Psychiatrists say they will attempt to manage patients through ACT alone, but most end up on a CTO. Giving the patient an opportunity to co-operate with the treatment is better than deeming them to be unlikely to adhere as soon as the process starts. Most clinicians try not to immediately place the person on a CTO; they would prefer to develop a therapeutic alliance with the patient and then place them on a CTO if necessary. This is possible with ACT because it provides a safety net when testing a patient’s ability to adhere to their treatment plan. One family member explained that “when you’ve got an ACT team coming in…and you do go off your meds, they’re going to be aware”. This gives the team an opportunity to work with the patient and
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The problem could have a simple solution, such as an adjustment to the medications. A CTO can then be added to the treatment plan if it is evident that compliance will not occur without additional coercion. If we can involve the patient in constructing their own plan for recovery, but still hold some power when the person does not have the capacity to make decisions in their best interest, the treatment may be successful.
To ensure successful treatment before mentally ill people enter the justice system, the solution would also need to address the length of treatment. Family members and patients say that the CTOs are typically only in place for a few months and that this is deficient. Under the MHA, the director must review the detention on a regular basis to ensure the patient still fulfills the criteria to be considered an involuntarily …show more content…
Yet, the system is not perfect; there are problems with the proposed solution. Most importantly, it is possible that people would still slip through the cracks and end up in prison. This could occur when a person is not mentally ill enough to attract the attention of an ACT team but still has psychiatric symptoms that make them more likely to commit crimes. There is no easy solution because if ACT teams make contact with people mild psychiatric problems it could lead to challenges under section 7 of the Charter. If the person had a CTO, this would be unlikely to be a successful claim; if the person is ill enough to be deemed involuntary, then the deprivation of liberty would probably be justified under section 1 of the Charter. However, even without a CTO, ACT is moderately coercive. It is a significant amount of state intrusion on a mentally ill person who may not even be a harm to themselves or others. There would be a fine line between ‘too mild’ and ‘just right’ and, undoubtedly, some mistakes would be made before finding that perfect
The problem could have a simple solution, such as an adjustment to the medications. A CTO can then be added to the treatment plan if it is evident that compliance will not occur without additional coercion. If we can involve the patient in constructing their own plan for recovery, but still hold some power when the person does not have the capacity to make decisions in their best interest, the treatment may be successful.
To ensure successful treatment before mentally ill people enter the justice system, the solution would also need to address the length of treatment. Family members and patients say that the CTOs are typically only in place for a few months and that this is deficient. Under the MHA, the director must review the detention on a regular basis to ensure the patient still fulfills the criteria to be considered an involuntarily …show more content…
Yet, the system is not perfect; there are problems with the proposed solution. Most importantly, it is possible that people would still slip through the cracks and end up in prison. This could occur when a person is not mentally ill enough to attract the attention of an ACT team but still has psychiatric symptoms that make them more likely to commit crimes. There is no easy solution because if ACT teams make contact with people mild psychiatric problems it could lead to challenges under section 7 of the Charter. If the person had a CTO, this would be unlikely to be a successful claim; if the person is ill enough to be deemed involuntary, then the deprivation of liberty would probably be justified under section 1 of the Charter. However, even without a CTO, ACT is moderately coercive. It is a significant amount of state intrusion on a mentally ill person who may not even be a harm to themselves or others. There would be a fine line between ‘too mild’ and ‘just right’ and, undoubtedly, some mistakes would be made before finding that perfect