Court rules that CTO conditions cannot be too restrictive

Today (Monday 17 December 2018) a judgment handed down from the Supreme Court ruled that an individual placed on a Community Treatment Order (CTO) after coming out of hospital cannot be deprived of their liberty. Mental health charity Mind intervened in the case to highlight the widespread problem of CTOs.

CTOs are meant to help prevent people being re-admitted to hospital, for example by requiring them to attend appointments to help manage a mental health problem. However in PJ’s case – and many others – CTO conditions go much further, for example requiring them to live in a particular place or preventing them going outside without an escort.

This particular judgement handed down from the Supreme Court is important because it highlights that the conditions imposed on people can be very restrictive- often far more so than while in hospital. PJ was required to live in a care home and abide by their rules. This included his whereabouts being checked every 15 minutes and not being able to leave the premises without permission and a staff escort. PJ appealed against an earlier Court of Appeal decision that ruled a ‘responsible clinician’ had the power to impose conditions on a CTO which would deprive an individual of their liberty. The Supreme Court has now ruled in favour of PJ, effectively overturning the previous ruling. This means that going forward, mental health and legal professionals need to carefully look at the conditions imposed on their clients under CTOs to ensure that they don’t amount to depriving them of liberty.

Michael Henson-Webb, Head of Legal at Mind said:

“We are really pleased that the Supreme Court ruled in favour of PJ, recognising that he was being deprived of his liberty. Unfortunately, this isn’t a one-off case - we hear from many people who have extremely restrictive conditions imposed on them after coming out of hospital. We’ve long been campaigning for a scrapping of Community Treatment Orders, or at the very least - independent oversight into their use. This would allow to better monitor and police the rules placed on people and ensure that they are given a level of freedom conducive to getting and staying well.

“The recently published Mental Health Act review made references to the worryingly high use of CTOs and that people seem to be under them for a much longer timeframe than intended. At the same time, we know these orders are not effective in reducing hospital readmission. The review did acknowledge the need to tighten the rules for imposing them but didn’t go far enough in terms of calling for them to be scrapped altogether. We hope this latest legal challenge will once again bring into question the use of these orders.”