Reappraising community treatment orders — can there be consensus?

Kisely, Steve; O’Reilly, Richard

doi:10.5694/mja14.00663

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…'Before and after' studies have suggested that CTOs lead to a higher follow-up rate and lower readmissions, while the three RCTs conducted to date have demonstrated that CTOs have no effect on readmission rates. 12 It is important to note that CTOs are not the intervention in this study but rather the reconfiguration of the community mental health services. The pre-existing high rates of CTOs within these mental health services certainly warrants further examination.…”

Section: Discussionmentioning

confidence: 97%

Rate of community treatment orders and readmission orders following reconfiguration of community mental health services

O’Donoghue

Brophy

Owens

et al. 2016

Australas Psychiatry

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Section: Discussionmentioning

confidence: 97%

Rate of community treatment orders and readmission orders following reconfiguration of community mental health services

O’Donoghue

Brophy

Owens

et al. 2016

Australas Psychiatry

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“…Kisely and O’Reilly question if the purpose of the CTO is to ‘reduce revolving-door admissions, provide a less restrictive alternative to involuntary admission, prevent violence by people with severe mental illness, or increase stability and promote recovery’ (p.415) [69]. The CTO purpose will impact upon both the focus of interventions and expected outcomes including ‘hospital use, perceived coercion, violent acts and quality of life’ (p.415) [69]. This is important given the lack of clarity regarding discharge from orders.…”

Section: Discussionmentioning

confidence: 99%

Care planning for consumers on community treatment orders: an integrative literature review

et al. 2016

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BackgroundCase management is the established model for care provision in mental health and is delivered within current care philosophies of person-centred and recovery-oriented care. The fact that people with a mental illness may be forced to receive care and treatment in the community poses challenges for clinicians aiming to engage in approaches that promote shared decision-making and self-determination. This review sought to gain an in-depth understanding of stakeholders’ perspectives and experiences of care planning for consumers’ on CTOs.MethodsAn integrative review method allowed for inclusion of a broad range of studies from diverse empirical sources. Systematic searches were conducted across six databases. Following appraisal, findings from included papers were coded into groups and presented against a framework of case management.ResultsForty-eight papers were included in the review. Empirical studies came from seven countries, with the majority reporting on qualitative methods. Many similarities were reported across studies. Positive gains from CTOs were usually associated with the nature of support received, highlighting the importance of the therapeutic relationship in care planning. Key gaps in care planning included a lack of connection between CTO, treatment and consumer goals and lack of implementation of focussed interventions.ConclusionsCurrent case management processes could be better utilised for consumers on CTOs, with exploration of how this could be achieved warranted. Workers need to be sensitive to the ‘control and care’ dynamic in the care planning relationship, with person-centred approaches requiring core and advanced practitioner and communication skills, including empathy and trust.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1107-z) contains supplementary material, which is available to authorized users.

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“…See (Elder and Tapsell 2013, p. 259). 22 In addition to a shift in focus from the ethical legal justification of CTOs to contested evidence of their (clinical) effectiveness, there is also a claimed lack of clarity (in policy and legislation) about the purposes and objectives of compulsory community care and treatment (Kisely and O'Reilly 2015). In the case of Sweden's introduction of legislation for compulsory community treatment, (Sjöström et al 2011) ask the question how did compulsory community care become the solution in mental health policy in so many different legal and social contexts over the last 20 years?…”

Section: Research On Effectiveness and Benefitmentioning

confidence: 99%

Towards Changing Compulsory Community Mental Health Treatment in New Zealand: Shining Light on How Community Treatment Orders Are Produced

Schneller

Thom

Adams

2018

Laws

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Abstract:In this paper, we use a constructed scenario to illustrate making a compulsory community treatment order in the New Zealand context. Drawing on publicly available documentation, we outline the existing mental health law framework that produces community treatment orders and emerging complex problems of their high, increasing and disproportionate use. We provide examples of human rights, indigenous and clinical effectiveness research that appear to be destabilising the existing mental health law framework. We argue assemblage theory (Deleuze & Guattari) is a useful theoretical tool to unpack the making and continued use of compulsory community treatment orders in the context of complex destabilising and stabilising influences. This is followed by an outline of the concept of assemblage with reference to the constructed scenario, focusing on processes, practices, places, types of knowledge, roles, documents and how they connect to produce certain effects that both enable and constrain participants' actions. In the New Zealand context, we examine the potential for assemblage theory to generate new ways of thinking about compulsory mental health treatment in community settings by challenging perceived limitations and revealing opportunities for participants to act otherwise. We conclude with a proposal for further research shaped by this theory that explores the making of actual community treatment orders to reveal where there is potential to change existing relations towards more positive effects for participants.

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Reappraising community treatment orders — can there be consensus?

Cited by 12 publications

References 12 publications

Rate of community treatment orders and readmission orders following reconfiguration of community mental health services

Rate of community treatment orders and readmission orders following reconfiguration of community mental health services

Care planning for consumers on community treatment orders: an integrative literature review

Towards Changing Compulsory Community Mental Health Treatment in New Zealand: Shining Light on How Community Treatment Orders Are Produced

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