The World Health Organization (WHO) (2003) recognized the importance of mental health organization in communities all over the globe. Mental health legislation serves as a protection for the human rights of mentally ill patients who are considered as a vulnerable group of the society. It also serves as a legal structure that can be consulted when faced with pressing issues such as community integration of mentally ill patients, high quality care access and quality and protection of their civil rights and other rights such as housing, education and employment.
Legislation can also influence the promotion and prevention measures of mental disorders in the community. A good mental health legislation can strengthen the mental health policy of the community as the well as served as evaluation tool in achieving goals. WHO (2003) strongly suggested the mentally ill patients be treated in settings that upholds their personal freedom in the community including being able to work and attend their activities of daily living. In his article ‘Mental health law in postmodern society: time for new paradigms?
’, Carney (2003) examined the status of mental health law and its implementation in communities including emerging new policy, community treatment order (CTO). He stated that this new policy created confusion among the patients in a sense that it gave freedom to the once institutionalized patients initially but later, subjected back to CTO which holds similar directives for treatment and drug regimen. In some states, CTO may include freedom of movement restrictions.
Another issue that arises in implementation of CTO is the duration and necessity for the power that health institutions have to decide involuntary admissions and subsequently how CTO can control the lives of patients in the community. Carney stated that CTO may be equal to involuntary admission of patients that may violate civil rights in a way that misuse of coercive powers be used to patients not needed to be restricted. A section in the article also discussed about the reactions of different counties about the use of community treatment order with personality disorder.
It was believed to have received extreme reactions, both positive and negative. A group called Lunatics Liberation Front openly criticized the coercive power of CTO by creating pamphlet reading: ‘What Would YOU Do? IF YOU WERE FORCED to have your child on powerful mind-altering drugs such as Ritalin or Prozac? IF YOU FOUND OUT that anyone could be picked up off the street strictly on a psychiatrist’s or doctor’s order and locked up in a psychiatric hospital? ’
Besides Canada, Britain has also embarked in using similar measures but with replaced provisions such as the Care and Treatment Order (CTO) be issued by two doctors and another mental health profession under certain conditions, specifications of where the care must be provided, assurance of doctor’s involvement in giving orders to safeguard against abuse. However, the CTO was not immediately implemented and its status and priority was unknown for a period of time. This may be attributed to reservations to the said method.
Lastly, Carney believed that community-based care for mentally ill patients is inadequate as evidenced by dissatisfaction on the community treatment order (CTO). Although CTO is not the only element of community care, it still is the main component of community care. Carney (2003) quoted the statement of Ordowski (2001) about the right of people with mental illness being compromised due to inadequate available community based services and care options. There was emphasis on how community treatment orders are being delivered to the citizens.
Community treatment orders (CTO) are described as just a fortnightly injection at a local medical facility, a service given without appropriate case management, review or follow-up and is without access to, or support in accessing, a suitable range of services that corresponds to the patients’ needs for leisure, recreation, education, training, work, accommodation and employment. References Carney, T. (2003). ‘The Mental health law in postmodern society: time for new paradigms? ’ Psychiatry, Psychology and Law 10(1). Retrieved from http://www. highbeam. com/doc/1G1-121081848.