title: Involuntary psychiatric treatment in the community: general practitioners and the implementation of community treatment orders.
abstract: BACKGROUND
  There are no data about general practitioners' (GPs') involvement in involuntary psychiatric community treatment orders (CTOs). We examined stakeholder perspectives on the GP's role in this area.
  
  
  METHODS
  Semi-structured interviews were conducted around CTO experiences with 38 participants: patients, carers, clinicians and Mental Health Review Tribunal members. Data were analysed using established qualitative methodologies.
  
  
  RESULTS
  Sixteen participants specifically spoke about GPs. The analysis identified four themes in their accounts: GPs as 'instruments' of CTOs; GPs as primary caregivers within a CTO; GPs as 'outsiders'; and practical challenges for GPs. Within these themes, participants identified the value of GPs in the provision of care for people living with severe and persistent mental illness, the challenges of coercive processes and the dangers of GPs being isolated from them.
  
  
  CONCLUSIONS
  GPs play an important role in the implementation of CTOs. Failure to better integrate GPs in the care of people on CTOs appears to be a significant shortcoming of its implementation.
authors.affiliation: GradCert Bioethics, BA Comms, PhD candidate, Centre for Values, Ethics and the Law in Medicine, University of Sydney, NSW.
authors.forename: Edwina
authors.initials: E
authors.lastname: Light
authors.forename: Ian
authors.initials: I
authors.lastname: Kerridge
authors.forename: Michael
authors.initials: M
authors.lastname: Robertson
authors.forename: Philip
authors.initials: P
authors.lastname: Boyce
authors.forename: Terry
authors.initials: T
authors.lastname: Carney
authors.forename: Alan
authors.initials: A
authors.lastname: Rosen
authors.forename: Michelle
authors.initials: M
authors.lastname: Cleary
authors.forename: Glenn
authors.initials: G
authors.lastname: Hunt
authors.forename: Nick
authors.initials: N
authors.lastname: O'Connor
authors.forename: Christopher
authors.initials: C
authors.lastname: Ryan
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders; D003156:Community Mental Health Services / Q000458:organization & administration*; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D009517:New South Wales; D010819:Physician's Role