International Perspectives on the Use of Community Treatment Orders: Implications for Mental Health Social Workers

Substantial changes to mental health law and policy have occurredthroughout the Western world during the last decade. The drifttowards control, particularly in the form of Community TreatmentOrders (CTOs), has profound implications for the role of mentalhealth social workers, yet this issue is rarely discussed inacademic literature. This paper seeks to redress this gap inknowledge by examining aspects of law, policy and practice usingthree case studies: Victoria, Australia; Ontario, Canada; andregions of the UK. The paper begins by critically reviewingselected literature on CTOs, revealing competing claims aboutefficacy and their impact upon service users¹ and practitioners.A discussion of policy and practice contexts in the three jurisdictionsis then presented and supported with a typology, to illustratecontrasts and comparisons. In their conclusions, the authorsassert that mental health social workers often have a crucialpart to play in the implementation of CTOs but that this isnot always acknowledged in law and organizational policy. Socialworkers’ roles and responsibilities need to be more explicitlyidentified in mental health law. At the same time, there shouldbe a continuing debate about how such coercive powers fit withcodes of ethics and practice standards, at national and internationallevels.