Invited commentary: Community treatment orders

Tom Burns

doi:10.1192/pb.23.11.647

Abstract

Moncrieff & Smyth (1999, this issue) are certainly right that community treatment orders (CTOs) are high on the agenda and that psychiatrists need to think long and hard about them – about the political and ethical implications, not just their practical and therapeutic applications. Their concerns are important and reflect a wide constituency – identical views were expressed and considered during the consultation that preceded the College's document proposing a Community Supervision Order in 1993 (Royal College of Psychiatrists, 1993). Moncrieff & Smyth make no mention of that document, nor the limited, but recent, survey of psychiatrists' opinions that accompanied it (Burns et al, 1993). Do all College documents achieve obscurity quite so quickly?

Highlights

Moncrieff & Smyth (1999, this issue) are cer tainly right that community treatment orders (CTOs) are high on the agenda and that psychiatrists need to think long and hard about them - about the political and ethical implica tions, not just their practical and therapeutic applications
Moncrieff & Smyth use the classical debating technique of posing a different question to that under consideration, demolishing it and sub sCtiotnuctilnugdinagditfhfaetreCnTt oOnseatrhea"tthseuiwtsrothnegirsoplruotpioonsatlo. the wrong question" they imply that the question was "how can psychiatry control antisocial behaviour?" This was not the question - if it wqueersetifoenw pwsaysch"iiastritshtesrewaouglrdousupppoofrpt aatieCnTtsO.wThhoe are poorly served by the present legislation, who are currently repeatedly subject to compulsory asedrmveisdsiboyn aaCndTOw?"hose welfare would be better
College members were clear that a CTO would contribute little to the problems of violence or the homeless mentally ill

Summary

Introduction

Moncrieff & Smyth (1999, this issue) are cer tainly right that community treatment orders (CTOs) are high on the agenda and that psychiatrists need to think long and hard about them - about the political and ethical implica tions, not just their practical and therapeutic applications. College members were clear that a CTO would contribute little to the problems of violence or the homeless mentally ill. To work it has to be part of a broader treatment package and relationship between professional and patient - it cannot substitute for either.

Results

Conclusion