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Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study

Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study
Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study
Purpose

Current literature on personal experiences of community treatment orders (CTO) is limited. This paper examines participants’ experiences of the mechanisms via which the CTO was designed to work: the conditions that form part of the order and the power of recall. We also report an emergent dimension, legal clout and participants’ impressions of CTO effectiveness. This paper will contribute to a fuller picture of how the law is implemented and how CTOs operate in practice.

Methods

In-depth qualitative interviews were conducted with a purposive sample of 26 patients, 25 psychiatrists and 24 family carers about their experiences and views of CTOs. Data were analysed using the constant comparative method.

Results

All three sample groups perceived the chief purpose of CTOs to be medication enforcement and that its legal clout was central to achieving medication adherence. Understanding of how the inbuilt mechanisms of the CTO work varied considerably: participants expressed uncertainty regarding the enforceability of discretionary conditions and the criteria for recall. We found mixed evidence regarding whether recall simplified responses to relapse or risk. The range of experiences and views identified within each group suggests that there is no single definitive experience or view of CTOs.

Conclusions

The (perceived) focus of the CTO on medication adherence combined with the variations in understanding within and across groups might not only have consequences for how CTOs are viewed and subsequently experienced, but also for broader goals in patient care and patient and carer involvement.
community treatment orders, coercion, compulsory community treatment, involuntary outpatient treatment, community mental health
0933-7954
1873-1882
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b

Canvin, K., Rugkåsa, J., Sinclair, J. and Burns, T. (2014) Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study. Social Psychiatry and Psychiatric Epidemiology, 49 (12), 1873-1882. (doi:10.1007/s00127-014-0906-0).

Record type: Article

Abstract

Purpose

Current literature on personal experiences of community treatment orders (CTO) is limited. This paper examines participants’ experiences of the mechanisms via which the CTO was designed to work: the conditions that form part of the order and the power of recall. We also report an emergent dimension, legal clout and participants’ impressions of CTO effectiveness. This paper will contribute to a fuller picture of how the law is implemented and how CTOs operate in practice.

Methods

In-depth qualitative interviews were conducted with a purposive sample of 26 patients, 25 psychiatrists and 24 family carers about their experiences and views of CTOs. Data were analysed using the constant comparative method.

Results

All three sample groups perceived the chief purpose of CTOs to be medication enforcement and that its legal clout was central to achieving medication adherence. Understanding of how the inbuilt mechanisms of the CTO work varied considerably: participants expressed uncertainty regarding the enforceability of discretionary conditions and the criteria for recall. We found mixed evidence regarding whether recall simplified responses to relapse or risk. The range of experiences and views identified within each group suggests that there is no single definitive experience or view of CTOs.

Conclusions

The (perceived) focus of the CTO on medication adherence combined with the variations in understanding within and across groups might not only have consequences for how CTOs are viewed and subsequently experienced, but also for broader goals in patient care and patient and carer involvement.

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More information

e-pub ahead of print date: 14 June 2014
Published date: 1 December 2014
Keywords: community treatment orders, coercion, compulsory community treatment, involuntary outpatient treatment, community mental health
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 371894
URI: http://eprints.soton.ac.uk/id/eprint/371894
ISSN: 0933-7954
PURE UUID: d7dc8bf9-d7ed-43b0-bb18-8c7f3083da97
ORCID for J. Sinclair: ORCID iD orcid.org/0000-0002-1905-2025

Catalogue record

Date deposited: 24 Nov 2014 10:12
Last modified: 29 Oct 2019 02:03

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Contributors

Author: K. Canvin
Author: J. Rugkåsa
Author: J. Sinclair ORCID iD
Author: T. Burns

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