Community treatment orders (CTOs)

This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.

Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.

All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.

A care coordinator is the main point of contact and support if you need ongoing mental health care. They keep in close contact with you while you receive mental health care and monitor how that care is delivered – particularly when you’re outside of hospital. They are also responsible for carrying out an assessment to work out your health and social care needs under the care programme approach (CPA).

A care coordinator could be any mental health professional, for example:

• a nurse
• a social worker
• another mental health worker.

This is decided according to what is most appropriate for your situation.

A care coordinator usually works as part of the community mental health team.

This is a law that applies to England and Wales which allows people to be detained in hospital (sectioned) if they have a mental health disorder and need treatment. You can only be kept in hospital if certain conditions are met.

See our pages on the Mental Health Act for more information.

When the Mental Health Act talks about someone with mental health problems and whether or not they should be sectioned, it often uses the term 'mental disorder'. The Act says that this can include “any disorder or disability of mind”.

Mental disorder can include:

• any mental health problem normally diagnosed in psychiatry
• certain learning disabilities.

This means medical treatment for your mental health problem that is:

• suitable for you
• available
• takes into account the nature and degree of your mental health problem and your individual circumstances.

AMHPs are mental health professionals who have been approved by a local social services authority to carry out duties under the Mental Health Act. They are responsible for coordinating your assessment and admission to hospital if you are sectioned.

They may be:

• social workers
• nurses
• occupational therapists 
• psychologists.

An IMHA is an advocate specially trained to help you find out your rights under the Mental Health Act 1983 and help you while you are detained. They can listen to what you want and speak for you.

• You have a right to an IMHA if you are:
  detained in hospital under a section of the Mental Health Act, but not if you are under sections 4, 5, 135 and 136
• under Mental Health Act guardianship, conditional discharge and community treatment orders (CTOs)
• discussing having certain treatments, such as electroconvulsive therapy (ECT).

In Wales, voluntary patients can also have an IMHA.

See our pages on IMHAs (England) and IMHAs (Wales) for more information.

Hospital managers are an independent team of people in a hospital who make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities and can make decisions related to your detention.

In practice, most of the day-to-day decisions are taken by individuals authorised by the hospital managers to do so. This can include hospital staff. Decisions about discharge are normally delegated to a team of people who are independent of the hospital. You can apply to them to be discharged from your section and they will decide whether or not to discharge you.

The Mental Health Act Administrator works in the hospital and deals with collecting and keeping the section or community treatment order (CTO) papers safe. They make sure that procedures are followed – like making sure you are given the right information and arranging hearings.

A person is detained if they are being kept in hospital under section and are not free to leave.