So the ConDems announced that there will be “investment” in mental health. At the same time they will monitor the “significant number” of CTOs (Compulsory Treatment Orders). In 2009 – 10 more than 4,000 people were subjected to a psychiatric asbo. This is ten times the numbers predicted by the DoH when orders were first introduced in 2008. This means in reality that people can be recalled to hospital if they refuse to take their meds while in the community. Dr Tony Zigmond ((Royal College of Psychiatrists) rightly says, “…patients who had the capacity to choose whether to follow a doctor’s recommendations should have the right to decline”.. He also said that the previous NL government made the criteria too broad. He further says, “foolish, stupid strategy. You can’t escape from the criteria. A CTO is like a lobster pot. It is easy to get into and very hard to get out”..
The implications are that psychiatrists are over-zealous in applying a CTO under the belief that it will be better to be safe than sorry and err on the side of caution. It is sugar coating CTOs to make them more palatable to swallow and they are nothing more than psychiatric ASBOs.
CTOs are a way, apparently, of reducing psychiatric admissions yet studies shown in Australia, that CTO placement, aboriginal ethnicity, younger age, personality disorder and previous health service use were all associated with increased admission rates. The authors conclusion stated that we “should question the rationale for CTOs and advocate more effective treatments” (British Journal of Psychiatry, 2004).
Furthermore, The Institute Of Psychiatry’s International Experiences of Community Treatment Orders) (March 2007) noted as well that ethnicity data from Israel, USA, New Zealand and Australia,“indicate that relative to the proportion of the general population comprised by their ethnic group, most ethnic groups might be over-represented amongst CTO recipients.” None of the nine experimental studies found evidence suggesting that CTOs reduce either hospital readmission or length of stay, or that they improve compliance.
A report published by the Care Quality Commission late last year stated:
Of a sample of 208 CTOs, the CQC found that 30% of patients had no reported history of refusing to comply with treatment, suggesting that CTOs were wrongly being issued as a preventive measure.
“We have found too much poor and unacceptable practice and this must be tackled,” said CQC chief executive Cynthia Bower. ”Our top priority is to protect the interests of patients, and we will use our powers to ensure that care providers address these issues and make real improvements.”
Psychiatric ASBOs were always a retrograde step brought in by a social authoritarian government (thank-you NL!). Instead of support service users are policed. If a person can live in the community then they should be trusted in whether they take their medication. It is about choice. And surely the service user is the best person to know whether medication works or doesn’t work? And if the service user is experiencing dire side-effects are they expected to keep taking it?
Mental health service users already, for good reason, feel stigmatised and victimised and psychiatric ASBOs only increase that fear. One of the biggest criticisms from mental health service users (and from my own personal experience I echo it) is not being listened to and your needs, demands, concerns regularly ignored by professionals this creates more powerlessness and lack of control over your surroundings. This will add to the distress and will in no way increase better mental health. CTOs attack civil liberties and instil fear, stigma, mistrust and create a tightly controlled passive society…..
See also the article The Times – “Mental patients ‘trapped’ by abuse of forced drugs regime”… (can’t link to it as you need a sub!!!)
Posted by harpymarx 
