BJSW Advance Access originally published online on November 30, 2005
British Journal of Social Work 2006 36(7):1085-1100; doi:10.1093/bjsw/bch392
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Community Treatment Orders for People with Serious Mental Illness: A New Zealand Study
Anita Gibbs trained as a social worker at Bristol University before working as a probation officer in Avon during the 1990s. She undertook a PhD at Bristol before taking up academic positions in Oxford, the Open University and, since 1999, Otago, New Zealand. She has published extensively on social work topics and current interests are mental health, supervised contact services and the needs of Pacific Island people.
John Dawson is Professor of Law at the University of Otago in Dunedin, New Zealand. He studied law at Otago and Harvard and has published widely in law and psychiatry journals. He recently edited a book on the law on biomedical research. In 2003, he spent 5 months travelling in Australia, Canada, the UK and Switzerland studying involuntary outpatient care.
Richard Mullen initially trained in Medicine in Leeds, England, and subsequently in Psychiatry in London and Dunedin, New Zealand. For the past 10 years he has been a consultant in general adult psychiatry, and for the past 4 years, a senior lecturer in the department of psychological medicine at the University of Otago.
Correspondence to Dr Anita Gibbs, Senior Lecturer, Department of Social Work and Community Development, University of Otago, PO Box 56, Dunedin, New Zealand. E-mail: anita.gibbs{at}stonebow.otago.ac.nz
New Zealand legislation allows for the involuntary outpatient treatment of people with serious mental illness. This study examines the views of service users, family members and mental health professionals (MHPs) about the impact of this regime. Semi-structured interviews were completed with forty-two service users, twenty-seven family members and ninety MHPs, with recent experience of the regime. Participants were asked to comment on the functions of community treatment (or non-resident) orders, their benefits and restrictions, decisions about their termination and any impact on relationships. Most service users believed the main purpose of the order was to ensure they took medication. They also believed the order provided better access to other treatments, supported accommodation and care from MHPs. Families considered the orders provided relief for them and a supportive structure for their relative’s care. MHPs found the orders useful for engaging service users in a continuing therapeutic relationship, and for promoting treatment adherence. In each group, a majority of those interviewed viewed involuntary community treatment in a generally positive light, while acknowledging the restrictions imposed on service users’ freedom.
Keywords: community treatment orders, outpatient commitment, mental health, service user