A Mental Health Officer (MHO) makes the application for a Compulsory Treatment Order (CTO). Two mental health (medical) reports by Approved Medical Practitioners (AMP) or one AMP and one General Practitioner are required to accompany this application.

The application specifies the compulsory measures sought, the medical treatment proposed and any other services proposed. The MHO must notify the patient, Named Person/nearest relative, Mental Welfare Commission and Mental Health Tribunal of the application. The MHO must inform patient of their right to Independent Advocacy Services and a solicitor and assist the person to access them.

The CTO is usually authorised for 6 months initially and then reviewed. If the CTO is continued by the Responsible Medical Officer at this stage, then there is a further review after 6 months and subsequently annual reviews.

 

Criteria for a Compulsory Treatment Order (CTO):

  • The person is likely to be suffering from a mental disorder.
  • Treatment is available which is likely to prevent the mental disorder worsening or alleviate symptoms or effects. Treatment includes nursing care and other therapeutic input (e.g. from Allied Health Professional, Psychologist) as well as administering medication.
  • There is a significant risk to the person’s health, safety and/or welfare.
  • The person presents a significant risk to others.
  • The person’s decision making ability with regard to medical treatment is significantly impaired as a result of the mental disorder.
  • The compulsory measures are considered to be necessary. A less restrictive option is not possible.

The Mental Health Tribunal Hearing

The CTO application is heard at a Tribunal Hearing. The Tribunal panel includes a legal member, a medical member and a lay member. The patient, the Named Person/relatives, Mental Health Officer, Responsible Medical Officer, the patient’s solicitor and anyone else with an interest in the application all have the right to attend this hearing.

The Tribunal Panel has the Power to:

  • Grant the Order sought i.e. authority to detention in hospital and provision of medical treatment.
  • Refuse the Order sought.
  • Specify measures other than those set out in the application e.g. the panel can decide to make it a community based order rather than a hospital based order.
  • Grant an Interim Order for a shorter period (usually 4 weeks), for example to allow for an independent psychiatric opinion to be sought by the patient’s solicitor.