When can I be put on a Community Treatment Order (CTO)?
A Community Treatment Order can be made after you have been detained under certain sections, if the mental health professionals believe that you have a mental disorder which makes it appropriate for you to receive medical treatment (usually medication) for your health or your safety or the protection of other persons but that treatment can be provided without you being detained in hospital. A CTO is only necessary if your Responsible Clinician considers that it may be necessary to exercise the power to recall you to hospital if you do not receive such treatment.
How does a CTO restrict me?
Under the CTO you are allowed to live in the community on the understanding that you will stick to a number of conditions. The conditions must be that you will make yourself available for medical examination when needed for consideration of extension of the CTO and, if necessary, to allow a Second Opinion doctor to confirm that you should be given medication. Other conditions may be, for example, receiving medical treatment and living at a particular address. You cannot be forced to stick to the conditions, but if you do not, you face being brought back to hospital and being detained under exactly the same section you were on before the CTO.
You can only be brought back to hospital if your doctor to believe that you require medical treatment in hospital for your mental disorder and there would be a risk of harm to your health or safety or to anyone else, if you remained in the community. If you are brought back to hospital your doctor has up to 72 hours to decide whether to end the CTO so that you go back onto the section you were on before the CTO, or to discharge you back into the community on the CTO. During these 72 hours you can be treated without your consent.
The CTO lasts for up to 6 months initially. If health professionals think that you need to be subject to it for longer than the initial 6 months, it can be renewed for a further 6 months and then for periods of one year at a time.
How do I come off my CTO?
Your doctor can discharge you at any time if you no longer need the CTO.
Your nearest relative can request your discharge. Once your nearest relative makes such a request your doctor has 72 hours in which to agree or disagree. Your nearest relative can only ask for your discharge once during a 6 month period.
The Hospital Managers may conduct a review of your case by reading reports usually prepared by your doctor, social worker and nurse and asking them questions. The Hospital Managers may also speak to you to find out what your wishes are. They have the power, if they believe it is the right thing to do, to discharge your CTO straight away.
A Tribunal can discharge you. The Tribunal is an independent panel of 3 people, a lawyer, psychiatrist and a layperson. Reports will be provided by your doctor and nurses. The Tribunal can:
- discharge you (immediately or delayed for a period of time);
- adjourn for further information;
- make binding recommendations
If the 6 months run out and the CTO is not renewed, the CTO expires and you will be discharged.
What about services after my CTO ends?
After you are discharged you are entitled to free aftercare services for as long as you need them. If you do not receive them then we can help you to obtain the services you need.