Controversial powers to treat mental health patients in the community while seriously curtailing their freedoms have been criticised by one of their strongest supporters.
Popularly known as "psychiatric Asbos", Community Treatment Orders (CTOs) were introduced five years ago after a series of high-profile cases that involved mentally ill people attacking members of the public. The draconian measures have now been shown to make no clinical difference – and the psychiatrist who championed them is calling for their immediate suspension.
CTOs gave doctors legal authority to impose conditions on their patients after they are released from hospital such as where they must live, what drugs they must take and even how much alcohol they could consume.
If they broke any of these stipulations they could be immediately recalled and sectioned to a psychiatric unit.
Now Tom Burns, the psychiatrist who originally advised the government on CTOs, has also come to the conclusion they are ineffective and unnecessary. Professor Burns, once a strong supporter of the new powers, said he has been forced to change his mind after a study he conducted proved the orders "don't work".
CTOs were introduced with the aim of reducing the number of readmissions of patients who were regularly in and out of hospital by compelling them to take their medication.
But after leading the UK's largest randomised trial of CTOs, Professor Burns has discovered that they made absolutely no difference to these so-called "revolving door" patients.
"The evidence is now strong that the use of CTOs does not confer early patient benefits despite substantial curtailment of individual freedoms," said Professor Burns, who is head of the social psychiatry department at Oxford University.
"Their current high usage should be urgently reviewed. I think there should be a moratorium on their use at least for a year or so while we think through how we can improve on the quality of evidence we've got. If we can't do that I think it really is unjustified to continue to use them."