The use of Community Treatment Orders in an intellectual disability service

The literature on the use of Community Treatment Orders (CTOs) is primarily focused on people without intellectual disabilities. This paper aims to explore how CTOs are used in people with intellectual disability in the UK.

An audit was conducted among Consultant Psychiatrists in intellectual disability psychiatry in Nottinghamshire Healthcare NHS Trust. Each consultant was asked to provide information on demographic data of their patients on CTOs, reasons for being on a CTO, conditions specified, patients' capacity to consent and their understanding of their CTOs. Conditions of CTOs were analysed using thematic analysis.

There were 17 CTOs done for patients with intellectual disability from November 2008 to May 2011. Mean age was 38 with a range of 20‐59. All patients had a mild or moderate intellectual disability. Only a small percentage of patients had a diagnosis of schizophrenia. More than 50 per cent had a diagnosis of pervasive developmental disorder (PDD). All patients had behavioural problems as a reason for being on a CTO. About one third of patients did not have any understanding of their CTOs. Themes of conditions were focused on providing a structured life to prevent relapse of the mental disorder.

This paper highlights that CTOs are used differently in the intellectual disability population. CTOs are adapted to use for patients with behavioural challenges and PDD in an intellectual disability population. This contrasts with its common use to manage non‐compliance with medication in patients with schizophrenia in the general adult population. This paper also suggests the main themes of conditions which clinicians can use when deciding on CTO conditions.