Abstract
This editorial discusses the pros and cons of community treatment orders (CTOs) from the perspective of community general adult psychiatry. There is little scientific evidence supporting the application of CTOs. Preconditions of a CTO to work are likely to be met by few patients. The time for the application of a CTO may be better spent for patient-centred care until there is sufficient new and robust evidence that identifies the patients that might profit.
Highlights
The power to recall a patient to hospital by one doctor alone may reduce clinical governance in comparison with a full Mental Health Act assessment
The use of coercion without or even against scientific evidence may be seen as unethical and might violate the patients’ human rights. These circumstances may increase the stigma against psychiatry.[29]
It is impossible to disprove that community treatment orders (CTOs) may not work at an individual level in some patients
Summary
Psychiatrists in the National Health Service (NHS) work within a legislative framework that includes CTOs. The patient does not want to continue to take the medication that is likely, from the perspective of the treating psychiatrist, to help maintain improvement and reduce risk of relapse This may be for a range of reasons including side-effect burden, a disagreement that the medication is responsible for any improvement, a subjective perception that the medication has not helped, a belief that the medication is not necessary to maintain wellness or a disagreement that the problem being treated is a treatable mental disorder. The patient’s experience of a hospital stay was negative and the possibility of a hospital readmission is seen as a sufficiently coercive or aversive threat This threat is sufficient enough to make the patient change their previous rejection and to accept treatment they otherwise would not accept. The number of patients for whom all these conditions apply may be limited
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
