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The prescriptive nature of Community Treatment Orders (CTO’s) has led to debate about the coercive nature of this legislative development. This debate helps to show the interface between ethics and the law in mental health practice: on what basis is it just to lawfully deprive a person of freedom(s)? Discuss.
The care related to serious psychiatric disorders has been mostly found to be effectively delivered in the community settings, rather than an inpatient one. In order to further facilitate such a cumulative level of community-based care, the different mental health-related acts of the Australian State, as well as the territory areas, govern the use of community treatment orders (CTOs). They can provide psychiatric treatment to the mentally ill patient even in the absence of individual consent (Churchill, 2007).
Though the institution of CTO can happen in the grounds where there is an involuntary level of care and treatment required by the patient or the competency of the mentally ill patient to provide informed consent to the health care professional for a medical procedure. It makes the health care workers uncertain regarding the care to be provided, but it remains a subject of debate in terms of its acceptability and efficacy in spite of being there since the last few decades Caplan., (2013).
This essay will critically focus on the various ethical, legal and theoretical policies and frameworks from the perspective of health care providers and mentally ill patients and also evaluate them regarding evidence-based practices which are being currently available under the purview of CTOs.
Legal and ethical issues
One of the most fundamental objectives of any legislation related to mental health is the protection and promotion of lives, coupled with the overall improvement in the well-being of the citizens. It is a matter of the fact that legal legislations are required in the form of laws so that it can be achieved and mental health legislation also follows the same pathway. Some practical researches conducted across the world have, however, highlighted the vulnerability of mentally ill people towards abuse and violation of their basic fundamental rights (Light et al, 2012). The society which aims to respect and provide care to its mentally ill population thus must put forward legislation which protects those (Kiseley et al, 2013). The application of progressive legislation can thus be one of the effective tools which promote access to a mental health care facility as well as overall protect their rights and promote the well-being of every individual.
The mere presence of particular legislation in the field of mental health, however, does not guarantee human right respect or protection. A global survey has indicated that approximately 51% of the countries have not passed any mental health legislation related amendments since the 1990s and 15% countries have their legislation since its inception in the 1960s, and no alterations have been made since then(Kisley et al, 2014). Those countries where the legislations have not been updated since a long time have resulted in the violation of mental health legislation instead of the promotion of well-being or protection of mentally ill people (Tew et al, 2011). It is due to the fact that the initial drafts of mental health legislation were made in favour of the common public and safeguarding their interests from the so-called “dangerous” or extremely viable mentally ill patients who even needed isolation from the general community (Light et al, 2012). There are also legislations which permit the custodial care of people for longer terms bearing toa serious threat to the society but cannot provide care for themselves, and thus their basic rights have also been found to be violated (Rugkåsa., 2014). Therefore, outdated laws are the main reasons for the violation of basic rights. Reforms in mental health legislation are thus required as a result of the need arising to understand the burdens of social, personal and economic aspects of life (Lexén, &Svensson., 2016)