title: Community Treatment Orders (CTOs): a demographic cross-sectional analysis.
abstract: OBJECTIVE
  Existing research on Community Treatment Orders (CTOs) questions what purposes they serve, for whom and for how long. This study aimed to identify demographics of the CTO population, differences between individuals who require short CTOs from those who require repeat CTO and clinician-determined factors which influence these decisions.
  
  
  METHODS
  Using a cross-sectional snapshot method, 301detailed audits were analysed for frequencies and relationships between variables.
  
  
  RESULTS
  People on CTOs (n = 301) comprised 9% of the community mental health population (n = 3268); 21% (n = 62) having it be their first CTO, 50% (n = 149) on repeat CTOs (continuous) and 29% (n = 85) on second episode or more of CTOs (non-continuous). There were 82% (n = 231) of people on a CTO who had a primary diagnosis of schizophrenia. There was a higher occurrence of males with co-existing factors of aggression and current substance misuse. Age had a relationship with length of actual and predicted CTOs.
  
  
  CONCLUSIONS
  Men of middle age, with a diagnosis of schizophrenia, a history of aggression, current substance misuse and reported previous CTO efficacy are the primary individuals predicted to require ongoing CTOs. Improving CTO efficacy should focus on providing targeted intervention for this group and a closer analysis of the use of CTOs in other groups.
authors.affiliation: Clinical Nurse Consultant, Quality and Research, Mental Health, Sydney Local Health District, Sydney, NSW, Australia sophie.isobel@sswahs.nsw.gov.au.
authors.forename: Sophie
authors.initials: S
authors.lastname: Isobel
authors.affiliation: Community and Partnerships Manager, Mental Health, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Clenaghan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology / Q000628:therapy*; D054869:Clinical Audit; D000066491:Clinical Decision-Making; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000076083:Involuntary Treatment, Psychiatric / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011618:Psychotic Disorders / Q000453:epidemiology / Q000628:therapy*; D012559:Schizophrenia / Q000453:epidemiology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult
keywords: Community Treatment Orders; coercion; community mental health; compliance; involuntary treatment