Community Treatment Orders (CTOs) provide legal means to deliver mental health care to individuals with serious mental disorders, inclusive of a comprehensive plan of community-based treatment or care, with supervision that is less restrictive than being detained in a psychiatric facility (Canadian Mental Health Association, Durham, 2019). CTO’s began in Canada in the 1990’s and became a part of Newfoundland and Labrador’s (NL) Mental Health Care and Treatment Act in 2008. CTOs are centered around less restrictive care, which is aligned with the principles of recovery oriented and person-centered care (WHO, 2021). These principles are the foundation of both the World Health Organization’s focus, and of NL’s strategic plan to address service gaps. Since their inception, the prescription of CTO’s has risen consistently within NL each year (Personal Communication, 2021). Most qualitative work involving CTO service user experience has taken place outside of Canada, and thus this is the first known study to explore the experiences of individuals who have been prescribed a CTO in the province of NL. This research employed an interpretive description (ID) approach and blended analysis, to answer the research question(s): What is the experience of individuals who have been prescribed a CTO; how can these experiences inform the use of CTOs and; how do the policy structures of CTOs influence the lives of people who live with them? Interviews were conducted with four participants with three emerging concepts identified during data analysis: “knowingness”, “confinement”, “engagement”, and the unique element for one participant: “growth”. The participants’ experiences were interpreted and discussed within the context of current literature. A phenomenological study was used to inform policy analysis on the topic. Study findings contribute to understanding the experiences for individuals prescribed CTOs and add to the growing body of literature surrounding the topic. Implications for the future of CTOs in NL and areas for future research are provided.
Keywords: community treatment orders; CTO; mandated community treatment; lived experience
