Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020
Background Compulsory mental health treatment has increased globally. In Scotland, compulsory treatment for >28 days is permitted under hospital- and community-based compulsory treatment orders. Community-based compulsory treatment has not been shown to lead to improved outcomes, and scrutiny of...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-11-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424007518/type/journal_article |
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| _version_ | 1850194588366536704 |
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| author | Lisa Schölin Rohan Borschmann Arun Chopra |
| author_facet | Lisa Schölin Rohan Borschmann Arun Chopra |
| author_sort | Lisa Schölin |
| collection | DOAJ |
| description | Background
Compulsory mental health treatment has increased globally. In Scotland, compulsory treatment for >28 days is permitted under hospital- and community-based compulsory treatment orders. Community-based compulsory treatment has not been shown to lead to improved outcomes, and scrutiny of their use is needed.
Aims
To describe the trend, duration and demographic characteristics of compulsory treatment orders in Scotland over a 14-year period.
Method
We conducted a retrospective analysis of order use in Scotland from 1 January 2007 to 31 December 2020, focusing on the (a) number and demographic characteristics of those treated, (b) duration, (c) extensions beyond the 6-month review point and (d) characteristics of new versus continued orders.
Results
The number of individuals on a community-based order increased by 118% (571 v. 1243) from 2007 to 2020, compared with a 16% increase (1316 v. 1532) for hospital-based orders. Of orders starting in 2007, 57.3% were extended, compared with 43.7% in 2020. The median duration was 6 months for first-time orders and 9 months for subsequent orders, which were longest for males (median 11 months); those of African, Caribbean or Black (median 11 months), Asian (median 11 months) and mixed ethnicity (median 10 months); and individuals from the most deprived communities (median 10 months).
Conclusions
There has been a marked rise of community-based compulsory treatment orders in Scotland. If existing trends continue, there will be more people receiving care under community-based orders than hospital-based orders, fundamentally changing the nature of involuntary treatment. Further work needs to explore associations between demographic and diagnostic characteristics on order duration.
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| format | Article |
| id | doaj-art-237e1de83af545cd9d52e9b22bcd76c4 |
| institution | OA Journals |
| issn | 2056-4724 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-237e1de83af545cd9d52e9b22bcd76c42025-08-20T02:13:58ZengCambridge University PressBJPsych Open2056-47242024-11-011010.1192/bjo.2024.751Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020Lisa Schölin0https://orcid.org/0000-0002-1348-672XRohan Borschmann1https://orcid.org/0000-0002-0365-7775Arun Chopra2https://orcid.org/0000-0002-5895-0645Centre for Cardiovascular Science, University of Edinburgh, UKDepartment of Psychiatry, University of Oxford, UK; Centre for Mental Health and Community Wellbeing, University of Melbourne, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Australia; and Justice Health Group and School of Population Health, Curtin University, AustraliaMental Welfare Commission for Scotland, UKBackground Compulsory mental health treatment has increased globally. In Scotland, compulsory treatment for >28 days is permitted under hospital- and community-based compulsory treatment orders. Community-based compulsory treatment has not been shown to lead to improved outcomes, and scrutiny of their use is needed. Aims To describe the trend, duration and demographic characteristics of compulsory treatment orders in Scotland over a 14-year period. Method We conducted a retrospective analysis of order use in Scotland from 1 January 2007 to 31 December 2020, focusing on the (a) number and demographic characteristics of those treated, (b) duration, (c) extensions beyond the 6-month review point and (d) characteristics of new versus continued orders. Results The number of individuals on a community-based order increased by 118% (571 v. 1243) from 2007 to 2020, compared with a 16% increase (1316 v. 1532) for hospital-based orders. Of orders starting in 2007, 57.3% were extended, compared with 43.7% in 2020. The median duration was 6 months for first-time orders and 9 months for subsequent orders, which were longest for males (median 11 months); those of African, Caribbean or Black (median 11 months), Asian (median 11 months) and mixed ethnicity (median 10 months); and individuals from the most deprived communities (median 10 months). Conclusions There has been a marked rise of community-based compulsory treatment orders in Scotland. If existing trends continue, there will be more people receiving care under community-based orders than hospital-based orders, fundamentally changing the nature of involuntary treatment. Further work needs to explore associations between demographic and diagnostic characteristics on order duration. https://www.cambridge.org/core/product/identifier/S2056472424007518/type/journal_articleLongitudinal dataobservational studyout-patient treatmentin-patient treatmentpsychiatry and law |
| spellingShingle | Lisa Schölin Rohan Borschmann Arun Chopra Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 BJPsych Open Longitudinal data observational study out-patient treatment in-patient treatment psychiatry and law |
| title | Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 |
| title_full | Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 |
| title_fullStr | Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 |
| title_full_unstemmed | Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 |
| title_short | Temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in Scotland from 2007 to 2020 |
| title_sort | temporal patterns and individual characteristics of compulsory treatment orders for mental disorders in scotland from 2007 to 2020 |
| topic | Longitudinal data observational study out-patient treatment in-patient treatment psychiatry and law |
| url | https://www.cambridge.org/core/product/identifier/S2056472424007518/type/journal_article |
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