Tonight:
-5°c
Mental health workers worried over community treatment
8 Sep 2010More than 7,000 sufferers of mental illness have been sent for treatment in the community - a far higher number than expected, experts said today.
The surge raises concerns about the number of people given community treatment orders for mental health issues, according to a study from the Mental Health Alliance.
The report pointed to “serious concerns” about the increase, including the “disproportionate use” of CTOs for people from black and other ethnic minority communities and the possibility patients are being discharged from hospital earlier than they should be.
Patients detained in hospital can be discharged under CTOs and supervised by a doctor, nurse or social worker.
Care plans include medication and therapeutic treatments, but can also include detail to restrict a patient's movements. If a patient refuses to take medication, they can be sent back to hospital.
Experts also pointed to shortcomings in community support and delays for patients in obtaining second opinions to authorise treatment.
Today's report said the Department of Health significantly underestimated CTO use in the first 12 months following their introduction in November 2008.
Rather than the expected 400 to 600, about 4,000 CTOs were issued across England and Wales in the first year, and more than 6,000 had been issued by the end of March this year.
“The (total) number is likely to have risen to over 7,000 by the end of July 2010, with some 4,000 to 5,000 patients under a CTO at that date,” the study said.
Twice as many men as women are placed on CTOs, which were introduced to stop “revolving door” patients repeatedly going in and out of hospital.
The orders were also brought in to reduce public anxiety about mental health patients falling off the NHS radar.
Alison Cobb, chair of the Mental Health Alliance, said: “We are concerned about the large numbers of people made subject to CTOs, given their coercive nature and the limited international evidence for positive effects.
“It is particularly worrying when people tell us about not getting the support they need or feeling stigmatised.
“We need to understand more about why so many CTOs are being imposed, and what impact they are having on people's health and quality of life. We also need to know more about people's progression off CTOs.”
The report's author, Simon Lawton Smith, head of policy at the Mental Health Foundation, added: “The evidence on use of CTOs is only slowly emerging, and these are preliminary findings.
“But there is enough evidence to show that not everyone discharged from hospital under a CTO is getting the support they need to return successfully to the community.
“Much more needs to be done to ensure that CTOs are only imposed in strict accordance with legal requirements and are backed up by proper care and support.”
A spokeswoman for the Department of Health said: “We welcome this report. Community treatment orders are a potentially useful tool when used properly. But we must all remain vigilant to ensure that they are not being used unnecessarily or ineffectively.
“In the months ahead, we will be working across Government to reshape the mental health strategy to set clear outcomes and offer a roadmap for delivering them.”
