Community treatment orders: exploring the paradox of personalisation under compulsion

Laura Banks, Julia Stroud, Karolina Doughty

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The introduction of supervised community treatment, delivered through community treatment orders (CTOs) in England and Wales, contrasts with the policy of personalisation, which aims to provide service users autonomy and choice over services. This article draws upon findings from a primarily qualitative study which included 72 semi-structured interviews (conducted between January and December 2012) with practitioners, service users and nearest relatives situated within a particular NHS Trust. The article also refers to a follow-on study in which 30 Approved Mental Health Practitioners were interviewed. The studies aimed to develop a better understanding of how compulsory powers are being used in the community, within a policy context that emphasises personalisation and person-centred care in service delivery. Findings from the interview data (which were analysed thematically) suggest that service users were often inadequately informed about the CTO and their legal rights. Furthermore, they tended to be offered little, or no, opportunity to make choices and have involvement in the making of the CTO and setting of conditions. Retrospectively, however, restrictions were often felt beneficial to recovery, and service users reported greater involvement in decisions at review stage. Areas of good practice are identified through which person-centred care can be better incorporated into the making of CTOs.
Original languageEnglish
Pages (from-to)e181-e190
JournalHealth and Social Care in the Community
Volume24
Issue number6
DOIs
Publication statusPublished - 19 Aug 2015

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compulsion
personalization
community
human being
interview
best practice
autonomy
mental health

Bibliographical note

© 2015 John Wiley & Sons Ltd

Keywords

  • coercion
  • ethics
  • mental health
  • person-centred care
  • supervised community treatment
  • user involvement

Cite this

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title = "Community treatment orders: exploring the paradox of personalisation under compulsion",
abstract = "The introduction of supervised community treatment, delivered through community treatment orders (CTOs) in England and Wales, contrasts with the policy of personalisation, which aims to provide service users autonomy and choice over services. This article draws upon findings from a primarily qualitative study which included 72 semi-structured interviews (conducted between January and December 2012) with practitioners, service users and nearest relatives situated within a particular NHS Trust. The article also refers to a follow-on study in which 30 Approved Mental Health Practitioners were interviewed. The studies aimed to develop a better understanding of how compulsory powers are being used in the community, within a policy context that emphasises personalisation and person-centred care in service delivery. Findings from the interview data (which were analysed thematically) suggest that service users were often inadequately informed about the CTO and their legal rights. Furthermore, they tended to be offered little, or no, opportunity to make choices and have involvement in the making of the CTO and setting of conditions. Retrospectively, however, restrictions were often felt beneficial to recovery, and service users reported greater involvement in decisions at review stage. Areas of good practice are identified through which person-centred care can be better incorporated into the making of CTOs.",
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Community treatment orders: exploring the paradox of personalisation under compulsion. / Banks, Laura; Stroud, Julia; Doughty, Karolina.

In: Health and Social Care in the Community, Vol. 24, No. 6, 19.08.2015, p. e181-e190.

Research output: Contribution to journalArticleResearchpeer-review

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