Community Treatment in Mental Health

Community treatment order is a legal notice or order that is made by a Mental Health Review Tribunal or magistrate. It set the rules and regulations for the patients when they can take or accept medication, counselling, therapy, management, rehabilitation and other services when they are still living in the community.

Running Head: COMMUNITY TREATMENT IN MENTAL HEALTH
COMMUNITY TREATMENT IN MENTAL HEALTH
Name of the Student
Name of the University
Author Note

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Introduction
Community treatment order is a legal notice or order that is made by a Mental Health
Review Tribunal or magistrate. It set the rules and regulations for the patients when they can
take or accept medication, counselling, therapy, management, rehabilitation and other
services when they are still living in the community (Justice Action, 2019). It is developed by
the mental health facility that designs personalized care plan for every individual suffering
from mental disorder. If any person does not comply with the rules then the patient is taken to
a mental health facility so that the patient can receive proper treatment and care (Kiseley,
Campbell & O’Reilley, 2017) CTOs can be made for a period of twelve months. It is possible
for a person to have more than one CTO. CTO is generally made by the magistrate when a
person is detained or is a patient of mental health facility and even for a person who is not in
any mental health facility.
Discussion
When the magistrate or the legislation decides a CTO for any person it keeps in mind
that the patient receives maximum safety and effective care. It makes sure that the mental
health facility has an appropriate treatment plan for the patient and if previously the patient
was suffering from any mental disorder then there has to be a history for the refusal of the
treatment (Mhrt.nsw.gov.au, 2019). Now-a-days the patients with mental illness are forced to
received care and primary treatment in the community poses a great deal of challenge for the
clinicians, patients and the family members as well. The idea of the people having a stronger
say about their health, care and treatment is increased due to excessive involvement of the
customers to the better healthcare services and that is linked to better economic and clinical
outcomes. Case management is the established management procedure with mental patients.
It aims to integrate care and support to a number of services as the individuals have special

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needs. The most integral part of case management is the buildup of therapeutic relationship of
the patients with that of the caregivers (Dawson et al., 2016).
The challenges that exist in the community treatment are the barriers that prevent the
involvement of the patients with facilitators and caregivers who are involved in the making
the care plan for the respective patients. The doctors associated with mental health further
face a challenge of forced care sits with the framework for the care service. Thus, the mental
health physicians face a number of challenges on executing CTO orders for the patients.
Compulsory care management process also challenges the concept of personal care planning.
The core components of care management should be consumer suitability, assessment and
care planning, consumer goals, CTO goals as well as the coordination of care. The
effectiveness of the care management will be influenced by a number of factors such as
quality of relationship between the consumers and staff members. The implementation of
CTO is affected by the legislation, delivery model of the service that is supposed to be
provided to the patient and resource availability. CTO has received a lot of criticism from the
consumers and workers as well. It is seen that implementing CTO in case of mental patients
reduces the vulnerability of the patient along with the improvement of psychosocial functions
of the client however, it poses a great threat to the autonomy of the individual (Burns et al.,
2013).
When a person is asked to follow the treatment according to CTO, it leads to labelling
of the patient with mental inability. The situation is even affected badly when there is
continuous surveillance by the CTO that can worsen the stress and anxiety level of the
patients. Mental health is also linked to AOD treatment. These patients need special care and
treatment as they suffer from dual disorders like alcohol abuse as well mental problems. The
treatment of these patients with dual disorders involve mental health treatment as well as
AOD (Medicalxpress.com, 2019). The treatment plan for such patients must be least

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restrictive and should be most clinically appropriate. The workers must be seen from a
holistic view and bi-psychosocial perspective (Dual diagnosis, 2019). AOD treatment linked
with mental health treatment must include peer support that is a valuable assets in the
recovery process. The staff should be culturally competent so that it can handle the diverse
group of patients. To develop effective treatment plan for AOD and mental health will
involve multidisciplinary teams and approaches. This kind of treatment also requires gender-
specific approaches that should be provided by the workers.
There is always a conflicting theory behind the success rate of CTO in mental health
treatment. As the patient community involves a lot of cultural and ethical diversities thus, the
CTOs must incorporate workers who have a multi-diversity approach. CTO should also
involve a multilevel model that will allow the physicians to estimate variation and calculate
the outcome of a particular person. The effectiveness of CTO can also be increased by the
participation of the workers, consumer and carers in a huge number. The use of peer support
can also be aimed to accelerate the use of medicines (Weich et al., 2018).
Conclusion
Thus it is concluded that CTOs is a community treatment service that is supervised by
the laws and legislation. This kind of treatment might hamper the autonomy of the patient as
well as generate a feeling of stress among them. Again there are certain patients in which the
treatment is linked with AOD where the clinicians face certain challenges that need to be
addressed for the better implementation of the CTO.

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References
Burns, T., Rugkåsa, J., Molodynski, A., Dawson, J., Yeeles, K., Vazquez-Montes, M., ... &
Priebe, S. (2013). Community treatment orders for patients with psychosis (OCTET):
a randomised controlled trial. The Lancet, 381(9878), 1627-1633.
Dawson, S., Lawn, S., Simpson, A., & Muir-Cochrane, E. (2016). Care planning for
consumers on community treatment orders: an integrative literature review. BMC
psychiatry, 16(1), 394. doi:10.1186/s12888-016-1107-z
Dual Diagnosis. (2019). Chapter 4 -- Linkages For Mental Health and AOD Treatment.
Retrieved from https://www.dualdiagnosis.org/resource/patient-assessments/aod-
treatment/
Justice Action. (2019). Community Treatment Orders. Retrieved from
https://www.justiceaction.org.au/mental-health/mental-illness-issues/community-
treatment-orders
Kisely, S. R., Campbell, L. A., & O'Reilly, R. (2017). Compulsory community and
involuntary outpatient treatment for people with severe mental disorders. Cochrane
database of systematic reviews, (3).
Medicalxpress.com. (2019). Alcohol and other drug (AOD) treatment is more effective when
the family is involved. Retrieved from https://medicalxpress.com/news/2016-06-
alcohol-drug-aod-treatment-effective.html
Mhrt.nsw.gov.au. (2019). Mental Health Review Tribunal - Community Treatment Orders.
Retrieved from https://www.mhrt.nsw.gov.au/civil-patients/community-treatment-
orders.html

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Weich, S., Duncan, C., Bhui, K., Canaway, A., Crepaz-Keay, D., Keown, P., ... & Singh, S.
(2018). Evaluating the effects of community treatment orders (CTOs) in England
using the Mental Health Services Dataset (MHSDS): protocol for a national,
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