The introduction of supervised community treatment, delivered through community treatment orders (CTOs) in England and Wales, contrasts with the policy of personalisation, which aims to provide service users autonomy and choice over services. This article draws upon findings from a primarily qualitative study which included 72 semi-structured interviews (conducted between January and December 2012) with practitioners, service users and nearest relatives situated within a particular NHS Trust. The article also refers to a follow-on study in which 30 Approved Mental Health Practitioners were interviewed. The studies aimed to develop a better understanding of how compulsory powers are being used in the community, within a policy context that emphasises personalisation and person-centred care in service delivery. Findings from the interview data (which were analysed thematically) suggest that service users were often inadequately informed about the CTO and their legal rights. Furthermore, they tended to be offered little, or no, opportunity to make choices and have involvement in the making of the CTO and setting of conditions. Retrospectively, however, restrictions were often felt beneficial to recovery, and service users reported greater involvement in decisions at review stage. Areas of good practice are identified through which person-centred care can be better incorporated into the making of CTOs.

Child homicide has been a key influence on childcare policy and practice over the last three decades, with a particular focus on the assessment, management and monitoring of situations where children are at risk and on associated inter-agency working. A psychosocial analysis of the pre-offence experiences of 68 adults (mostly parents or carers) who killed or attempted to kill a child identified complex, intricate and heterogeneous processes in respect of their interpersonal relationships, stress and mental health and the relationship of these factors to the offence. These findings indicate that the current policy and practice focus upon procedures and performance in safeguarding children may not address successfully the complex needs of those adults who may pose a risk to children. It is suggested that appropriate therapeutic services should be more readily available. Key words

The perceptions of service users have an important role in determining the value and potential effectiveness of CTOs. A consideration of these issues should be integral to the process of assessing whether a CTO is appropriate in individual cases.

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Social workers and medical practitioners, particularly those in general practice, provide services for individuals who experience social exclusion. Access to medical, health and social care services has been identified as problematic for refugees and asylum seekers, reflecting their marginalised status within society. It is widely accepted that multi-agency responses and working together are key requirements in improving access to services and promoting social inclusion; however, achieving this across professional and agency boundaries often remains challenging. Joint planning and training have been suggested as being important in improving communication, leading to more flexible and creative services. This paper describes the genesis and implementation of a series of innovative interprofessional workshops for medical and social work students, focussing specifically on marginalised groups. Learning and teaching input was developed by, and came from, service users and qualified medical, health and social work practitioners. The paper focuses particularly on the sessions relating to refugees and asylum seekers. The content and structure of the sessions are discussed and students' responses are reported. The implications for future inter-professional learning and practice in relation to socially excluded groups are highlighted.