Abstract
Purpose
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.
Methods
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.
Results
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.
Conclusions
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.
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Acknowledgments
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.
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Appendix
Appendix
Questions asked in relation to CTOs
Do you find a CTO ‘traumatic’? | Yes | A little | No opinion | Not Really | No |
Are your rights are violated by a CTO? | Yes | A little | No opinion | Not Really | No |
Does a CTO give you a “safety net”? | Yes | A little | No opinion | Not Really | No |
Does a CTO make it more difficult to get on with your doctor? | Yes | A little | No opinion | Not Really | No |
Does a CTO make it harder to trust your doctor? | Yes | A little | No opinion | Not Really | No |
Does going to court upset you? | Yes | A little | No opinion | Not Really | No |
Do you like being on a CTO? | Yes | A little | No opinion | Not Really | No |
Do you only take your medication because of the CTO? | Yes | A little | No opinion | Not Really | No |
Does the CTO interfere with your social life? | Yes | A little | No opinion | Not Really | No |
Does the CTO stop you from working? | Yes | A little | No opinion | Not Really | No |
Does the CTO make you unhappy? | Yes | A little | No opinion | Not Really | No |
Does the CTO help with your care? | Yes | A little | No opinion | Not Really | No |
Does the CTO protect you? | Yes | A little | No opinion | Not Really | No |
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Newton-Howes, G., Lacey, C.J. & Banks, D. Community treatment orders: the experiences of Non-Maori and Maori within mainstream and Maori mental health services. Soc Psychiatry Psychiatr Epidemiol 49, 267–273 (2014). https://doi.org/10.1007/s00127-013-0734-7
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DOI: https://doi.org/10.1007/s00127-013-0734-7