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Community treatment orders – a bridge too far?

Published online by Cambridge University Press:  02 January 2018

Joanna Moncrieff  and
Marceleno Smyth
Joanna Moncrieff*
Affiliation:
Department of Psychological Medicine, Chelsea and Westminster Hospital 1 Nightingale Place, London SW10 9NG
Marceleno Smyth
Affiliation:
North Birmingham Mental Health Trust, Academic Unit, 71 Feltham Road, Birmingham B23 6AL
*
∗Gloucester House, 194 Hammersmith Road, London W6 8BS
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Compulsory treatment in the community is high on the agenda in the current review of mental health legislation and the government has already announced its intention to introduce a ‘community treatment order’ (CTO; Department of Health, 1998). Concern about the implications of community care has been gathering momentum over the last decade, spurred on by tragedies such as those involving Ben Silcock and Christopher Clunis in the early 1990s. The notion that community care has failed has taken deep root with the media and the government (Department of Health, 1998). This is despite the lack of any evidence to suggest that mental illness is less effectively treated (Johnstone et al, 1991; Anderson et al, 1993) or that violence attributable to the mentally ill is rising (Taylor & Gunn, 1999). It also indicates a tendency to ignore the fact that patients prefer to live in the community (Tyrer, 1998). Psychiatrists, who are increasingly implicated in this purported failure of care, feel besieged. In such a climate, the promise of more power is understandably attractive. However, we feel that psychiatrists should resist pressure for this sort of ‘quick fix’ and reflect upon some of the dilemmas involved.

Type
Review Articles
Information
Psychiatric Bulletin , Volume 23 , Issue 11: The Journal of Trends in Psychiatric Practice , November 1999 , pp. 644 - 646
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 Royal College of Psychiatrists

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