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Explains what a community treatment order is, how it affects you and how you can change or end it.
A community treatment order (CTO) is an order made by your responsible clinician to give you supervised treatment in the community.
This means you can be treated in the community for your mental health problem, instead of going to hospital, but your responsible clinician can return you to hospital and give you immediate treatment if necessary.
While you are in the community, you will have a specialist care team:
If you are subject to a CTO, the Mental Health Act describes you as a 'community patient'.
A responsible clinician can make a CTO if you are on a:
You cannot be put on a CTO if:
To find out more about different sections and what they mean, see our information on sectioning.
You can only be put on a CTO if:
An approved mental health professional must agree in writing that these criteria are met, and they are appropriate for you.
A CTO lasts 6 months from the date of the order, but it can be renewed. Your responsible clinician will decide whether to renew your CTO. An approved mental health professional will also need to approve this before the CTO can be renewed.
You will need to have an appointment with your responsible clinician so that they can decide whether your CTO should be renewed – this is a condition of your CTO that you must follow.
When you are discharged from hospital onto a CTO you are entitled to free aftercare services under section 117 of the Mental Health Act 1983.
This means support in the community to help you with your mental health problems and to help you stay well and not have to return to hospital. You will not have to pay for this support.
For more information about section 117 aftercare services see our guide to leaving hospital.
If you are on a CTO, you have the right to get support from someone called an independent mental health advocate (IMHA).
An IMHA can help you in all sorts of ways. For example, they can:
Your hospital managers should give you information about your CTO rights and advocacy services. If they don’t, you should ask the Mental Health Act administrator of the hospital or your care coordinator.
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.See our full list of legal terms.
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:
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.See our full list of legal terms.
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.See our full list of legal terms.
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:
This means medical treatment for your mental health problem that is:
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:
In Wales, voluntary patients can also have an IMHA.See our full list of legal terms.
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.See our full list of legal terms.
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.See our full list of legal terms.
This information was published in December 2017. We will revise it in 2019.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.