Hello. This is a shorter version on my video on Community Treatment Orders
under the Mental Health Act 2007. If a patient is on a Section 3, Section 37, Hospital Direction or
Transfer Direction no longer requires treatment in hospital and can have this in the community,
the Responsible Clinician, with the agreement of the Approved Mental Health Practitioner,
may discharge the patient under Supervised Community Treatment.
The patient must suffer from a mental disorder of a nature or degree that requires treatment
for their disorder and that it is necessary for their health, safety or safety of others that
he or she should receive treatment. The patient needs to be liable to be recalled to hospital
by the Responsible Clinician, and treatment in the community needs to be available for the patient.
The Responsible Clinician and the Approved Mental Health Professional need to put it in writing that
they agree for the CTO to go ahead. There are 2 mandatory conditions for the community treatment
order. The first is that the patient makes themselves available to be seen by the Responsible
Clinician for the purposes of extending the Community Treatment Order and the second is
that the patient makes themselves available to be seen by a Second Opinion Appointed Doctor
for the purpose of reviewing their medication, treatment plan and consent to treatment for this.
The Community Treatment Order initially lasts for 6 months and can be renewed for a further 6
months and then annually thereafter. Before it is time for renewal or otherwise of the
Community Treatment Order, the patient needs to be seen by the Responsible Clinician, and the
Responsible Clinician and Approved Mental Health Professional need to both agree that continuation
of the Community Treatment Order is appropriate for the patient and that the criteria for the CTO
are still being met. At any time, the Responsible Clinician can take the patient off the CTO.
The patient may be recalled to hospital for a period of up to 72 hours if they break either
of the mandatory conditions of the CTO. The patient may also be recalled to hospital by
the Responsible Clinician if in his or her opinion the patient requires their medical
treatment in hospital and that there is a risk to their health, safety or safety of others if the
patient is not given treatment for their mental disorder in hospital. Breach of a non-mandatory
condition will be taken into account when considering the criteria for recall to hospital.
During the 72-hour period that the patient is recalled to hospital, the Responsible Clinician
may revoke the Community Treatment Order and the patient would remain in hospital under a Section
3. The admission criteria for a Section 3 must be met, and the Approved Mental Health Professional
will need to agree that the criteria are met and that revocation of the CTO is appropriate for the
patient. The patient or Nearest Relative can appeal against the CTO of the patient
in the following ways: the patient may at any time request that the managers of the hospital
responsible for the patient's treatment - that is the hospital that they were discharged from - take
them off the CTO; the patient may also apply to a Mental Health Tribunal each time he is put on a
CTO or the CTO is extended - so within the first 6 months of being on a CTO then within months
6 -12 and then annually thereafter; the Nearest Relative may also appeal to the Hospital Managers
to take the patient off a CTO. This will happen if within 72 hours the Responsible Clinician does not
write a report to state that the patient needs to remain on the CTO for their own health, safety or
safety of others. If the Responsible Clinician does write this, then the Nearest Relative will
within 28 days be able to apply to the Mental Health Review Tribunal to consider discharging the
patient from their Section. I hope this has been useful. Thank you for listening. 'Bye for now.