Community Treatment Orders

What is a Community Treatment Order?

A Community Treatment Order ("CTO") is a doctor's order for a person to receive treatment or care and supervision in the community. The treatment or care and supervision is based on a community treatment plan which outlines the medications, medical appointments and other aspects of care the doctor believes is necessary to allow the person to live in the community rather than hospital.

Who can be put on a CTO?

A person can only be placed on a CTO if very specific rules or conditions, which are specified by law, are met. All of the following conditions must be met:

  • The person must have a serious mental illness, and:
    1. During the past three years the person must have been a patient in a psychiatric facility on two or more times, or for a total of 30 days or more; or
    2. The person must have previously been on a CTO.
  • A community treatment plan must have been developed with the input of the person or his/her substitute decision maker, the doctor and any others involved in his/her care;
  • The doctor must have examined the person in the 72 hours before the plan is entered into and believes:

    1. That the person is suffering from a mental illness that requires continuing treatment or care and supervision while living in the community;
    2. If the person is not currently a patient in a psychiatric facility, he/she would meet the conditions for a psychiatric assessment (Form 1);
    3. If the person does not receive continuing treatment or care and supervision in the community, it is likely, because of his/her mental illness, that he/she will cause serious bodily harm to him/herself or someone else, or he/she will experience substantial mental or physical deterioration or physical impairment; and
    4. The person is able to comply with the plan, and the detailed treatment or care and supervision are available in the community.
  • The doctor has talked to all the people who are named in the community treatment plan;
  • The doctor is satisfied that the person and his/her substitute decision maker have consulted with a rights adviser and been informed of the person's legal rights; and
  • The person or his/her substitute decision maker has consented to the plan.

Do I have to agree to being put on a CTO?

Yes, you must have consented to a CTO before you can be placed on one.

Can I change my mind about being on a CTO?

Yes. You or your substitute decision maker can withdraw consent at any time. If consent is withdrawn the doctor must review your condition within 72 hours to decide if you can live in the community without the CTO.

What happens if I do not comply with the CTO?

Firstly you will be contacted by the doctor and reminded of your responsibilities under the treatment plan. The mental health services team will make every effort to see that you do comply with the requirements. Following this the doctor can make an ‘order for examination’. This will require you to be brought to the doctor for a re-evaluation of your condition and can be done forcibly with the help of the police if necessary. This examination can lead to you being put back onto your CTO, being re-admitted to hospital, or being released if you are deemed to be well.

If you have any further questions or require advice please contact us on 01733 882800 or by using the link below.


Richard Boucher