taylor (a2), Kirsty Mackay (a1), Callum Macleod (a3) and Donald Lyons (a3)...
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