Website of the Department of Health

• Document type:
  Guidance
• Author:
  Department of Health, Institute of Psychiatry
• Published date:
  7 March 2007
• Primary audience:
  Health and social care professionals
• Publication format:
  Electronic only
• Gateway reference:
  Not required
• Pages:
  222
• Copyright holder:
  Crown

The Government is introducing supervised community treatment (SCT) to allow more patients to live safely, under supervision, in the community instead of in hospital. SCT will help more patients to rebuild their lives in the community and help to reduce the risk that a minority of patients pose to themselves and the public.

We commissioned the Institute of Psychiatry to undertake this literature review of the research available from the many countries in the world, which use different forms of SCT (often known as community treatment orders) to ensure we were up to date with the evidence. We would like to thank the authors for a thorough piece of work. The overall conclusion is a fair one -  that it is very difficult to secure reliable evidence in this area, and that as result there is very little conclusive evidence to demonstrate that SCT is either effective or ineffective.

This situation reflects, at least in part, the problem of doing gold standard trials in this area. This is a difficult area to research and, although some studies have reported positive findings, these findings can not be regarded as reliable. More research will be needed.

We are encouraged by reports from clinicians, carers and patients  in other countries that community treatment orders are of benefit and where they have made criticisms we hope to learn from these. We are confident that SCT, with its range of checks and balances, will be well received in England and Wales.

The review highlights that there is a gap in current research. Future work needs to focus on who benefits from SCT, the effect of compliance with treatment and key outcomes.  The Government has awarded 2 major funding grants of around £1 million to fill this gap and support the successful implementation of SCT in England and Wales.