Spinning the revolving door: The governance of non-compliant psychiatric subjects on community treatment orders

Abstract

This article examines the enactment of community treatment orders (CTOs) in Alberta, Canada to illustrate how civil law is used to constitute and govern psychiatric patients in the community. I argue that the logic of CTOs constitutes the psychiatric patient as a fractured subject who is simultaneously capable/incapable of making medical decisions and at risk/risky. These paradoxical characterizations highlight how depictions of rationality and choice are contingent on consenting to a pharmacological regime designed to normalize these patients. This construction functions to eliminate opportunities for rationally informed types of non-compliance and promotes hospitalization as the only way to manage harmful, risky and non-conforming individuals. I contend that CTOs are a flawed instrument of regulation that cannot manage ‘legally’ capable but non-compliant individuals.