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| The Mental Health Act 2007: Alternatives to hospital or curtailments of liberty? |
Every so often I come across an article on Community Treatment Orders
(CTOs). Usually the view expressed is critical and it always produces a stab of
disquiet. More on the bad feelings in a second, but before that, it’s worth
just establishing what we’re talking about. The norm that people with mental
health problems can be given treatment against their will and detained in
hospital is well established. In the United Kingdom the Mental Health
Act 2007 extended this principle by allowing people such compulsory
treatment at home (i.e. without admission). The twinge of unease comes because
I, in the face of a good deal of criticism from colleagues, thought this change
was a good idea.
Let’s leave aside whether such compulsory powers are right or wrong. Feelings run high but there is no sense in which the abandonment of enforced treatment is on the table. Let’s also leave aside the idea of confining compulsory treatment to cases where people lack the capacity to consent. Unlike physical health (where any of us has a right to refuse treatment unless we lack capacity) the UK the Mental Health Act allows treatment on the basis of mental illness While there are powerful arguments that this situation is unjust, these have struggled to gain traction. Here I want to focus on the narrower question of whether, in a world were compulsion is established, CTOs have been helpful.
Let’s leave aside whether such compulsory powers are right or wrong. Feelings run high but there is no sense in which the abandonment of enforced treatment is on the table. Let’s also leave aside the idea of confining compulsory treatment to cases where people lack the capacity to consent. Unlike physical health (where any of us has a right to refuse treatment unless we lack capacity) the UK the Mental Health Act allows treatment on the basis of mental illness While there are powerful arguments that this situation is unjust, these have struggled to gain traction. Here I want to focus on the narrower question of whether, in a world were compulsion is established, CTOs have been helpful.
