Community treatment orders (CTOs)
Explains what a community treatment order (CTO) is, how it can affect you, and how you or your family members can change or end it.
View this information as a PDF (new window)
Can family members be involved with a CTO?
Yes. Under the Mental Health Act, a family member called your nearest relative will have certain powers related to your care if you are on a CTO.
The Mental Health Act says that your nearest relative has the right to:
- Receive information about you
- Ask for an independent mental health advocate to see you
- Discharge you from your CTO
If your nearest relative wishes to discharge you from your CTO, they need to write to your hospital managers. They must give at least 72 hours' notice.
If your responsible clinician doesn't object to the discharge notice, your CTO will end once the 72 hours have passed.
If your responsible clinician does object, they can make a report to the hospital managers. This report would say that, in their view, you would act in a way that would be dangerous to yourself or others. They must submit this report before the 72 hours are up.
If the responsible clinician objects to the discharge notice, then the notice will not have any effect. And your nearest relative will not be able to use this right again for the next six months, starting from the date of the responsible clinician’s report.
See our information on nearest relatives to find out more about who your nearest relative is and what their rights are.
Mental Health Act 1983 (MHA)
This is a law that applies to England and Wales which allows people to be detained in hospital (sectioned) if they have a mental health disorder and need treatment. You can only be kept in hospital if certain conditions are met.
See our pages on the Mental Health Act for more information.
Visit our full listing of Legal TermsNearest relative
The nearest relative is a family member who has certain responsibilities and powers if you are detained in hospital under the Mental Health Act. These include the right to information and to discharge in some situations.
The law sets out a list to decide who will be your nearest relative. This can sometimes be changed.
See our pages on the nearest relative for more information.
Visit our full listing of Legal TermsIndependent mental health advocate (IMHA)
An IMHA is an advocate specially trained to help you find out your rights under the Mental Health Act 1983 and help you while you are detained. They can listen to what you want and speak for you.
- You have a right to an IMHA if you are:
detained in hospital under a section of the Mental Health Act, but not if you are under sections 4, 5, 135 and 136 - under Mental Health Act guardianship, conditional discharge and community treatment orders (CTOs)
- discussing having certain treatments, such as electroconvulsive therapy (ECT).
In Wales, voluntary patients can also have an IMHA.
See our pages on IMHAs (England) and IMHAs (Wales) for more information.
Visit our full listing of Legal TermsHospital managers (also known as Mental Health Act managers)
Hospital managers are an independent team of people in a hospital who make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities and can make decisions related to your detention.
In practice, most of the day-to-day decisions are taken by individuals authorised by the hospital managers to do so. This can include hospital staff. Decisions about discharge are normally delegated to a team of people who are independent of the hospital. You can apply to them to be discharged from your section and they will decide whether or not to discharge you.
Visit our full listing of Legal TermsResponsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsThis information was published in June 2022. We will revise it in 2025.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.
