Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study
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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
(1990) · Cited by 24,217 · see citing works
(2006) · Cited by 18,730 · see citing works
Qualitative evaluation and research methods
Ellis, D. J. (1990) · International Journal of Information Management · doi:10.1016/0268-4012(90)90041-p · Cited by 17,942 · see citing works
The Constant Comparative Method of Qualitative Analysis
Glaser, B. G. (1965) · Social Problems · doi:10.2307/798843 · Cited by 4,937 · see citing works
Personal life : new directions in sociological thinking
Smart, C. (2013) · Research Explorer (The University of Manchester) · Cited by 488 · see citing works
Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial
Burns, T., Rugkåsa, J., Molodynski, A., Dawson, J., Yeeles, K., Vazquez-Montes, M., Voysey, M., Sinclair, J., & Priebe, S. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60107-5 · Cited by 347 · see citing works
Self-citationBurnard, P. (2006) · Nurse Researcher · doi:10.7748/nr.13.4.84.s4 · Cited by 346 · see citing works
Swartz, M. S., Swanson, J. W., Wagner, H. R., Burns, B. J., Hiday, V. A., & Borum, R. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.12.1968 · Cited by 337 · see citing works
Assessing the New York City involuntary outpatient commitment pilot program
Steadman, H. J., Gounis, K., Dennis, D., Hopper, K., Roche, B., Swartz, M., & Robbins, P. C. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.3.330 · Cited by 312 · see citing works
International experiences of using community treatment orders
Churchill, R. C., Owen, G. S., Singh, S. P., & Hotopf, M. H. (2006) · PsycEXTRA Dataset · doi:10.1037/e622832007-001 · Cited by 204 · see citing works
Adapt or adopt: developing and transgressing the methodological boundaries of grounded theory
Cutcliffe, J. R. (2005) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2005.03514.x · Cited by 200 · see citing works
Code of practice for the Mental Health Act 1983
Elliott, A. (1986) · BMJ · doi:10.1136/bmj.292.6535.1597-a · Cited by 147 · see citing works
Community Treatment Orders: International Comparisons
Dawson, J. (2005) · Otago University Research Archive (University of Otago) · Cited by 87 · see citing works
How patients in New Zealand view community treatment orders
Gibbs, A., Dawson, J., Ansley, C., & Mullen, R. (2005) · Journal of Mental Health · doi:10.1080/09638230500229541 · Cited by 86 · see citing works
A qualitative analysis of the use of community treatment orders in Saskatchewan
O’Reilly, R. L., Keegan, D. L., Corring, D., Shrikhande, S., & Natarajan, D. (2006) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2006.06.001 · Cited by 60 · see citing works
Community Treatment Orders for People with Serious Mental Illness: A New Zealand Study
Gibbs, A., Dawson, J., & Mullen, R. (2005) · The British Journal of Social Work · doi:10.1093/bjsw/bch392 · Cited by 53 · see citing works
Controllers and controlled: an analysis of participant constructions of outpatient commitment
Scheid‐Cook, T. L. (1993) · Sociology of Health & Illness · doi:10.1111/1467-9566.ep11346883 · Cited by 48 · see citing works
Dilemmas for clinicians in use of Community Treatment Orders
Mullen, R., Dawson, J., & Gibbs, A. (2006) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2006.09.002 · Cited by 43 · see citing works
CTOs: what is the state of the evidence?
Rugkåsa, J., Dawson, J., & Burns, T. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0839-7 · Cited by 42 · see citing works
Self-citationMaori Experience of Community Treatment Orders in Otago, New Zealand
Gibbs, A., Dawson, J., Forsyth, H., Mullen, R., & Te Oranga Tonu Tanga (Maori Mental Health Team) (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2004.01468.x · Cited by 40 · see citing works
Family Perspective on Community Treatment Orders: A New Zealand Study
Mullen, R., Gibbs, A., & Dawson, J. (2006) · International Journal of Social Psychiatry · doi:10.1177/0020764006066836 · Cited by 32 · see citing works
Insight and use of community treatment orders
Dawson, J., & Mullen, R. (2008) · Journal of Mental Health · doi:10.1080/09638230802052187 · Cited by 32 · see citing works
Coping with Compulsion: Women's Views of Being on a Community Treatment Order
Gibbs, A. (2010) · Australian Social Work · doi:10.1080/03124070903265740 · Cited by 14 · see citing works
Schwartz, K., O’Brien, A.-M., Morel, V., et al. (2010) · Carleton University's Institutional Repository (MacOdrum Library, Carleton University) · Cited by 13 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Effectiveness of community treatment orders: The international evidence
Rugkåsa, J. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743715620415 · Cited by 98 · see citing works
Self-citationA systematic review of the views and experiences of subjects of community treatment orders
Corring, D., O'Reilly, R., & Sommerdyk, C. (2017) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2017.03.002 · Cited by 51 · see citing works
Stuen, H. K., Rugkåsa, J., Landheim, A., & Wynn, R. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1083-x · Cited by 35 · see citing works
Self-citationBrekke, E., Clausen, H., Brodahl, M., & Landheim, A. S. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05264-z · Cited by 10 · see citing works
“Service users, carers and practitioners experience coercion differently and hold different attitudes towards it [32–34].”
BackgroundCommunity treatment orders: A qualitative study of stakeholder perspectives
Goulet, M.-H., Lessard-Deschênes, C., Pariseau-Legault, P., Breton, R., & Crocker, A. G. (2023) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2023.101901 · Cited by 3 · see citing works
- Authors
- Canvin, K., Rugkåsa, J., Sinclair, J., & Burns, T.
- Affiliations
- Warneford Hospital (GB)
- Akershus University Hospital (NO)
- University of Southampton (GB)
- Corresponding author
- Canvin, Krysia
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2014-06-14
- Volume
- 49
- Issue
- 12
- Pages
- 1873-1882
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W2008831434
- Cited by
- 56
- References
- 24
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 6 · 2018: 8 · 2017: 7 · 2016: 11 · 2015: 4
- FWCI
- 8.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0606-1006)
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- community treatment orders, mental health law, medication adherence, psychiatric patients, psychiatrists, family caregivers, relapse, patient and carer involvement
- MeSH terms
- Attitude of Health Personnel, Attitude to Health, Community Mental Health Services, Female, Humans, Male, Patients, Physicians, Psychiatry, Treatment Outcome, Caregivers, Uncertainty, Qualitative Research, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
