New Study Calls for Targeted Use of Community Treatment Orders to Improve Mental Health Outcomes

New Study Calls for Targeted Use of Community Treatment Orders to Improve Mental Health Outcomes

Brisbane, 24 July 2025 — A landmark Queensland-wide study has found that Community Treatment Orders (CTOs)—legal mandates for psychiatric treatment in the community—may only benefit individuals with non-affective psychosis, such as schizophrenia, and could be ineffective or even harmful for others.

Published in the British Journal of Psychiatry, the study analysed data from over 32,000 individuals across Queensland between 2018 and 2022. It revealed that CTOs did not reduce hospital admissions or bed-days overall, but significantly improved outcomes for people with non-affective psychosis, including fewer readmissions and shorter hospital stays.

The research also highlighted concerning disparities: First Nations Australians and those from culturally and linguistically diverse backgrounds were more likely to be placed on CTOs, raising questions about equity and cultural sensitivity in mental health care.

"This is the first jurisdiction-wide study to show that CTOs may only be effective for a specific subgroup—those with non-affective psychosis," said lead author Professor Steve Kisely, from The University of Queensland.
"Our findings suggest that indiscriminate use of CTOs may dilute their potential benefits and unnecessarily subject individuals to coercive treatment without clear evidence of efficacy."

Professor Lisa Brophy, co-author and mental health policy expert at La Trobe University, added:
"These results underscore the urgent need for culturally responsive care and more judicious use of CTOs. We must ensure that mental health interventions are both effective and equitable, especially for marginalised communities."

The study calls for policy reform to restrict CTOs to individuals with non-affective psychosis, aligning clinical practice with evidence-based outcomes. It also recommends enhanced cultural competence in mental health services and further research into non-coercive alternatives like assertive outreach.

This research was supported by the Australian Research Council 

Contact: s.kisely@uq.edu.au