Variation in the use of compulsory community treatment orders between district health boards in New Zealand

Objective To report rates of Compulsory Community Treatment Order (CTO) use by District Health Boards (DHBs) in New Zealand and analyse whether socio-demographic factors explain any variability. Methods The annualised rate of CTO use per 100,000 population was calculated for the years 2009-2018 using national databases. Rates were adjusted for age, gender, ethnicity, and deprivation and are reported according to DHBs to allow comparisons between regions. Results The annualised rate of CTO use for New Zealand was 95.5 per 100,000 population. CTO use varied between DHBs from 53 to 184 per 100,000 population. Standardising for demographic variables and deprivation made little difference to this variation. CTO use was higher in males and young adults. Rates for Maori were more than three times that of Caucasian people. CTO use increased as deprivation became more severe. Conclusions CTO use increases with Maori ethnicity, young adulthood, and deprivation. Adjusting for socio-demographic factors does not explain the wide variation in CTO use between DHBs in New Zealand. Other regional factors appear to be the major driver of variation in CTO use.

Automated summary

This study aims to report the rates of Compulsory Community Treatment Order (CTO) use by District Health Boards (DHBs) in New Zealand and analyze whether socio-demographic factors can explain the variability. The annualized rate of CTO use per 100,000 population for the years 2009-2018 was calculated using national databases. The results show that CTO use varies significantly between DHBs and is higher in males, young adults, and those with higher deprivation levels. Adjusting for socio-demographic factors did not explain the wide variation in CTO use between DHBs in New Zealand, suggesting that other regional factors play a major role.