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The benefits and harms of community treatment orders for people diagnosed with psychiatric illnesses: A rapid umbrella review of systematic reviews and meta-analyses.
Kisely, Steve; Zirnsak, Tessa; Corderoy, Amy; Ryan, Christopher James; Brophy, Lisa.
Afiliación
  • Kisely S; School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
  • Zirnsak T; Metro South Addiction and Mental Health Services, Woolloongabba, QLD, Australia.
  • Corderoy A; Griffith Criminology Institute (GCI), Griffith University, Mount Gravatt, QLD, Australia.
  • Ryan CJ; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
  • Brophy L; Social Work and Social Policy, Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.
Aust N Z J Psychiatry ; 58(7): 555-570, 2024 07.
Article en En | MEDLINE | ID: mdl-38650311
ABSTRACT

AIMS:

Community treatment orders have been introduced in many jurisdictions with increasing use over time. We conducted a rapid umbrella review to synthesise the quantitative and qualitative evidence from systematic reviews and/or meta-analyses of their potential harms and benefits.

METHODS:

A systematic search of Medline, PubMed, Embase and PsycINFO for relevant systematic reviews and/or meta-analyses. Where available, participants on community treatment orders were compared with controls receiving voluntary psychiatric treatment. This review is registered with PROSPERO (CRD42023398767) and the Open Science Framework (https//osf.io/zeq35).

RESULTS:

In all, 17 publications from 14 studies met the inclusion criteria. Quantitative synthesis of data from different systematic reviews was not possible. There were mixed findings on the effects of community treatment orders on health service use, and clinical, psychosocial or forensic outcomes. Whereas uncontrolled evidence suggested benefits, results were more equivocal from controlled studies and randomised controlled trials showed no effect. Any changes in health service use took several years to become apparent. There was evidence that better targeting of community treatment order use led to improved outcomes. Although there were other benefits, such as in mortality, findings were mostly rated as suggestive using predetermined and standardised criteria. Qualitative findings suggested that family members and clinicians were generally positive about the effect of community treatment orders but those subjected to them were more ambivalent. Any possible harms were under-researched, particularly in quantitative designs.

CONCLUSIONS:

The evidence for the benefits of community treatment orders remains inconclusive. At the very least, use should be better targeted to people most likely to benefit. More quantitative research on harms is indicated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios Comunitarios de Salud Mental / Trastornos Mentales Límite: Humans Idioma: En Revista: Aust N Z J Psychiatry Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios Comunitarios de Salud Mental / Trastornos Mentales Límite: Humans Idioma: En Revista: Aust N Z J Psychiatry Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido