The Code of Practice highlights that conditions might include ‘where the patient is to live, and avoidance of known risk

factors or high-risk situations relevant to the patient’s mental disorder’ [Department of Health, 2008]. We wonder how many patients will be recalled to hospital specifically because a condition regarding place of residence (applicable to over half of our sample) has not been upheld, or a urine drug screen sample has not been Inhibitors,research,lifescience,medical consistently provided. Further, it is stated that conditions should only minimally restrict the patient’s liberty while being consistent with achieving their purpose [Department of Health, 2008]. Requiring access to a patient’s home is intrusive and may not be consistent with the ‘least restrictive principle’ governing compulsory treatment, as is suggested by the use of this condition for almost a third of our sample. Further monitoring of conditions, particularly regarding place of residence, seems appropriate and should include subsequent alterations to the conditions Inhibitors,research,lifescience,medical (after CTO initiation) for which there are no current additional checks in place. Also, the process by which a responsible clinician

and approved Inhibitors,research,lifescience,medical mental health practitioner formulate the conditions to be imposed is in need of more consideration and structure by policymakers. This should also anticipate how these conditions might be challenged by the patient, potentially at the point of CTO renewal if not earlier. Medication Our finding of 88/138 (63.8%) of those with schizophrenia on a CTO being prescribed an LAI is double that reported by http://www.selleckchem.com/products/Belinostat.html Barnes and colleagues who highlighted that in the UK, LAI use Inhibitors,research,lifescience,medical for patients

with schizophrenia is 35% on acute wards, 36% for assertive outreach team cases, 28% on forensic wards [Barnes et al. 2009]. In 2002 in the state of Victoria, Australia, just under half of those with schizophrenia on CTOs were prescribed an LAI [Lambert et al. 2009]. Thus far, there has been no definitive evidence to suggest the Inhibitors,research,lifescience,medical use of a CTO with an LAI is more beneficial, in terms of long-term GSK-3 outcomes, than either an LAI alone or a CTO with an oral antipsychotic. Moreover the alleged superior long-term benefits in relapse prevention of LAIs over oral antipsychotics lack definitive evidence [selleck chem Dovitinib Leucht et al. 2011; Rosenheck et al. 2011; Patel et al. 2009] although a large cohort study favoured depot antipsychotics over their equivalent oral preparations [Tiihonen et al. 2011]. That said, the CTO may grant access to treating the patient with an LAI and also provide sufficient time to establish a regular injection routine. In turn this allows patients a better chance of establishing some control over their illness and, with it, a measure of improved insight [Lambert et al. 2009].