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What Families Have to Say about Community Treatment Orders (CTOs)

Publication: Canadian Journal of Community Mental Health
22 February 2019

Abstract

Qualitative studies provide a different kind of understanding of the effectiveness of community treatment orders (CTOs) by exploring the perspectives of stakeholders. This article documents a systematic review of 12 qualitative studies that explored the views of families of individuals on a CTO. Relevant databases and grey literature were searched. Themes were identified: the benefits of CTOs outweigh the disadvantages, CTOs increased their involvement in care, and families were dissatisfied with aspects of the CTO process. Recommendations include how to maximize the benefits of CTOs, reduce administrative burdens and employ strategies to increase involvement of families in the care of their loved ones.

Résumé

Les études qualitatives proposent une lecture différente de l’efficacité des ordonnances de traitement communautaire (OTC) en examinant les points de vue des différents intervenants. Le présent article documente une revue systématique de 12 études qualitatives exposant le point de vue de familles d’individus faisant l’objet d’une OTC. Des bases de données pertinentes et des sources de documentation parallèle ont été consultées. Divers thèmes ont été dégagés : les avantages des OTC l’emportent sur les inconvénients; les OTC permettent d’accroître l’implication des familles dans les soins prodigués; les familles démontrent de l’insatisfaction vis-à-vis certains aspects des procédures des OTC. Les recommandations portent notamment sur la façon de maximiser les avantages des OTC, l’allègement du fardeau administratif et l’adoption de stratégies en vue d’accroître la participation des familles dans les soins apportés à leurs proches.

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References

Brophy L. and McDermott F. 2013 Using social work theory and values to investigate the implementation of community treatment orders Australian Social Work 66 1 72 -85
Canvin K., Rugkasa J., Sinclair J., and Burns T. 2014 Patient, psychiatrist and family caregiver experiences of community treatment orders: Qualitative study Social Psychiatry and Psychiatric Epidemiology 49 1873 -1882
Corring D., O’Reilly R., and Sommerdyck C. 2017 A systematic review of the views and experience of subjects of community treatment orders International Journal of Law and Psychiatry 18-May-2017, DOI information:
Dawson, J. (2005). Community treatment orders: International comparisons. Dunedin: Otago University Print: www.otago.ac.nz/law/otagoCTO/index.html
Dreezer, & Dreezer, Inc. (2005). Report on the legislated review of community treatment orders, required under Section 33.9 of the Mental Health Act for the Ontario Ministry of Health and Long-Term Care: Toronto, Ontario.
Eastman N. 1994 Mental health law: Civil liberties and the principle of reciprocity British Medical Journal 308 43
Flyckt L., Löthman A., Jörgensen L., Rylander A., and Koernig T. 2013 Burden of informal care giving to patients with psychoses: A descriptive and methodological study International Journal of Social Psychiatry 59 2 137–146 Epub 2011 Nov 17
Gault I. 2009 Service-user and carer perspectives on compliance and compulsory treatment in community mental health services Health and Social Care in the Community 17 5 504 -513
Gibbs A., Dawson J., Forsyth H., and Mullen R. & Te Oranga Tonu Tanga 2004 Maori experience of community treatment orders in Otago, New Zealand Australian & New Zealand Journal of Psychiatry 38 830–835
Gibbs A., Dawson J., Ansley C., and Mullen R. 2005 How patients in New Zealand view community treatment orders Journal of Mental Health 14 4 357 -368
Gibbs A., Dawson J., and Mullen R. 2006 Community treatment orders for people with serious mental illness: A New Zealand study British Journal of Social Work 36 1085 -1100
Glick I. D., Stekoll A. H., and Hays S. 2011 The role of the family and improvement in treatment maintenance, adherence, and outcome for schizophrenia Journal of Clinical Psychopharmacology 31 1 82 -85
Grant M. and Booth A. 2009 A typology of reviews: An analysis of 14 review types and associated methodologies Health Information and Libraries Journal 26 91 -108
Hartmann M., Bäzner E., Wild B., Eisler I., and Herzog W. 2010 Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis Psychotherapy and Psychosomatics 79 3 136–148 Epub 2010 Feb 20
Kirby, M., & Keon, W. (2004). Report 1, Mental health, mental illness and addiction: Overview of policies and programs in Canada. Interim report of the Standing Senate Committee on Social Affairs, Science and Technology. (p. 26).
Kisely S. and O’Reilly R. 2015 Reappraising community treatment orders—can there be consensus? Medical Journal of Australia 202 8 415 -416
LaForest, G. V., & Lahey, W. (2013). Involuntary Psychiatric Treatment Act (IPTA) review: Interview analysis. Nova Scotia Health Research Foundation: Halifax, Nova Scotia.
Lawton Smith, S. (2010). Supervised community treatment: Briefing paper 2. Mental Health Alliance: London, UK.
Light E., Robertson M., Boyce P., Carney T., Rosen A., Cleary M., and Kerridge I. 2014 The lived experience of involuntary community treatment: A qualitative study of mental health consumers and carers Australasian Psychiatry 22 4 345 -351
Malatest, R. A., & Associates (2012). The legislated review of community treatment orders: Final report. Ontario Ministry of Health and Long Term Care: Toronto, Ontario.
Martire L. M., Lustig A. P., Schulz R., Miller G. E., and Helgeson V. S. 2004 Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness Health Psychology 23 6 599 -611
Maughan D., Molodynski A., Rugkåsa J., and Burns T. 2014 A systematic review of the effect of community treatment orders on service use Social Psychiatry and Psychiatric Epidemiology 49 4 651–663
Mental Health Commission of Canada (MHCC). (2013). National guidelines for a comprehensive service system to support family caregivers of adults with mental health problems and illnesses. Author: Ottawa, Ontario.
Mental Health Services Act, SS 1984-85-86, c M-13.1, http://canlii.ca/t/52jhk
Mullen R., Gibbs A., and Dawson J 2006 Family perspective on community treatment orders: A New Zealand study International Journal of Social Psychiatry 52 5 469 -478
Munetz M. R. and Geller J. L. 1993 The least restrictive alternative in the post-institutional era Hospital and Community Psychiatry 44 10 967 -973
Nakhost A., Perry J. C., and Frank D. 2012 Assessing the outcome of community treatment orders in managing psychiatric patients at 2 McGill University—associated hospitals Canadian Journal of Psychiatry 57 6 359 -365
Noyes, J., Popay, J., Pearson, A., Hannes, K., & Booth, A. on behalf of the Cochrane Qualitative Research Methods Group. (2008). Chapter 20: Qualitative research and Cochrane reviews. Version 5.1.0—updated in 2011. http://handbook.cochrane.org
Nunes, J., & Simmie, S. (2002). Beyond Crazy, Journeys Through Mental Illness. Toronto, ON: McClelland and Stewart Ltd.
O’Reilly R. L. 2004 Why are community treatment orders controversial? Canadian Journal of Psychiatry 49 9 579 -584
O’Reilly R., Keegan D., Corring D., Shrikhande S., and Natarajan D. 2006 A qualitative analysis of the use of community treatment orders in Saskatchewan International Journal of Law and Psychiatry 29 516 -524
O’Reilly R., Dawson J., and Burns T. 2012 Best practices in the use of involuntary outpatient treatment Psychiatric Services 63 5 421 -423
Owens N. and Brophy L. 2013 Revocation of community treatment order in a mental health service network Australasian Psychiatry 2 1 46 -50
Petrila J. and Christy A. 2008 Florida’s outpatient commitment law: A lesson in failed reform? Psychiatric Services 59 21 -23
Steadman H., Gounis K., Dennis D., Hopper K., Roche B., Swartz M., and Robbins P. C. 2001 Assessing the New York City involuntary outpatient commitment pilot program Psychiatric Services 52 3 330 -336
Stein L. I. and Test M. A. 1980 Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation Archives of General Psychiatry 37 4 392 -7
Stensrud B., Hoyer G., Granerud A., and Landheim A. 2015 ‘Responsible, but still not a real treatment partner’: A qualitative study of the experiences of relatives of patients on outpatient commitment orders Issues in Mental Health Nursing 36 583 -591
Stroud J., Banks L., and Doughty K. 2015 Community treatment orders: Learning from experiences of service users, practitioners and nearest relatives Journal of Mental Health 24 2 88 -92
Swartz M. S. and Swanson J. W. 2004 Involuntary outpatient commitment, community treatment orders, and assisted outpatient treatment: What’s in the data? Canadian Journal of Psychiatry 49 9 585 -591
Swartz M. S. and Swanson J. W. 2013 Can states implement involuntary outpatient commitment within existing state budgets? Psychiatric Services 64 7 -9
Swartz, M. S., M.S., Hoge S.K., Pinals D.A., Lee E., Lee L., Sidor M., Bell T., Ford E., & Johnson S. (2015). Resource document on involuntary outpatient commitment and related programs of assisted outpatient treatment. American Psychiatric Association.
University of Sydney. (2013). Community treatment orders: The lived experience of consumers and carers in NSW. Centre for Values, Ethics & the Law in Medicine, 1–51.
Vine R. and Komiti A. 2015 Carer experience of community treatment orders: Implications for rights based/recovery oriented mental health legislation Australasian Psychiatry 23 2 154 -157

Information & Authors

Information

Published In

cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 37Number 2July 2018
Pages: 1 - 12

History

Version of record online: 22 February 2019

Key Words

  1. community treatment order
  2. family
  3. qualitative
  4. systematic review

Mots-clés

  1. ordonnance de traitement communautaire (OTC)
  2. famille
  3. qualitatif(ve)
  4. revue systématique

Authors

Affiliations

Deborah Corring [email protected]
Richard O’Reilly
Christina Sommerdyk
Parkwood Institute, St. Joseph’s Health Care
Elizabeth Russell
Parkwood Institute, St. Joseph’s Health Care

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