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An exploration of service user and practitioner experiences of community treatment orders
- Authors:
- STROUD Julia, DOUGHTY Karolina, BANKS Laura
- Publisher:
- University of Brighton
- Publication year:
- 2014
- Pagination:
- 97
- Place of publication:
- Brighton
This research study investigates service user and practitioner experiences of community treatment orders (CTOs) within a climate of personalisation of services that aims to provide service users with increased autonomy and choice over their care. A CTO is the legislative power by which patients with mental health difficulties who are treated involuntarily in hospital can be discharged into the community but still remain subject to compulsory treatment. The CTO thus extends the setting for involuntary treatment from being exclusively confined to the hospital ward to the community. A case study method was used in relation to CTOs in the trust area and included quantitative analysis of trust data and semi-structured qualitative interviews with 72 participants including service users, nearest relatives, care coordinators, responsible clinicians, approved mental health professionals and service (accommodation) providers. The study findings suggest CTOs can be effective for the ‘right’ service user with certain needs and perceptions: for example, to work within clear boundaries. CTOs were perceived as more successful in teams where they were carefully planned over time as an appropriate intervention, rather than where they were made almost as a matter of course. The study indicates a number of specific ways in which CTOs could be better aligned with ethical practice and person-centred care. These include: full involvement of service users in all stages of the process; approved mental health professionals involvement as early as possible in any team discussions about the potential making of a CTO; avoiding decision-making around the making of the CTO taking place during a ward round since this can be a disempowering environment for the service user; nearest relatives to be involved where appropriate; and better information and training on CTOs to be provided to service users and providers. (Edited publisher abstract)