The Efficacy of Involuntary Treatment in the Community

SUMMARY

Since the passing of the Mental Health Act (1986), Victoria, Australia, has implemented Community Treatment Orders (CTOs) as an alternative to involuntary inpatient admission for patients who are assessed as unable to be treated less restrictively but in an effort to avoid frequent hospital admissions. It is estimated that currently 3,000 people are annually placed on CTOs in this Australian state. The following article will review existing international and national literature on the subject of forms of involuntary treatment in the community before reporting on the findings of a research project that focused on gaining both consumer and service provider perspectives on the efficacy of CTOs. The research method was largely qualitative, involving three focus groups attended by 30 consumers, as well as 18 individual interviews with service providers. The aim of the project was to offer a voice to both consumers and service providers about their experiences and views of current practice and policy implementation in an area that can have a profound effect on the rights of consumers. Findings suggest that CTOs involve complex decision-making that tests professionals' ability to make judgements about legal and clinical processes. Consumers were generally dissatisfied with many aspects of the use of CTOs and both groups tended to view CTOs as stigmatising and disempowering. There were a variety of views expressed about the process of admission, discharge, and community supports. The article concludes by discussing the findings in the context of existing national and international literature and makes a number of recommendations about law reform, and service provision.

Key Words:

• Involuntary treatment
• outpatient commitment
• consumer perspectives
• mental health law
• community treatment orders (CTOs)