What do you need to know about community treatment orders?
About Community Treatment Orders. A community treatment order (CTO) is part of the Mental Health Act. A CTO allows you to leave hospital and be treated safely in the community rather than hospital. A CTO means that you have to keep to certain conditions in the community.
What is community treatment for mental health problems?
This means you can be treated in the community for your mental health problem, instead of staying in hospital. But your responsible clinician can return you to hospital and give you immediate treatment if necessary.
What is assertive community treatment?
The simple definition of assertive community treatment is an intensive, integrated approach to community mental health service delivery. What this means is that mental health services are provided in a community setting (rather than a more restrictive residential or hospital setting) to people experiencing serious mental illness.
Can a doctor send you back to hospital for community treatment?
Your responsible clinician can send you back to hospital if you don’t follow the conditions of your community treatment order (CTO). Going back to hospital is known as being ‘recalled’. Doctors won’t recall you as a punishment.
What is treatment in the community?
Treatment in the community applies to a person subject to a treatment authority, forensic order or treatment support order. Classified patients or persons subject to judicial orders may receive limited community treatment in the form of escorted on-ground leave only.
What is the purpose of community treatment orders in Canada?
Community treatment orders (CTOs) in Canada require people with mental illness to comply with a treatment plan that generally requires them to attend regular, specified appointments to receive medication, counselling, and education.
What is a community treatment order UK?
Overview. If you've been detained in hospital, you might be told you can leave by a Community Treatment Order (CTO). But a CTO gives your psychiatrist the power to recall you to hospital if necessary for your safety or the safety of others.
How do you get a CTO?
A CTO usually originates from psychiatric units in designated facilities across the province. Depending on where the person lives, they may be admitted to a psychiatric facility far away from their home community.
What is the criteria for a community treatment order?
The criteria for making an order include :a prior history of hospitalization;a community treatment plan for the person has been made;examination by a physician within the previous 72 hours before entering into the CTOs plan.ability of the person subject to the CTOs to comply with it;More items...•
How does community treatment order work?
A Community Treatment Order (CTO) is a legal order made by the Mental Health Review Tribunal or by a Magistrate. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in the community.
Who can be put on a CTO?
You can only be put on a CTO if you are in hospital under certain sections, and if certain criteria are met. A CTO lasts 6 months from the date of the order. It can be renewed by your responsible clinician. If you want to be discharged from your CTO, you can apply to the Mental Health Tribunal.
Can I refuse a CPN?
This CPN may well need some retraining and if their manager's don't know, they can't address it. But to answer your question, yes you can refuse to see them.
What is an RC in mental health?
Responsible Clinician (RC) is the Approved Clinician (AC) who has overall responsibility in terms of the Mental Health Act 1983 (as amended by the Mental Health Act 2007) for a patient's case, including those who discharged from hospital but who remain liable to be detained (e.g. those on a Community Treatment Order ( ...
How many conditions can be attached to a community treatment order?
What conditions can be attached to a CTO? Every community treatment order (CTO) will have these two conditions: If your responsible clinician asks to see you about renewing your CTO, you must make yourself available to meet them.
Can you be forced to take medication on a section 2?
Under Section 2, you can't refuse treatment. However some treatments can't be given to you without your consent unless certain criteria are met. These treatments include electro-convulsive therapy (ECT). If you are unhappy about your treatment, you should talk to your named nurse or psychiatrist.
Can a CPN section you?
Former member. Hi, CPN's don't have the power to section but they can certainly call on the right people to have you sectioned.
Where is active community treatment implemented?
ACT Locations. Assertive community treatment has been implemented in countries such as the United States, Canada, Australia, and the United Kingdom. For example, specifically in the United States, ACT was implemented across the country by the Department of Veterans Affairs.
What is assertive community treatment?
The simple definition of assertive community treatment is an intensive, integrated approach to community mental health service delivery. What this means is that mental health services are provided in a community setting (rather than a more restrictive residential or hospital setting) to people experiencing serious mental illness.
What is ACT in mental health?
Criticism of ACT. Assertive community treatment (ACT) is a form of community-based mental health care for individuals experiencing serious mental illness that interferes with their ability to live in the community, attend appointments with professionals in clinics and hospitals, and manage mental health symptoms.
What is Act treatment?
ACT is designed to provide treatment that is not restrictive and accessible. The Assertive Community Treatment Association (ACTA) has developed a number of key principles that guide this form of treatment. These include:
What is a primary service provider?
Acting as a primary service provider for a range of treatment services. Offering individualized treatments designed to meet each person's needs and help them reach their goals. Helping clients become better integrated into their communities and gain access to needed services.
What is a treatment plan centered around?
Your treatment plan will be centered around your own personal strengths, needs, and desires for the future
Is Act effective for mental health?
Know that your team will be available to answer questions and offer support to you long-term in the community at locations that serve you best. As a person living with serious mental illness, ACT is an effective long-term support that should serve you well.
What is the name of the family member who will have certain rights relating to your care and treatment?
A family member, called your nearest relative, will have certain rights relating to your care and treatment, like finding out information about you and discharging you.
Who can take decisions on a CTO?
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
What is an IMHA advocate?
An IMHA is an advocate specially trained to help you find out your rights under the Mental Health Act 1983 and help you while you are detained. They can listen to what you want and speak for you.
What is a CTO in hospital?
If you have been detained in hospital, you may be discharged on to a community treatment order (CTO).
How long does a CTO last?
A CTO lasts 6 months from the date of the order, and can be renewed by your responsible clinician. If you want to be discharged from your CTO, you can apply to the Mental Health Tribunal. While you are on a CTO, you have the right to get support from someone called an independent mental health advocate (IMHA).
What conditions are added to a CTO?
Conditions are added to the CTO which you have to follow, like having to live in a certain place or going to appointments for treatment. You can only be put on a CTO if you are under certain sections , and if certain criteria are met.
Can you be detained under the Mental Health Act?
detained in hospital under a section of the Mental Health Act, but not if you are under sections 4, 5, 135 and 136. under Mental Health Act guardianship, conditional discharge and community treatment orders (CTOs) discussing having certain treatments, such as electroconvulsive therapy (ECT).
What is VA Community Care?
VA’s Community Care Contact Center can assist Veterans with resolving adverse credit reporting or debt collection actions resulting from authorized VA community care claims. Specially trained call center staff work one-on-one with Veterans to research and resolve collection-specific issues.
How many criteria are there for a veteran to receive community care?
There are six criteria that can qualify a Veteran to receive community care. Veterans only need to meet one of these to be eligible.
What to do when a veteran arrives for an appointment?
Getting Care. When a Veteran arrives for the appointment, the community provider should have the appointment, VA referral, and medical documentation on file. If a Veteran needs a follow-up appointment, the community provider should check to make sure VA has authorized additional care before scheduling the appointment.
Where does a veteran receive care?
Veteran receives care from a community provider in the VA's network.
Do you have to get approval from the VA before receiving care?
In most cases, Veterans must receive approval from VA before receiving care from a community provider to avoid being billed for the care. VA staff members generally make all eligibility determinations for community care. YouTube. Veterans Health Administration.
Can a veteran be a community provider?
Please note the following about eligibility for community care: Veterans must receive approval from VA prior to obtaining care from a community provider, in most circumstances. Veterans must either be enrolled in VA health care or be eligible for VA care without needing to enroll to be eligible for community care.
Can a veteran live in Guam?
For instance, if you are a Veteran living in Guam, you would be eligible for community care because you reside in a state or territory without a full-service VA medical facility.
Who leads group therapy sessions?
Group therapy sessions are led by a counselor or psychologist. The psychologist leads the discussion and encourages all of the group members to participate. When Shelby attends a group therapy session, she discovers that she's not the only one who suffers from anxiety.
What is sociocultural therapy?
Sociocultural treatments consider an individual's family and cultural background when determining the most appropriate treatments for psychological disorders. Learn about sociocultural treatments, including the types of therapy used in these treatments. Explore community treatment, group therapy, and family therapy. Updated: 09/18/2021
What does Shelby learn from therapy?
She is able to talk about her fears and frustrations with her generalized anxiety disorder, and she is able to hear other patients' perspectives , too. She can get ideas for how to deal with her anxiety and find support from the other group members.
What is psychological treatment?
Traditionally, treatment for psychological disorders involved being committed to a psychiatric facility, like an asylum. In this case, the treatment focused completely on the individual. Since many of the patients would never leave the asylum, there was no need to worry about society's impact on the patients, or the patients' ability to live in society at large.
Why is group therapy important?
Since many psychological disorders are triggered or affected by society and culture, group therapy is a good way for people to talk about and find ways to deal with the aspects of society that contribute to their disorders. Family Therapy.
Can Shelby's family come to therapy?
She might still go to individual and group therapy, but as her psychologist, you might also recommend that her family come to therapy together. Family therapy is the process of treating a family unit, not just an individual. As Shelby's psychologist, you might ask that her family come to therapy with her.
Is family therapy a good idea?
The basic assumption behind family therapy is that the problem is a result of the dynamics of the family. While this may often be true, it might not always be true. Still, even for disorders that are not wholly a result of family behaviors, family therapy is a great way to support a patient. Lesson Summary.
What is community treatment plan?
The plan creates conditions which are listed in what is called a Community Treatment Plan, and can include such things as required medication, medical appointments, and staying away from drugs and alcohol. It may even specify the area they can live in; in general, any requirements that the doctor believes are necessary to allow the patient to live in the community may be part of the plan. It is a form of compulsory treatment, because if the patient does not comply and is said to be unfit to live in the community by the doctor, they must remain (or possibly be) institutionalized.
Why are community treatment orders controversial?
Community Treatment Orders are controversial: on one hand there are those who support CTOs on the grounds that it offers a less restrictive alternative to hospitals; on the other hand there are those who say that it is “coerced” treatment and it violates the patients’ rights. Indeed, those who support CTO’s argue that in many cases the patients do not have insight into their condition (they do not think they have a mental illness) and society has an obligation to “care for citizens who cannot care for themselves” (see the article by Dr. O’Reilly, linked below). Another major argument for Compulsory Treatment Orders is that it reduces the number of patients who become victims of harm or abuse, but studies of aggressive incidents and hospitalization rates have given inconclusive results. It is not clear whether or not CTO is effective in meeting this goal.
Why are CTOs used?
There is also a concern that CTOs may be used to compensate for under-resourced facilities for individuals with mental health challenges, and a general lack of funding for mental health services. In addition, CTOs have been criticized on ethical grounds; some opponents of CTOs question the impact on fundamental human rights for the patients when doctors are given the power to define what someone can or cannot do in their life. It also raises the question of whether “recovery” can have real value if treatment is done against the patients will as it also may damage the necessary ongoing relationship between the patient and their treatment team. Another problem with consent is that CTOs are based upon considerations of risk and harm instead of the patient’s capacity to consent. It is argued that if patients are not actually a risk to others but rather are a risk to themselves, CTOs may be considered discriminatory; after all, there are lots of people who take risks that are potentially dangerous, such as smoking.
What is a CTO in Canada?
Brian’s law includes something called a Community Treatment Order (CTO). A CTO is a legal order made by a physician or psychiatrist. It outlines the conditions that a patient leaving a psychiatric ward has to meet in order to live in a community setting. A CTO allows a psychiatrist to call police to bring patients in for an assessment if they fail to comply with the treatment plan that goes with the Order. In Canada, all jurisdictions except New Brunswick and the Territories use CTOs or comparable legislation.
What happens if a patient is not a patient in a psychiatric facility?
If patient is not currently a patient in a psychiatric facility, they clearly meet the conditions for a psychiatric assessment.
What is a CCLA?
The CCLA is an independent, non-profit organization with supporters from across the country. Founded in 1964, the CCLA is a national human rights organization committed to defending the rights, dignity, safety, and freedoms of all people in Canada.
Why do people use CTOs?
Professionals like CTOs because they make life easier in overstretched services. Since administration of medication can simply be legally enforced, staff don’t have to spend as much time forging an alliance with patients. If patients relapse, the mechanism to bring them back into hospital is quicker and easier than if they were not on a CTO (and of course therefore there are fewer safeguards against wrongful admission). Moreover, CTOs now seem to be used sometimes as a means to discharge people from hospital before they have fully recovered from the acute episode that led to admission. Underpinning all these practical reasons, however, is a difficulty in recognising that sometimes our interventions might not be as useful as we think.
What are the effects of CTOs?
We should not forget that the treatment people are forced to take by CTOs consists of toxic drugs (antipsychotics) that are known to cause brain damage (tardive dyskinesia) and brain shrinkage with long-term use, as well as weight gain, diabetes, heart disease and sexual dysfunction among other unpleasant effects .
Why are controlled trials important?
That is why randomised controlled trials can be so important in establishing whether an intervention really does what it is thought to do or not.
Do CTOs keep people out of hospital?
The fact that CTOs are still being applied after the OCTET study found that they do not keep people out of hospital, or improve people’s mental health, demonstrates how deeply embedded and influential is the idea that people who are psychiatric patients are ‘sick,’ and need to have whatever treatment the doctor orders.
Do CTOs have any benefits?
Despite Professor Burn’s previous commitment to CTOs, the study report concluded that there is no evidence that CTOs have any benefits and that they do not ‘justify the significant curtailment of patients personal liberty’ (Burns et al, 2013, p 1627). In presentations around the country, Professor Burns has not shrunk from acknowledging that his previous ideas about the benefits of CTOs were wrong.
Definition of Act
History
- How did assertive community treatment get its start? Go back to the 1970s and a picture will quickly emerge of a shift away from the institutionalization of patients with severe mental illness. At the same time, community services were poorly set up to help these people who were no longer living in institutional settings. The founders of ACT were Leonard I. Stein, Mary Ann Test, …
Who Assertive Community Treatment Serves
- If you or a family member has been assigned ACT services, you might wonder why you were chosen to receive this type of service. Below is a list of the most common reasons a person will be offered assertive community treatment services: 1. Persons with severe symptoms of mental illness 2. People with significant thought disorders such as schizophren...
Act Locations
- Assertive community treatment has been implemented in countries such as the United States, Canada, Australia, and the United Kingdom. For example, specifically in the United States, ACT was implemented across the country by the Department of Veterans Affairs. Services are not provided in a clinic, but rather in the patient's home, in community locations (such as a coffee sh…
Characteristics
- If you are about to enter assertive community treatment, you are probably unsure of what to expect. Most ACT programs have similar structures, so the following may give you some guidance on what the program will offer. 1. Your treatment plan will be centered around your own personal strengths, needs, and desires for the future 2. ACT is offered long-term but not unlimite…
Services Provided by Act
- What are the specific services that you can expect to receive from the ACT team? The following is a list of some of the primary services that assertive community treatment offers:1 1. Initial and ongoing assessments 2. Psychiatric services such as coping with psychotic episodes or crises 3. Substance abuse services 4. Help with employment and housing 5. Education for family membe…
The Benefits
- Overall, research evidence on assertive community treatment has been positive with some caveats. A 2016 evidence review showed that ACT reduced self-reported psychiatric symptoms, hospital stays, and emergency department visits among people with mental illness and substance abuse.2 In general, from the dozens of randomized controlled trials that have been conducted, i…
Criticism of Act
- Overall, there have been some criticisms of the ACT program. One is that ACT is simply a system of coercion in which hospitals deny admission to patients based on their enrollment in the ACT program. At the same time, isn't staying in the community the goal of all mental health initiatives? In this way, it seems that regardless of whether the tactics are coercive, if patients can be treate…