Abstract
We commend Ingram et al. [1] for their study that demonstrates how the use of community treatment orders (CTOs) is associated with reduced homelessness. CTOs continue to be used by mental health services, both in Australia and overseas despite research yielding conflicting findings [2–4]. Most of the studies however, used hospitalization as a measure for effectiveness of CTOs. It is likely that hospitalization may not be a sensitive measure, calling for the need to carefully monitor other measures including homelessness, incarceration, violence and care giver burden. Unfortunately, such measures are not always documented [5]; we believe that monitoring of qualitative and quantitative measures for patients on CTOs should be mandated, particularly when applications are made to extend the period of CTOs. This would not only enable better and more comprehensive scientific reviews of effectiveness of CTOs, but is also a necessary ethical safeguard for patients maintained on CTOs.