Involuntary treatment in the community: role of community treatment orders

Abstract

SummaryAlthough community treatment orders (CTOs) have been used internationally since the 1980s, they were only introduced into England and Wales in 2007 by amendments to the 1983 Mental Health Act. Aimed to replace the common use of extended Section 17 leave to enforce community treatment, CTOs are believed to offer patients more protection owing to stringent criteria for their use. Literature reviews, however, do not demonstrate any evidence favouring the use of CTOs and in this age of evidence-based medicine it is questionable whether psychiatrists will change from a familiar practice to an unproven one.

Advocacy Coalitions and Mental Health Policy: The Adoption of Community Treatment Orders inOntario

“…Consequently, adequate resources were not available in the community to meet the needs of newly released patients, and many struggled to reintegrate into the society (see Paikin ). CTOs emerged roughly 30 years ago and were first implemented in Australia and several U.S. states (Woolley ). The first Canadian jurisdiction to adopt CTOs was Saskatchewan in 1995 (Churchill et al .…”

Community treatment orders: current practice and a framework to aid clinicians

“…Community treatment orders: current practice and a framework to aid clinicians { Peter Lepping, 1,2 involuntary commitment is not always necessary. In Australia, it is possible to receive involuntary depot medication in the community without returning to hospital.…”

“…The 2007 amendments to the Mental Health Act 1983 introduced community treatment orders (CTOs) as part of supervised community treatment. 1 Although these are technically part of Section 17 leave, they effectively allow conditions to be placed on patients for treatment in the community. These conditions may include all aspects of medical and social care that are directly related to the patient's mental health as long as they 'ensure that the patient receives medical treatment for [his or her] mental disorder, prevent a risk of harm to the patient's health or safety, [or] protect other people' (p. 226).…”

Clinical stability in the community associated with long-term approved leave under the Mental Health Act 2001

“…CTOs were subsequently introduced into England and Wales in November 2008, following the MHA 2007, which added sections 17 A-G to the MHA 1983. This amendment allowed for supervised community treatment and was aimed primarily at those individuals who had repeated involuntary admissions to acute psychiatric units (Woolley, 2010, Lally, 2013. Before the introduction of CTOs, earlier initiatives in the United Kingdom, included extended leave for patients under the MHA 1983 and a 'Supervision Register' on discharge from involuntary status (Sensky et al 1991, Rugkåsa & Burns, 2009).…”