Community treatment orders: the experiences of Non-Maori and Maori within mainstream and Maori mental health services
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Community treatment orders (CTOs) are sometimes used to coerce patients into treatment on the basis that such treatment is in their best interest. The experiences of Maori, New Zealand’s indigenous ethnic minority are less well known and this paper compares the views of Maori and non-Maori about CTOs.
Patients with experience of CTOs for greater than 6 months participated. Self-report measures were used to identify patients’ views of compulsory treatment. Demographic data, heath service characteristics, the experience of coercion, views of compulsory community treatment, satisfaction with care, social functioning, and psychopathology were assessed.
There were few differences in demographic or clinical characteristics between Maori and non-Maori. There were no differences in the views of Maori compared to non-Maori patients with respect to compulsory community treatment. There were no differences in the views of Maori cared for by mainstream compared to culturally specialist Maori mental health service.
In a well-established system of compulsory treatment, there is no evidence of greater negative impact of CTOs in an indigenous minority population. The opportunity for Maori to self-select between mainstream and specialist Maori mental health services may minimize the negative aspects of compulsory community treatment for Maori.
KeywordsCommunity treatment orders Community mental health Ethics Psychiatry and law Maori health
Assistance with initial data management was provided by Dr. James Stanley, Wellington School of Medicine, Otago University. Development of the initial data collection tools and the methodology was provided by WIT and Te Taiwhenua O Heretaunga. Te Taiwhenua O Heretaunga, assisted with data collection, has reviewed this paper and is happy for it being submitted for publication. Funding for the collection of the data was provided by the Hawke’s Bay Medical Research Fund.
Conflict of interest
The authors declare no conflict of interest.
- 1.Mental Health (Compulsory Assessment and Treatment) Act. (1992). Available at http://www.legislation.govt.nz/act/public/1992/0046/latest/DLM262176.html
- 3.Callaghan S, Ryan C (2012) Rising to the human rights challenge in compulsory treatment: new approaches to mental health law in Australia. Aust NZ J Psychiatry 46(7):11–20Google Scholar
- 6.Kisley S, Campbell L, Preston N (2005) Compulsory community and involuntary outpatient treatment for people with severe mental disorders. Cochrane Database of Systematic Reviews, Issue 3, Art No CD004408. doi: 10.1002/14651858.CD004408.pub2
- 7.Newton-Howes G (2012) A factor analysis of patients’ views of compulsory community treatment orders: the factors associated with detention. Psychiatry, Philosophy and Law Available at: http://www.tandfonline.com/doi/full/10.1080/13218719.2012.715827
- 8.Ministry of Health (2012) Office of the Director of Mental Health: Annual Report 2012. Ministry of Health, WellingtonGoogle Scholar
- 12.United Nations Declaration on the Rights of Indigenous Peoples. (2007) Available at: http://www.un.org/esa/socdev/unpfii/documents/DRIPS_en.pdf
- 17.Newton-Howes G, Marsh R (2012), Personality dysfunction and social functioning in schizophrenia. Personality and Mental Health. Available at: http://onlinelibrary.wiley.com/doi/10.1002/pmh.1206/abstract;jsessionid=A4BC7543320232F4BABF08ABA12583EB.d02t04?deniedAccessCustomisedMessage=&userIsAuthenticated=false
- 18.Otago CTO Study (2000). Patient interview tool used as basis for development of research. Available at: http://www.otago.ac.nz/law/otagoCTO/instruments/index.html