Enforced Community Treatment: Ethics & Effectiveness

Mental health problems constitute a major public health problem and are associated with substantial level of disability, in terms of personal distress and suffering, disruption in occupational and social functioning. They also have significant economic and humanitarian impact on families and the community. Relapse and chronicity are common with risk of ongoing morbidity and mortality. Compulsory community treatment is being utilized as a health care approach, despite much disagreement and lack of research demonstrating its effectiveness. One of the few Australian studies that has attempted to address this issue, the current pilot project found that compulsory community treatment had a positive impact upon hospital admission rates and medication usage. People with a serious mental illness on community orders, their family and Mental Health Review Tribunal members all rated community orders as being helpful in a number of areas. Despite these findings many ethical dilemmas remain and further research is needed.