Care planning for consumers on community treatment orders: an integrative literature review.
BACKGROUND
Case management is the established model for care provision in mental health and is delivered within current care philosophies of person-centred and recovery-oriented care. The fact that people with a mental illness may be forced to receive care and treatment in the community poses challenges for clinicians aiming to engage in approaches that promote shared decision-making and self-determination. This review sought to gain an in-depth understanding of stakeholders' perspectives and experiences of care planning for consumers' on CTOs.


METHODS
An integrative review method allowed for inclusion of a broad range of studies from diverse empirical sources. Systematic searches were conducted across six databases. Following appraisal, findings from included papers were coded into groups and presented against a framework of case management.


RESULTS
Forty-eight papers were included in the review. Empirical studies came from seven countries, with the majority reporting on qualitative methods. Many similarities were reported across studies. Positive gains from CTOs were usually associated with the nature of support received, highlighting the importance of the therapeutic relationship in care planning. Key gaps in care planning included a lack of connection between CTO, treatment and consumer goals and lack of implementation of focussed interventions.


CONCLUSIONS
Current case management processes could be better utilised for consumers on CTOs, with exploration of how this could be achieved warranted. Workers need to be sensitive to the 'control and care' dynamic in the care planning relationship, with person-centred approaches requiring core and advanced practitioner and communication skills, including empathy and trust.
School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, 5001, Australia. Suzanne.dawson@flinders.edu.au.
Suzanne
http://orcid.org/0000-0002-7357-625X
S
Dawson
School of Medicine, Flinders University, Adelaide, Australia.
Sharon
S
Lawn
School of Health Sciences, Nursing, City University London, London, UK.
Alan
A
Simpson
School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, 5001, Australia.
Eimear
E
Muir-Cochrane
D019090:Case Management; D006801:Humans; D037141:Mandatory Programs; D001523:Mental Disorders / Q000628:therapy*
Care Planning; Case Management; Community Mental Health; Community Treatment Orders