Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T17:07:30.916Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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

References

Anderson, J., Dayson, D., Wills, W., et al (1993) The TAPS Project. 13: Clinical and social outcomes of long-stay psychiatric patients after one year in the community. British Journal of Psychiatry, 162 (suppl. 19), 45 56.CrossRefGoogle Scholar
Byrne, P. (1999) Stigma of mental illness. Changing minds, changing behaviour. British Journal of Psychiatry, 174, 1 2.CrossRefGoogle ScholarPubMed
Cohen, D. (1994) Neuroleptic drug treatment of schizophrenia: The state of the confusion. Journal of Mind and Behaviour, 15, 139 156.Google Scholar
Crow, T. J., MacMillan, J. F., Johnson, A. L., et al (1986) The Northwick Park Study of First Episodes of schizophrenia: II. A randomised controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry, 148, 120 127.Google Scholar
Department of Health (1998) Modernising Mental Health Services. London: Department of Health.Google Scholar
Johnstone, E. C., Owens, D. G. C. & Leaky, J. (1991) Disabilities and circumstances of schizophrenic patients – A follow-up study. VI. Comparison of the 1975–85 cohort with the 1970–75 cohort. British Journal of Psychiatry, 159 (suppl. 13), 34 46.CrossRefGoogle Scholar
Kane, J. M., Honigfeld, G., Singer, J., et al (1988) Clozapine in treatment-resistant schizophrenics. Psychopharmacological Bulletin, 24, 62 67.Google Scholar
Mind (1998) Arguments Against Community Treatment Orders. A Note from Mind's Legal and Policy Development Unit. London: Mind.Google Scholar
Moncrieff, J. (1997) Lithium: evidence reconsidered. British Journal of Psychiatry, 171, 113 119.CrossRefGoogle ScholarPubMed
Rogers, A., Pilgrim, D. & Lacey, R. (1993) Experiencing Psychiatry-Users' Views of Services. London: Macmillan Press and Mind.Google Scholar
Sensky, T., Hughes, T. & Hirsch, S. (1991) Compulsory psychiatric treatment in the community. I. A controlled study of compulsory community treatment with extended leave under the Mental Health Act: special characteristics of patients treated and impact of treatment. British Journal of Psychiatry, 158, 792 798.Google Scholar
Taylor, P. J. & Gunn, J. (1999) Homicides by people with mental illness: myth and reality. British Journal of Psychiatry, 174, 9 14.CrossRefGoogle Scholar
Tyrer, P. (1998) Whither community care? British Journal of Psychiatry, 173, 359 360.Google Scholar
Wallace, C., Mullen, P., Burgess, P., et al (1998) Serious criminal offending and mental disorder. Case linkage study. British Journal of Psychiatry, 172, 477 484.CrossRefGoogle ScholarPubMed
Wessely, S., Castle, D., Douglas, A. J. (1994) The criminal careers of incident cases of schizophrenia. Psychological Medicine, 24, 483 502.Google Scholar
Wykes, T., Leese, M., Taylor, R., et al (1998) Effects of community services on disability and symptoms. PRISM Psychosis Study 4. British Journal of Psychiatry, 173, 385 390.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.