Mental health clinicians' perspectives on working with Community Treatment Orders

Abstract

This research explores the beliefs and experiences of mental health clinicians working with people who are subject to a Community Treatment Order (CTO). Previous research indicates that the effectiveness of CTOs is questionable and there have been debates about the ethics of compulsory community treatment generally. The opinions of stakeholders are therefore important. Previous research with mental health clinicians has predominantly been quantitative and survey-based. Participants took part in a semi-structured interview which focused on their views about CTOs based on their clinical experiences. A Grounded Theory approach was adopted to collect and analyse the data. Two core categories were constructed from the data: ‘Factors influencing decision-making in the use of a CTO’ and ‘Impact of decisions’. The first core category contained the subcategories ‘Service user characteristics’, ‘Clinicians’ constructions of appropriate care and treatment’, ‘Clinicians’ knowledge’, ‘Pragmatic and systemic influences’ and ‘Societal influences’. The second core category contained the subcategories ‘Impact on service user’, ‘Impact on therapeutic relationship’, ‘Impact on clinician’, and ‘Impact on service delivery’. The current research is placed in the context of previous literature. The limitations of the study are described. The clinical and research implications are explored.