Community Treatment Orders

In the August 2008 edition of the British Journal of Psychiatry, there is a debate about the introduction of Community Treatment Orders. Simon Lawton-Smith is head of policy at the Mental Health Foundation and argues against Community Treatment Orders (CTO’s) being a ‘good thing’. Professors Tom Burns and John Dawson argue that Community Treatment Orders are a ‘good thing’. Community Treatment Orders are part of the new Mental Health Act (2007) being introduced by the government in England and Wales. They allow treatment of patients to be enforced in the community as opposed to in hospital.

CTO’s have already been implemented in Australia, New Zealand and the USA so this approach has already been tested. There has already been debate about implementing CTO’s in the UK and in one study in 2000, 34% of psychiatrists were opposed to their introduction. However another study is quoted showing that once CTO’s have been established elsewhere, psychiatrists have been more supportive of their use than in the study above.

Based on previous experience of CTO’s elsewhere, typically they have tended to be used in a small group of people with chronic illness who are quite unwell. They will also be subject to the stringent requirements of mental health act legislation including a shorter period of time before cases are referred to the Mental Health Act Tribunal.

The new mental health act will introduce changes for the way mental health professionals work and for the experiences of some patients who are detained under the Mental Health Act (2007). More information is available on the DOH website. As with any period of change, this will be accompanied by reflection and learning, although experience from other areas as described above will be helpful in this regards.



The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor.


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