title: Community treatment orders - what are the views of decision makers?
abstract: BACKGROUND
  Community treatment orders (CTOs) are being increasingly used in Western countries. The scheme implies that mental health patients can live outside a hospital, but still be subject to coercive care to ensure compliance with their treatment. There is limited knowledge of how the scheme is practised.
  
  
  OBJECTIVE
  To gain knowledge of how decision makers weigh and evaluate various considerations when making decisions on CTOs.
  
  
  METHODS
  Qualitative in-depth interviews with decision makers responsible for CTOs in Norway.
  
  
  RESULTS
  Decision makers viewed CTOs as a useful scheme to ensure control, continuity and follow-up care in the treatment of outpatients with a history of poor treatment motivation. They had varied interest in and knowledge of the patient's life situation and how the scheme affects the patient's everyday life. Little attention was devoted to patient experiences of formal and informal coercion.
  
  
  CONCLUSIONS
  When deciding on CTOs, decision makers should pay more attention to the negative consequences that patients may experience. In many cases, decision makers are probably not aware of these coercive factors.
authors.affiliation: a Division of Mental Health and Substance Abuse , University Hospital of North Norway , Tromsø , Norway.|b Department of Community Medicine , The Arctic University of Norway , Tromsø , Norway , and.
authors.forename: Henriette
authors.initials: H
authors.lastname: Riley
authors.affiliation: c Department of Health and Care Sciences , Faculty of Health Sciences, The Arctic University of Norway , Tromsø , Norway.
authors.forename: Geir Fagerjord
authors.initials: GF
authors.lastname: Lorem
authors.affiliation: b Department of Community Medicine , The Arctic University of Norway , Tromsø , Norway , and.
authors.forename: Georg
authors.initials: G
authors.lastname: Høyer
mesh_terms: D001291:Attitude of Health Personnel; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders; D003156:Community Mental Health Services; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D009664:Norway; D010045:Outpatients; D010349:Patient Compliance
keywords: Coercion; community coercion; community treatment orders; outpatient commitment