Sample Ethics Paper on Community Treatment Orders(CTOs)

Community treatment orders (CTOs) refer to a treatment plan for people with
labels of having a spiritual crisis, emotional disorders, sad or low energy, or troubled.
CTO involves being treated outside of a psycho prison. People who have been placed
under CTO have a legal order to get treated for their labels at mandatory therapy sessions,
counseling, and emotional management classes (Gledhill, 2009). CTO patients have the
legal mandate to comply with everything that has been prescribed for them, failure to
which they can get incarcerated at a psycho prison CTO n to get the desired psychiatric
treatment.
Ethical issues are surrounding these orders are they impede an individual's civil
liberties and lack evidence to prove their success.
Community treatment orders do not result in decreased symptoms or low chances
of readmission. According to a study conducted by Kisely & Hall (2014), most CTO
orders are forceful, which reduces the willingness of a psychiatric survivor to be
cooperative. The patients are constantly faced with the threat of being incarcerated when
they fail to turn up for treatment sessions. These patients feel that their lives are
controlled. Some become rebellious to the treatments, which do not go well for them as
psychiatrists recognize this as a failure for the patient to be normal. Consequently, the
Community treatment orders fail to reduce symptoms in patients, their chances at
readmission, or positive social functioning. It leads to ethical concerns shrouding
Community treatment orders.
Community treatment orders have no evidence of being successful. According to
Burns & Dawson (2009), patients with labels of having problems in living are almost
always prescribed with community treatment orders. The two scholars argue that while

3
CTos is a feature of treatment for patients with disorders labels, this is a questionable
ethical decision. It owes to the lacking of evidence that proves that CTOs are successful
in treating the labels recognized. They argue that there is a responsibility to the relevant
stakeholders to conduct research demonstrating the success of CTOs. Thus, CTOs are
faced with the ethical concern of lacking evidence to prove that they are successful.
CTOs are shrouded in the question of their clinical success and impeding on the
civil liberties of persons. McIvor (1998) argues that there is insufficient literature to
show how CTOs operate and analyze their accomplishments. In addition, he claims that
CTos cannot be passed as ethical due to the numerous pieces of literature which show
that they impede on the liberties of citizens by compelling them to partake in treatments
that they may not be willing to. It is worsened by the fact that they are faced with threats
of psychiatric incarceration if they fail to show up for their treatment. McIvor concluded
that for CTOs to be rid of the ethical concerns surrounding them, they should have
research and literature proving that they are more than community outreach programs and
help people with mental disorder labels in ways that do not contradict their civil liberties.
Otherwise, alternatives to community treatment orders should have to be explored.
Lack of results from CTOs has been found to recur in many studies. In a survey
carried out by O'Reilly et al., the resulted from a randomized study of people with labels
of a severe mental disorder showed that there were no conclusive results of better social
functioning or improved quality of life of the CTO patients as compared to voluntary
patients who were in standard care. They concluded that a wide range of outcomes could
result from CTO, which may not be the desired outcome. This study further shows there
are ethical concerns regarding success rates in CTOs.

4
Community treatment orders are prevalent. It is despite lacking sufficient success
proof. The areas where troubled people are assigned to get treatment also treat people
who go there voluntarily. CTOs should not be abolished. However, there should be
research to help in ensuring that there are success stories for those who do not go out of
their own volition.

5

References

Burns, Tom & Dawson, John. (2009). Community treatment orders: How ethical without
experimental evidence?. Psychological medicine. Doi 39. 1583-
6..1017/S0033291709005352.
Gledhill, K. (2007). Community Treatment Orders. Journal of Mental Health Law ISSN
1466-2817. JMHL. Doi.149. 10.1916.211.
Kisely  S.R., Campbell  L.A., & O'Reilly  R. Compulsory community and involuntary
outpatient treatment for people with severe mental disorders. Cochrane Database
of Systematic Reviews 2017, Issue 3. Art. No.: CD004408. DOI:
10.1002/14651858.CD004408.pub5. Accessed 27 September 2021.
Kisely, S., & Hall, K. (2014). An Updated Meta-Analysis of Randomized Controlled
Evidence for the Effectiveness of Community Treatment Orders. The Canadian
Journal of Psychiatry. Doi 59(10), 561–564.
https://doi.org/10.1177/0706704371405901010
McIvor, R. (1998). The Community Treatment Order: Clinical and Ethical Issues.
Australian & New Zealand Journal of Psychiatry, 32(2), 223–228.
https://doi.org/10.3109/00048679809062732