Abstract
One criticism was that the 12-month follow-up failed to capture a true clinical picture, and that more time was necessary to demonstrate their worth. The team that carried out this original work have now published 3-year data on 330 individuals detained under section of the Mental Health Act,1 randomised on discharge to CTO or voluntary status via Section 17 leave. No improvements in readmission rates, time to first readmission, or duration of readmissions were found for those placed on CTOs. The findings are even more powerful than the original results; CTOs now exist in various forms in over 75 jurisdictions, but no solid scientific evidence has yet been produced to support them. If there are subpopulations for whom (or specific circumstances in which) they work, such characteristics have yet to be delineated. A ‘least restrictive’ principle underpins the Mental Health Act, and a strong rebuttal is needed to justify ongoing CTO use – so-called ‘revolving-door patients' should not be replaced by revolving-door policy.
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