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Community treatment orders (CTOs)
Explains what a community treatment order (CTO) is, how it can affect you, and how you or your family members can change or end it.
Mental Health Tribunal for CTOs
This page is about applying to the Mental Health Tribunal to discharge you from a community treatment order (CTO). It covers:
How can I apply for discharge from a CTO?
If you want to be discharged from your CTO, you can apply to the Mental Health Tribunal.
The Tribunal will only consider how your mental health is now, and whether you should still be on your CTO or discharged from it. They cannot look at the conditions of your CTO. If you want help through this process, you can get support from an independent mental health advocate (IMHA).
When exactly you can apply will depend on what kind of section you are on:
Section 3
- If you're on a CTO under section 3, you can apply to be discharged within the first 6 months from the date that the CTO was made.
- After 6 months your responsible clinician can renew your CTO for a further 6 months. After that your responsible clinician can apply for your CTO to be renewed once a year. If your CTO is renewed, you can apply to be discharged during each period of renewal.
- If your CTO is revoked, you can apply to be discharged within 6 months, starting on the day the CTO was revoked.
If you apply to the Tribunal while detained under section 3 and you are then put on a CTO before your hearing, the Tribunal will still go ahead but will still consider whether you meet the criteria for a CTO instead of the section 3. You will not lose any right to apply for a further hearing.
Section 37
- If you're on a CTO after detention under section 37, you can't apply for a Tribunal within the first 6 months of the date of the hospital order being made.
- After 6 months your responsible clinician can renew your CTO for a further 6 months. After that your responsible clinician can apply for your CTO to be renewed once a year. If your CTO is renewed, you can apply to be discharged during each period of renewal.
- If your CTO is revoked, you can apply to be discharged within 6 months, starting on the day the CTO was revoked. You cannot apply for a Tribunal within the first 6 months of the date of the hospital order being made.
- If you apply to the Tribunal while detained under section 37 and you are then put on a CTO before your hearing, the Tribunal will still go ahead but will still consider whether you meet the criteria for a CTO instead of the section 37. You will not lose any right to apply for a further hearing.
Section 47/49 (Notional section 37)
- If you are placed on section 47/49, you are still a serving prisoner. But if your sentence ends and you are still in hospital, you are automatically put under what is known as Notional section 37. Sometimes this is written as s37N. Once you are on a Notional section 37 you can then be put on a CTO.
- After 6 months your responsible clinician can renew your CTO for a further 6 months. After that your responsible clinician can apply for your CTO to be renewed once a year. If your CTO is renewed, you can apply to be discharged during each period of renewal.
- If your CTO is revoked, you can apply to be discharged within 6 months, starting on the day the CTO was revoked.
If you apply to the Tribunal while detained under Notional section 37 and you are then put on a CTO before your hearing, the Tribunal will still go ahead. But it will consider whether you meet the criteria for a CTO instead of the Notional section 37. You will not lose any right to apply for a further hearing.
It is your right to have legal aid to pay for a solicitor to help you with your appeal, and during the hearing. Your savings or property will not have to be assessed for you to get this help.
When must I be referred to the Mental Health Tribunal?
The managers of the hospital responsible for your care must automatically refer you to the Mental Health Tribunal at certain times:
- If your CTO is revoked and you have to go back to hospital under your original section, you'll be referred to the Tribunal as soon as possible.
- If you're admitted under a section 2 or 3, and there has not been a Tribunal application or reference, you'll be referred to the Tribunal 6 months from the date you are admitted. See our pages on sectioning for more information about your rights when you are admitted under section 2 or 3.
- If you're aged 18 or over, and it has been 3 years since the last time the Tribunal considered your case, you must automatically be referred to the Tribunal again.
- If you're under 18 years old and it has been one year since the last time the Tribunal considered your case, you must automatically be referred to the Tribunal again.
You will still have a Mental Health Tribunal if you have a change in status. For example, if you have been referred to a Mental Health Tribunal because your CTO is revoked and you are then put under another CTO right before the hearing, the hearing will still go ahead.
Mental Health Tribunal (MHT)
This is a special court that deals with cases relating to the Mental Health Act 1983. The Tribunal decides whether you can be discharged from your section. It can sometimes make recommendations about matters such as hospital leave, transfer to another hospital, guardianship and community treatment orders (CTOs).
The court is made of a panel, which normally includes:
- a legally qualified chairperson
- a ‘lay member’ who has appropriate experience and qualifications in the area of mental health
- an independent psychiatrist, who will speak to you and examine you before the tribunal hearing in certain circumstances, and when you request to see them
Where you see a reference to the Mental Health Tribunal in this guide, it means:
- First Tier Tribunal (Mental Health), if you live in England, or
- Mental Health Review Tribunal for Wales, if you live in Wales.
Independent mental health advocate (IMHA)
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.
Visit our full listing of Legal TermsThis information was published in June 2022. We will revise it in 2025.
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