Supervised community treatment briefing

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One of the most controversial proposals in the government's Mental Health Bill (currently before parliament) is the introduction of supervised community treatment (SCT).

Under SCT, some patients who have been compulsorily detained in hospital for treatment will, on discharge, become subject to a community treatment order (CTO) requiring them to comply with certain conditions, including taking their medication. SCT can only be imposed on patients directly following a period of compulsory detention for treatment in hospital – it cannot be imposed on patients who are living in the community at the time.

A CTO will be made by a patient's responsible clinician with the agreement of an Approved Mental Health Professional, and will initially apply for six months. If it is considered necessary, it can then be renewed by the responsible clinician for a further six months and then annually. However, the responsible clinician can discharge the patient from SCT at any time, and the patient has a right to apply to the hospital managers and the Mental Health Review Tribunal for a discharge.

The proposal for SCT has met with significant opposition from some patient groups and some professionals. This briefing explores some of the surrounding issues and the available evidence on the likely effect of SCT, including evidence from abroad, where compulsory community treatment has been used for some time.