Community Treatment Orders

The introduction of Community Treatment Orders (CTOs) through the 2007 amendments to the Mental Health Act 1983 was one of the most significant changes to mental health law in the last 20 years. It is also an element which has proved controversial, and both service user and professional groups have voiced strong views about its use. Despite this, use has exceeded expectations and they are very much a part of many of our working lives.

In addition, the introduction of CTOs has highlighted the need to fully understand other areas of the Mental Health Act 1983, where people can remain subject to its powers whilst residing outside of hospital.

As with all areas of the Act, its guiding principles should inform practice. These are described in the Code of Practice as follows:

• Least Restrictive Option and Maximising Independence – wherever possible a patient's independence should be encouraged and supported with a focus on promoting recovery wherever possible.
• Empowerment and Involvement – patients should be fully involved in decisions about care, support and treatment. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this.
• Respect and Dignity – patients, their families and carers should be treated with respect and dignity and listened to by professionals.
• Purpose and Effectiveness – decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines.
• Efficiency and Equity – providers, commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. All relevant services should work together to facilitate timely, safe and supportive discharge from detention.

This module will consider how these principles may be applied with regard to Community Treatment Orders, Section 17 Leave and guardianship.

Please note: This module previously had the title Supervised community treatment.