International Perspectives on the Use of Community Treatment Orders: Implications for Mental Health Social Workers

• Published in: The British journal of social work 2006-10, Vol.36 (7), p.1101-1118
• Main Authors: Campbell, Jim, Brophy, Lisa, Healy, Bill, O’Brien, Ann Marie
• Format: Article
• Language: English
• Subjects: Codes of Conduct; Communities; Community health care; Community Mental Health; Community mental health services; Community Treatment Orders (CTOs); Crosscultural Differences; Ethical codes; Ethics; Health care policy; Hospital admissions; Jurisdiction; Medical case management; Medical practice; Mental health; Mental health care; Mental health law; mental health social workers; Occupational Roles; Policy making; Professional Ethics; Psychiatric hospitals; Psychiatric social workers; Social work; Social Workers; Work roles
• ISSN: 0045-3102; 1468-263X
• DOI: 10.1093/bjsw/bch423

Substantial changes to mental health law and policy have occurred throughout the Western world during the last decade. The drift towards control, particularly in the form of Community Treatment Orders (CTOs), has profound implications for the role of mental health social workers, yet this issue is rarely discussed in academic literature. This paper seeks to redress this gap in knowledge by examining aspects of law, policy and practice using three case studies: Victoria, Australia; Ontario, Canada; and regions of the UK. The paper begins by critically reviewing selected literature on CTOs, revealing competing claims about efficacy and their impact upon service users1 and practitioners. A discussion of policy and practice contexts in the three jurisdictions is then presented and supported with a typology, to illustrate contrasts and comparisons. In their conclusions, the authors assert that mental health social workers often have a crucial part to play in the implementation of CTOs but that this is not always acknowledged in law and organizational policy. Social workers’ roles and responsibilities need to be more explicitly identified in mental health law. At the same time, there should be a continuing debate about how such coercive powers fit with codes of ethics and practice standards, at national and international levels.