Coercion and Community Treatment Orders (CTOs): One Step Forward, Two Steps Back?edit
The shift from hospital-based care to community-based programs for people with serious and persistent mental illnesses has led to the creation of numerous treatment programs, including the recent implementation of community treatment orders (CTOs). This form of mandated outpatient commitment is controversial because it is widely acknowledged to be a coercive intervention. Yet, there is little discussion about why this intervention is considered coercive and whether coercion is acceptable in the context of emerging commitments to recovery for people with serious and persistent mental illnesses. Moreover, there is a need to evaluate whether CTOs advance or undermine the interests of people who are diagnosed with mental illness. This paper seeks to contribute to a discussion of these issues by exploring coercion and its role in community mental health care, and how it may co-exist with recovery in the implementation of community treatment orders.