Advising UK Law

Landmark English research evaluating the effectiveness of community treatment orders (CTOs) for psychiatric patients under outpatient care has had significant input from Professor John Dawson (Faculty of Law).

“Use of compulsion in outpatient care has been the pre-eminent issue for mental health law in the past three decades as many countries have closed their psychiatric hospitals."

New Zealand introduced a CTO regime in 1992 and Dawson's research on this resulted in him develop a relationship with Oxford's Professor Tom Burns who was advising the UK Parliament leading up to the introduction of its CTO regime in 2008.

When it was decided to research that regime, Dawson became involved as an advisor and wrote an opinion convincing the English ethics committee that the proposed randomised controlled trial was lawful.

This trial compared the outcomes for 167 people placed under a CTO, for an average of roughly six months, with 169 others placed under a “leave” regime, with equivalent powers, that was used on average for only a few weeks. That allowed them to compare the results of longer versus shorter compulsory outpatient care, finding longer care did not reduce rehospitalisation rates. The results were published in The Lancet (March 2013).

"The trial was rigorously conducted and found no difference in rates of readmission to hospital between the two randomly allocated groups, and no differences overall in their psychiatric symptoms or social functioning, quite contrary to our expectations," says Dawson.

He plans to return to Oxford to continue the work in 2014.