COMMUNITY TREATMENT ORDER and RECALL

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Community Treatment Orders (CTOs) exist under Section 17A Mental Health Act 83. A CTO can be imposed at the point of discharge to a patient subject to section 3 or 37. A CTO  suspends the section 3 or 37 authorisation for detention unless and until the patient is recalled to hospital.Patients subject to CTOs can be recalled to hospital by the Responsible Clinician.A recall notice is then served on the patient, who can be detained for up to 72 hours.By the end of this period the CTO must be revoked or the patient released.A recall decision may be made on the basis that in the RC’s opinion the patient requires medical treatment in hospital for their mental disorder and there is a risk to the patient or others if they are not recalled. The RC does not have to have examined the patient prior to issuing such a notice.The patient can also be recalled for failure to make themselves available as required by the compulsory statutory conditions.   Breaching any of the other conditions is not sufficient reason for recall. The CTO recall notice must take the form of form CTO3.  It should be given to the patient personally if possible. On the patient’s arrival at the hospital a form CTO4 must be completed, logging the time of their detention.  This marks the beginning of the period of up to 72 hours during which their care must be planned.  The form CTO5 is used if a decision to revoke the CTO is then taken.  If a patient cannot be persuaded to attend hospital, the community team should liaise with the inpatient team and consider seeking support of the police to achieve the patient’s admission to hospital. A warrant can be applied for under section 135 to allow a police officer to enter premises in order to retake the patient and convey them to a place of safety. Patients who are subject to a CTO can be admitted to hospital on an informal basis under Section 131.

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