title: The lived experience of involuntary community treatment: a qualitative study of mental health consumers and carers.
abstract: OBJECTIVE
  To describe the lived experiences of people subject to community treatment orders (CTOs) and their carers.
  
  
  METHODS
  We recruited 11 participants (five mental health consumers and six carers) through consumer and carer networks in NSW, Australia, to take part in interviews about their experiences. We analysed the interview data set using established qualitative methodologies.
  
  
  RESULTS
  The lived experiences were characterised by 'access' concerns, 'isolation', 'loss and trauma', 'resistance and resignation' and 'vulnerability and distress'. The extent and impact of these experiences related to the severity of mental illness, the support available for people with mental illnesses and their carers, the social compromises associated with living with mental illness, and the challenges of managing the relationships necessitated by these processes.
  
  
  CONCLUSIONS
  The lived experience of CTOs is complex: it is one of distress and profound ambivalence. The distress is an intrinsic aspect of the experience of severe mental illness, but it also emerges from communication gaps, difficulty obtaining optimal care and accessing mental health services. The ambivalence arises from an acknowledgement that while CTOs are coercive and constrain autonomy, they may also be beneficial. These findings can inform improvements to the implementation of CTOs and the consequent experiences.
authors: Doctoral candidate, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia edwina.light@sydney.edu.au.
authors: Edwina M
authors: EM
authors: Light
authors: Clinical Associate Professor, Mental Health Ethics, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia.
authors: Michael D
authors: MD
authors: Robertson
authors: Professor of Psychiatry, Discipline of Psychiatry, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
authors: Philip
authors: P
authors: Boyce
authors: Emeritus Professor, Sydney Law School, University of Sydney, Sydney, NSW, Australia.
authors: Terry
authors: T
authors: Carney
authors: Professorial Fellow, School of Public Health, University of Wollongong, Wollongong, NSW; and Clinical Associate Professor, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia.
authors: Alan
authors: A
authors: Rosen
authors: Associate Professor, School of Nursing and Midwifery, University of Western Sydney, Sydney, NSW, Australia.
authors: Michelle
authors: M
authors: Cleary
authors: Associate Professor, Principal Research Fellow, Discipline of Psychiatry, Concord Hospital, University of Sydney, Sydney, NSW, Australia.
authors: Glenn E
authors: GE
authors: Hunt
authors: Clinical Director, North Shore Ryde Mental Health Service, Sydney, NSW, and; Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia.
authors: Nick
authors: N
authors: O'Connor
authors: Senior Clinical Lecturer, Discipline of Psychiatry, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia.
authors: Christopher
authors: C
authors: Ryan
authors: Director and Associate Professor of Bioethics; Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia.
authors: Ian H
authors: IH
authors: Kerridge
keywords: carer; community treatment order; interview; involuntary treatment; mental health; patient experience; qualitative research