Data extraction The primary sources of data included the Mental Health Act office registers, source legal CTO documents, prescription charts and electronic patient records including medication details, contemporary clinical notes and summaries. A baseline data pro forma was completed by clinical research staff. Analysis Statistical analyses with SPSS software included baseline descriptive analyses. Age at CTO initiation was calculated and categorized according to ‘Count me in’ census categories [Care Quality Commission,

2009]. Conditions stated on CTO were coded according to commonly occurring themes (as #contain keyword# outlined in Table 3). Current antipsychotic medication was categorized according to class and formulation and antipsychotic polypharmacy was noted. Doses for antipsychotics were converted into percentage of maximum dose licensed according the British National Formulary (%BNF) [Royal Pharmaceutical Society of Great Britain, 2008]. Completion of SOAD certification was categorized according to time of completion and reason for lack Inhibitors,research,lifescience,medical of completion Inhibitors,research,lifescience,medical within 6 months (as outlined in Table 3). Table 3. CTO statutory reasons, conditions and medication. Results Sample characteristics There were 195 patients initiated on a CTO in the first year of www.selleckchem.com/products/Temsirolimus.html legislation: 65% were male,

52% were of black ethnic origin, 5.6% were legally married, and 3.1% were employed or were students (see Table 1). The mean age at CTO initiation was 40.6 years (SD 14.1, range 17.0–89.1 years). The most common Inhibitors,research,lifescience,medical diagnosis was schizophrenia (70.8%). Five potential cases were lost as the patients were

entered into the nationwide RCT and randomized to the non-CTO arm of the trial (four cases were randomized to the CTO arm of the trial and are included here) [OCTET team, personal communication]. Table 1. Sample characteristics. CTO use and ethnicity For the 195 patients, 30 (15.4%) CTOs were conversions from former supervised discharge orders (section 25a), and 7 (3.6%) patients were previously Inhibitors,research,lifescience,medical on a criminal court appointed treatment order (section 37). CTOs were started more frequently in the first phase of the study (first cohort quartile (Q1): 64 (32.8%, including 10 section 25a conversions); Q2: 62 (31.8%, including 20 section 25a conversions); Q3: 39 (20.0%); Q4: 30 (15.4%)). Variation in CTO use was identified for secondary care patients across the four local Carfilzomib boroughs in the Trust (N = 165, χ2 = 11.3, df = 3, p = 0.012; see Table 2). For each individual borough, the proportion of patients of black ethnic origin in the sample was significantly greater than expected, based on population data [Office for National Statistics, 2001]. However, based on Trust Mental Health Act data (April 2007-March 2008) for section 3 (6-month hospital treatment order) patients, the proportion of patients of black ethnic origin in our sample was not significantly greater than expected (observed 52.3%, expected 50.2%, N = 195, χ2 = 0.