Community treatment orders: learning from experiences of service users, practitioners and nearest relatives

Abstract

Background: The effectiveness of Community Treatment Orders (CTOs) has been examined previously. However, few studies have explored the significance of service user and practitioner understandings.

Aims: The study explored the experiences of service users, practitioners and nearest relatives, to identify key factors and good practice in relation to CTOs.

Method: A study of CTOs in a mental health NHS Trust in Southern England, including 72 semi-structured interviews, analysed thematically.

Results: CTOs were perceived as helpful in certain circumstances for the "right" service user. Factors influencing effectiveness included recognition of the containing elements of the CTO, a respect for its legal authority and an acceptance of conditions.

Conclusions: 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.

Keywords: Community treatment orders; coercion; community mental health; compulsory treatment.