Community treatment orders (CTOs)

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.

The nearest relative is a family member who has certain responsibilities and powers if you are detained in hospital under the Mental Health Act. These include the right to information and to discharge in some situations.

The law sets out a list to decide who will be your nearest relative. This can sometimes be changed.

See our pages on the nearest relative for more information.

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.

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.