Revocation of Community Treatment Orders in a mental health service network

Owens, Nicholas; Brophy, Lisa

doi:10.1177/1039856212470504

Cited by 10 publications

(13 citation statements)

References 7 publications

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“…Some studies with partial relevance consider supporters' views on restrictive practices from the Australian disability sector 16 and in relation to the use and revocation of community treatment orders. 17,18 As part of a larger study conducted by the Melbourne Social Equity Institute, The University of Melbourne, and funded by the National Mental Health Commission, five focus groups for consumers and five focus groups for supporters were conducted in four capital cities and one regional centre. This article analyses the perspectives of focus group participants related to barriers to reducing seclusion and restraint and the strategies for reducing these practices.…”

Section: Introductionmentioning

confidence: 99%

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Brophy

Roper²,

Hamilton

et al. 2016

Aust. Health Review

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Objective. This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.Methods. Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.Results. All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes.Conclusions. Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices.What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature.

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Section: Introductionmentioning

confidence: 99%

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Brophy

Roper²,

Hamilton

et al. 2016

Aust. Health Review

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show abstract

“…Of those that did, findings indicated consumers on CTOs had little knowledge about their care plan and what was in it with care plans often out of date and focussed on medication [25, 40, 41]. As the care plan is the means for recording the collaborative care planning process, Owens and Brophy [40] suggested that out dated care plans indicated that such conversations between clinicians and consumers may not be occurring regularly.…”

Section: Core Components Of Case Managementmentioning

confidence: 99%

“…Case managers can have a significant impact on consumers, who can experience the support as either positive or negative with the potential to ‘either assist or obstruct recovery’ [45, 55]. Owens and Brophy [40] for example, found workers were not making sufficient efforts to manage the risk of recall to hospital or the distress experienced by consumers subsequent to this. Establishing good therapeutic relationships and family involvement are necessary to good care coordination [24].…”

Section: Core Components Of Case Managementmentioning

confidence: 99%

“…Given the high level of needs typical to consumers on CTOs, it was surprising that there was little evidence of use of specialised interventions [24]. Though consumers on CTOs were often unemployed and living in difficult conditions, only a minority were receiving assertive care or input from psychosocial supports [40]. Brophy et al [24] stressed the need for workers to provide psychological, social and occupational interventions and avoid over-focussing on medication.…”

Section: Core Components Of Case Managementmentioning

confidence: 99%

“…Conversely, some consumers reported that the negative impact of being on a CTO would mean that they would avoid seeking help in the future [55]. In other papers, the small numbers of consumers receiving assertive and intensive psychosocial support as well as limited resources in rural areas was highlighted, indicating CTOs do not always enhance access to needed services and supports [7, 40]. It was often unclear in the studies if this was a consequence of lack of infra-structure and resources or poor referral and linking.…”

Section: Core Components Of Case Managementmentioning

confidence: 99%

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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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A systematic review of the views and experiences of subjects of community treatment orders

Corring

O’Reilly

Sommerdyk

2017

International Journal of Law and Psychiatry

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Revocation of Community Treatment Orders in a mental health service network

Abstract: The study identified opportunities for improving policy and practice, particularly in relation to reducing the amount of coercion experienced by people on CTOs and improving flexibility of service delivery.

Cited by 10 publications

References 7 publications

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

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

A systematic review of the views and experiences of subjects of community treatment orders

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