{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:24:47Z","timestamp":1793319887831,"version":"4.5.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"unspecified","delay-in-days":50,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796025000058_sec1a\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>There has been concern about violent acts and other criminal behaviour by people with a possible history of mental health problems. We therefore assessed the effects of community treatment orders (CTOs) on self-, third-party-, and agency-reported criminal behaviour when compared to voluntary treatment.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025000058_sec2b\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A systematic search of PubMed\/Medline, Embase, PsycINFO and criminal justice bibliographic databases for observational or randomised controlled trials (RCTs) comparing CTO cases with controls receiving voluntary psychiatric treatment. Relevant outcomes were reports of violence and aggression or contacts with the criminal justice system such as arrests and court appearances.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025000058_sec3c\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Thirteen papers from 11 studies met inclusion criteria. Nine papers came from the United States and four from Australia. Two papers were of RCTs. Results for all outcomes were non-significant, the effect size declining as study design improved from non-randomised data on self-reported criminal behaviour, through third party criminal justice records and finally to RCTs. Similarly, there was no significant finding in the subgroup analysis of serious criminal behaviour.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025000058_sec4d\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>On the limited available evidence, CTOs may not address aggression or criminal behaviour in people with mental illness. This is possibly because the risk of violence is increased by comorbid or nonclinical variables, which are beyond the scope of CTOs. These include substance use, a history of victimisation or maltreatment, and the wider environment. The management of risk should therefore focus on the whole person and their community through social and public health interventions, not solely legislative control.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796025000058","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T05:16:56Z","timestamp":1740028616000},"source":"Crossref","is-referenced-by-count":5,"title":["A systematic review and meta-analysis of the effect of community treatment orders on aggression or criminal behaviour in people with a mental illness"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-2924","authenticated-orcid":false,"given":"S.","family":"Kisely","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4064-652X","authenticated-orcid":false,"given":"C.","family":"Bull","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"S2045796025000058_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11292-014-9226-3"},{"key":"S2045796025000058_ref19","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"S2045796025000058_ref5","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2010.61.10.996"},{"key":"S2045796025000058_ref22","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2010.61.2.137"},{"key":"S2045796025000058_ref24","volume-title":"International Experiences of Using Community Treatment Orders","author":"Power","year":"1992"},{"key":"S2045796025000058_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21160"},{"key":"S2045796025000058_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/00048674241246436"},{"key":"S2045796025000058_ref30","doi-asserted-by":"publisher","DOI":"10.1177\/0093854801028002002"},{"key":"S2045796025000058_ref9","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2019.1619000"},{"key":"S2045796025000058_ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s10979-007-9095-7"},{"key":"S2045796025000058_ref31","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.9.1523"},{"key":"S2045796025000058_ref17","doi-asserted-by":"publisher","DOI":"10.1176\/ps.62.5.pss6205_0504"},{"key":"S2045796025000058_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30382-1"},{"key":"S2045796025000058_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2020.101565"},{"key":"S2045796025000058_ref2","first-page":"3","article-title":"The urgent need to review the use of CTOs and compliance with the UNCRPD across Australian jurisdictions","volume":"28","author":"Brophy","year":"2021","journal-title":"International Journal of Mental Health and Capacity Law"},{"key":"S2045796025000058_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2022.101813"},{"key":"S2045796025000058_ref33","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.176.4.324"},{"key":"S2045796025000058_ref29","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.3.330"},{"key":"S2045796025000058_ref6","first-page":"8","volume-title":"Human Rights Framework: An Ethical Imperative for Psychiatry","author":"Gill","year":"2019"},{"key":"S2045796025000058_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-52179-9_2"},{"key":"S2045796025000058_ref35","unstructured":"United Nations (2006) Convention on the Rights of Persons with Disabilities , adopted on 13 December 2006 , GA Res 61\/106, UN Doc A\/Res\/61\/106 (entered into force 3 May 2008). Available at: https:\/\/www.un.org\/development\/desa\/disabilities\/convention-on-the-rights-of-persons-with-disabilities.html."},{"key":"S2045796025000058_ref11","first-page":"52","article-title":"A follow-up of chronic patients committed to outpatient treatment","volume":"40","author":"Hiday","year":"1989","journal-title":"Hospital and Community Psychiatry"},{"key":"S2045796025000058_ref32","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.5.490"},{"key":"S2045796025000058_ref23","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.56.7.863"},{"key":"S2045796025000058_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.12.1.47"},{"key":"S2045796025000058_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/0160-2527(87)90026-4"},{"key":"S2045796025000058_ref18","first-page":"175","article-title":"Mental health laws: Where to from here","volume":"40","author":"McSherry","year":"2014","journal-title":"Monash University Law Review"},{"key":"S2045796025000058_ref25","doi-asserted-by":"publisher","DOI":"10.1177\/0706743715620415"},{"key":"S2045796025000058_ref20","doi-asserted-by":"publisher","DOI":"10.1177\/1039856214531080"},{"key":"S2045796025000058_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2018.12.001"},{"key":"S2045796025000058_ref16","doi-asserted-by":"publisher","DOI":"10.1071\/AH16074"},{"key":"S2045796025000058_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/schizbullopen\/sgac071"},{"key":"S2045796025000058_ref36","doi-asserted-by":"publisher","DOI":"10.1371\/annotation\/f4abfc20-5a38-4dec-aa46-7d28018bbe38"},{"key":"S2045796025000058_ref3","volume-title":"International Experiences of Using Community Treatment Orders","author":"Churchill","year":"2007"},{"key":"S2045796025000058_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2020.101634"},{"key":"S2045796025000058_ref13","article-title":"Compulsory community and involuntary outpatient treatment for people with severe mental disorders","volume":"3","author":"Kisely","year":"2017","journal-title":"Cochrane Database Systematic Reviews"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796025000058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T05:17:02Z","timestamp":1740028622000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796025000058\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":36,"alternative-id":["S2045796025000058"],"URL":"https:\/\/doi.org\/10.1017\/s2045796025000058","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e12"}}