Light Edwina, Kerridge Ian, Ryan Christopher, Robertson Michael
Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia.
Australas Psychiatry. 2012 Dec;20(6):478-82. doi: 10.1177/1039856212466159. Epub 2012 Nov 6.
Community treatment orders (CTOs) allow clinicians to provide unconsented outpatient treatment to people living with mental illness. Though controversial and of uncertain efficacy, CTOs are used throughout Australia and internationally. We sought to determine the prevalence of CTO use in Australian states and territories, and to examine changes in the pattern of use over time.
Australian state and territory mental health review tribunals and health departments were surveyed for the most recent annual data on the total number of CTOs made and the total number of individual people placed on a CTO.
Rates of CTO use range from 30.2 per 100,000 population (in Tasmania) to 98.8 per 100,000 population (in Victoria). Use of CTOs in Australia is high by world standards, appears to be increasing over time, and varies significantly across jurisdictions.
The high (by world standards), increasing and variable use of CTOs in Australia is concerning and raises important implications for mental health policymakers and legislators. Current mental health policy activity, particularly the new National Mental Health Commission, provides a unique opportunity to enhance transparency and accountability if regular and nationally uniform CTO data are collected and publically reported.
社区治疗令允许临床医生对患有精神疾病的人进行未经同意的门诊治疗。尽管存在争议且疗效不确定，但社区治疗令在澳大利亚和国际上都有使用。我们试图确定澳大利亚各州和领地使用社区治疗令的患病率，并研究其使用模式随时间的变化。
对澳大利亚各州和领地的心理健康审查法庭和卫生部门进行调查，以获取有关社区治疗令签发总数和被下达社区治疗令的个人总数的最新年度数据。
社区治疗令的使用率从每10万人30.2例（塔斯马尼亚州）到每10万人98.8例（维多利亚州）不等。按照世界标准，澳大利亚社区治疗令的使用率较高，且似乎随时间推移而上升，不同司法管辖区之间存在显著差异。
按照世界标准，澳大利亚社区治疗令的高使用率、上升趋势以及使用的差异性令人担忧，对心理健康政策制定者和立法者具有重要意义。如果收集并公开报告定期且全国统一的社区治疗令数据，当前的心理健康政策活动，特别是新成立的国家心理健康委员会，将提供一个提高透明度和问责制的独特机会。
