Exploratory study of the use of community treatment orders with clients of an Ontario ACT team

ABSTRACT

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining CTOs and ACT resulted in regular access to mental health supports, fewer hospitalizations and overall improvement of quality of life for their clients.

KEYWORDS:

• Mental health
• psychosocial intervention
• Social support
• Social Work

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ Two clients were not capable of providing consent.

² We are using “his/her” and “s/he” in this document to protect the identity of client participants.

³ This refers to the form that the physician completes when a client has failed to follow his or her obligations under the CTO; it authorizes the police to bring the client to the physician for an examination as to whether or not the client needs to be placed on a Form 1 (involuntary committal to hospital). If the psychiatrist does not deem that the client meets the criteria for a Form 1, the client will be offered ACTT services including medication support as well as other services if needed at the time of the assessment.

Additional information

Funding

This work was supported by the Mitacs [IT04831] and Homewood Health Center’s Research Institute [000000]. The authors would like to thank Mitacs and the Homewood Health Centre’s Research Institute.