Abstract
IntroductionThe prevalence of Community Treatment Orders (CTOs) in the Western world has generated considerable discussion regarding best practices in the outpatient treatment of the seriously mentally ill. Although problems encountered by ethnic minority communities in the various health care systems have been studied to some degree, there is an acute dearth of information on the effects of CTOs on minority individuals. This paper presents findings from research on the lived experiences of individuals from ethnic minority backgrounds who have been the subjects of CTOs in Toronto, Canada, and their perceptions of its impact on their lives.MethodsUsing a qualitative phenomenological approach, in-depth semi-structured interviews were conducted with individuals who have experienced CTOs. Purposive sampling was used to recruit participants (n = 24) from ethnic minority background in Toronto, Canada.ResultsParticipants perceived both positive and negative impacts of CTOs. The positives included affirmation of experiences with the mental health system; improved rapport with the case management and clinical team, increased medication compliance and feelings of empowerment. The negative feedback included feelings of being coerced and the stigma associated with it.ConclusionsThe findings of this study suggest that although CTOs are not a panacea for every mental health problem, they can be effective with a specific group who choose to follow through with the expectations of the treatment. The author, however argues that for these individuals to be on a CTO before getting better treatment, brings to the fore a number of issues with the mental health system. This is particularly concerning as it pertains to individuals of ethnic minority background.
Highlights
The prevalence of Community Treatment Orders (CTOs) in the Western world has generated considerable discussion regarding best practices in the outpatient treatment of the seriously mentally ill
A large body of research reveals that individuals of ethnic minority background experience inadequate mental health care, insufficient access to care, and racism in the health care system [1,2,3,4,5,6]
Research has shown that the physical and mental health of individuals from minority communities is impacted by a health care system that is shaped around the needs of the dominant culture [17,18]
Summary
The prevalence of Community Treatment Orders (CTOs) in the Western world has generated considerable discussion regarding best practices in the outpatient treatment of the seriously mentally ill. A large body of research reveals that individuals of ethnic minority background experience inadequate mental health care, insufficient access to care, and racism in the health care system [1,2,3,4,5,6]. Research has shown that the physical and mental health of individuals from minority communities is impacted by a health care system that is shaped around the needs of the dominant culture [17,18]. Individuals from ethnic minority backgrounds have higher dropout rates or non-compliance with treatment compared to the dominant group. This is attributed to adverse experiences in the mental health system and the cultural incompetence and insensitivity of service providers [7,22]. Based on the fact that minority individuals have less access to services than the dominant group, the tendency is high for them to seek mental health care later and they are often misdiagnosed, which results in the likelihood of receiving inadequate treatment [23,24]
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