To compare the post-discharge outcomes of people admitted to community-based residential mental health rehabilitation facilities subject to a Community Treatment Order (CTO) who do and do not have this order discontinued prior to discharge.

People subject to a CTO who were admitted across five Community Care Units (CCUs) in Queensland, Australia between 2005 and 2014 (N = 311), were grouped based on involuntary treatment status at the time of their discharge. Individuals whose status changed to voluntary (n = 63; CTO > VOL) were compared with those whose treatment remained involuntary (n = 248; CTO-CTO) on demographic, clinical and treatment-related characteristics. Group-level and individualised changes were assessed between the year pre-admission and the year post-discharge. The primary outcome measure was change in mental health and social functioning (Health of the Nation Outcome Scale). Secondary outcomes included disability (Life Skills Profile-16), service use, accommodation instability, and involuntary treatment. Logistic regression was completed to examine predictors of CTO discontinuation during CCU care. Potential predictors covered service-, consumer-, and treatment-related characteristics.

Compared to the CTO-CTO group, the CTO > VOL group had significantly longer episodes of CCU care, more frequent primary diagnoses of schizophrenia spectrum disorders, and were more likely to be female. Following discharge, CTO > VOL subjects had more frequent reliable and clinically significant improvement in HoNOS scores, as well as more frequently demonstrated reliable improvement in hospital bed use and accommodation instability than the CTO-CTO subjects. CTO discontinuation was predicted by longer duration of CCU care, being a female, and having a smaller number of psychiatry-related bed use prior admission.

Our findings suggest that CCU care of sufficient duration may lessen the need for subsequent compulsory treatment in the community.

比较根据社区治疗令 (CTO) 入住以社区为基础的心理健康康复设施的人在出院前是否停止了该命令的出院结果。

2005 年至 2014 年期间（N  = 311）在澳大利亚昆士兰州的五个社区护理单位 (CCU) 入住的受 CTO 约束的人根据出院时的非自愿治疗状态进行分组。将状态变为自愿的个体 ( n  = 63; CTO > VOL) 与那些治疗仍然是非自愿的个体( n = 248; CTO-CTO) 的人口统计学、临床和治疗相关特征。在入院前一年和出院后一年之间评估了组级和个体化的变化。主要结果测量是心理健康和社会功能的变化（国家健康结果量表）。次要结果包括残疾（生活技能简介-16）、服务使用、住宿不稳定和非自愿治疗。完成逻辑回归以检查 CCU 护理期间 CTO 停药的预测因素。潜在的预测因素涵盖服务、消费者和治疗相关的特征。

与 CTO-CTO 组相比，CTO > VOL 组的 CCU 护理时间显着延长，精神分裂症谱系障碍的初步诊断更频繁，并且更可能是女性。出院后，与 CTO-CTO 受试者相比，CTO > VOL 受试者在 HoNOS 评分方面有更频繁的可靠和临床显着改善，并且在医院病床使用和住宿不稳定方面更频繁地表现出可靠的改善。CTO 停药的预测因素包括 CCU 护理的持续时间较长、女性为女性以及入院前与精神病学相关的病床使用次数较少。

我们的研究结果表明，足够持续时间的 CCU 护理可能会减少后续社区强制治疗的需要。