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Community treatment orders (CTOs)

Explains what a community treatment order is, how it affects you and how you can change or end it.

  • This information applies to England and Wales.
  • This information applies to adults. It doesn't apply to children unless specifically stated.

When can I be recalled to hospital?

You can be recalled to any hospital if your responsible clinician thinks that:

  • you need medical treatment in hospital for your mental disorder, and
  • there would be risk of harm to your health or safety or to others if you are not recalled

You can only be recalled if you meet both criteria. For example, you cannot be recalled just because you stop taking your medication. But if you stop taking your medication, and your responsible clinician thinks that you will get unwell, they can recall you.

Your responsible clinician can also recall you if you don't follow the two conditions that are attached to every CTO.

Example

Dionne has a diagnosis of bipolar disorder and a condition of the CTO is to let the community psychiatric nurse into her house to give her medication.

Dionne decides that she is better and doesn't need her medication so she doesn't let her community psychiatric nurse into the house. She is not seen by her community psychiatric nurse or anyone for two weeks and they are worried that she is unwell. Her responsible clinician therefore decides to recall her.

What happens if I am recalled to hospital?

If you are recalled to hospital, firstly you must be given notice in writing. This can either be sent to you in the post or be given to you in person. The form they will use depends on whether you are in England or Wales:

  • If you are in England, visit this CTO forms page on the UK Government website. Here you can find a copy of 'Form CTO3 section 17e: community treatment order, notice of recall to hospital' as a Microsoft Word document in English. This is the form they will use to give notice of your recall to hospital in England.
  • If you are in Wales, visit this CP forms page on the NHS Cymru website. Here you can find a copy of 'CP3 - Section 20a - Report extending the community treatment period' as a PDF document in English. This is the form they will use to give notice of your recall to hospital in Wales.

You can either go to the hospital yourself or you could be taken to hospital by the police or ambulance. You can also ask that someone comes with you.

What will happen once I'm back in hospital?

Once you are back in hospital they will complete a form with your details, and to make a note of the time your detention started. The form they will use depends on whether you are in England or Wales:

  • If you are in England, visit this CTO forms page on the UK Government website. Here you can find a copy of 'Form CTO4 section 17e: community treatment order, record of patient's detention in hospital after recall' as a Microsoft Word document in English. This is the form they will use to record the details of your recall once you are in hospital in England.
  • If you are in Wales, visit this CP forms page on the NHS Cymru website. Here you can find a copy of 'CP5 - Section 17e - Notice of recall to a hospital' as a PDF document in English. This is the form they will use to record the details of your recall once you are in hospital in Wales.

You can be kept in hospital for up to 72 hours. Your responsible clinician will see you and decide what the next steps are. You can be forced to have treatment if your responsible clinician thinks that you need it. Your responsible clinician can then decide to either release you back to the community on the CTO or decide that you need to stay in hospital.

If you need to stay in hospital, your CTO will be revoked and you will be detained on your original section. An approved mental health professional will need to agree to this, and a form will be completed. The form they will use depends on whether you are in England or Wales:

  • If you are in England, visit this CTO forms page on the UK Government website. Here you can find a copy of 'Form CTO5 section 17f4: revocation of community treatment order' as a Microsoft Word document in English. This is the form they will use if your CTO is revoked and you are detained in hospital in England.
  • If you are in Wales, visit this CP forms page on the NHS Cymru website. Here you can find a copy of 'CP7 - Section 17f - revocation of a community treatment order' as a PDF document in English. This is the form they will use if your CTO is revoked and you are detained in hospital in Wales.

See our information on sectioning to find out about what happens when you are detained in hospital.

< Ending a CTO Mental Health Tribunal >

This information was published in December 2017.

This page is currently under review. All content was accurate when published. 

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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