OCTET: The Oxford Community Treatment Order Evaluation Trial
|Funder||National Institute for Health Research, Department of Health|
|Collaborators||Professor Tom Burns, Department of Psychiatry, University of Oxford|
From November 2008 English mental health legislation allows for the treatment of severely ill individuals outside hospital under compulsion. The OCTET study is a randomised controlled trial examining the efficacy and cost-effectiveness of the new supervised Community Treatment Orders (CTOs). HERC is conducting the economic analysis which pioneers the application of the capabilities approach to measure patient-related outcomes for this vulnerable group. The trial is part of a broader NIHR research programme on coercion in mental health in the UK.
On 11 April 2013 Drs Judit Simon and Paul Anand presented as part of a webinar on 'Measuring Capabilities among Individuals with Mental Health Disorders', the webinar focused on issues around the operationalisation of the capability approach for mental health research.
Judit Simon summarised the existing difficulties with outcome measurement in mental health economic evaluations and the potential advantages of the capability approach as opposed to the current gold standard QALY (quality-adjusted life year) approach. The applied example of the UK OCTET (Oxford Community Treatment order Evaluation Trial) study was presented where the capability profile of over 300 ‘revolving door’ mental health service users experiencing involuntary hospitalisation was measured using the OxCAP-MH (Oxford CAPabilities questionnaire-Mental Health). The contextual practicalities of instrument development were discussed together with the initial findings. Issues such as instrument generalisability, objective versus subjective capabilities, and the impacts of coercion, adaptation and altered perception have been considered further.
Paul Anand provided an overview of the capabilities measurement project. Paul argued that capabilities can be measured using survey data. Paul explained how some of the operationalisation and measurement issues have been overcome.