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CTO review released

June 21, 2012

On May 23, 2012 a review of Community Treatment Orders (CTOs) was released by the Ministry of Health and Long-Term Care (MOHLTC). CTOs are consent-based, and can be recommended by physicians to individuals with a serious mental illness as an alternative to institutionalization. This is a community treatment plan, which often includes medication.

The Mental Health Act, Section 33.9 necessitates a review of CTOs every five years, addressing the following questions:

  • Reasons that CTOs were or were not used during the review period;
  • Effectiveness of CTOs during the review period; and
  • Methods used to evaluate the outcome of any treatment used under CTOs.

Findings of the review indicate that more than half of CTO users surveyed were more satisfied with the treatment received under a CTO than with other treatment options. CTOs were also effective in improving adherence to medication. However, effectiveness of the CTOs varied with the quality of the community treatment plan, the access an individual had to services improving the social determinants of health and the differences in usage by practitioners.

The report recommends that mental health care providers and individuals with mental health conditions should continue to have access to CTOs. Other recommendations to the MOHLTC include the creation of a province-wide standard for usage of CTOs and increased access of information about CTOs among stakeholders. The report also advises the government to conduct a review of the safeguards available to CTO users and states that consistent province-wide administrative data is needed in the future for a conclusive review of CTOs.

The MOHLTC commissioned the review from R.A. Malatest & Associates Ltd. To access the full report “The Legislated Review of Community Treatment Orders,” visit

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