Time called on compulsory community mental health treatment

People in mental distress and their whānau do not feel heard in clinical review and court processes that lead to enforced treatment a report released today by Te Hiringa Mahara - Mental Health and Wellbeing Commission shows.

The Lived Experiences of Compulsory Community Treatment Orders report documents how tāngata whaiora, whānau and family, and Māori feel marginalised in processes that determine what treatment they receive.

"The use of compulsory community treatment orders is a practice from mental health that is out of step with human rights and current approaches to mental distress. We urge changes to these practices." Hayden Wano, Te Hiringa Mahara chair said.

"People found these orders counter-productive and they impacted on the relationship between tāngata whaiora and clinicians. Use of these orders is not aligned with New Zealand’s Te Tiriti o Waitangi and human rights obligations and they are not effective."

Compulsory community treatment orders (CCTO) are granted by a judge following an application by a clinician. The orders lead to people being medicated without consent and have their freedom of movement curtailed. People under a CCTO continue to live at home and are still able to work or study.

"We were told forced treatment can have a negative impact on peoples’ trust in and engagement with services. This is the opposite of what is needed to facilitate recovery," Mr Wano said.

The number of people subjected to a Compulsory Community Treatment Order under the Mental Health Act increased by 8% between 2017 and 2021. In 2021, almost 7,000 people were under compulsory treatment in our communities.

"We are surprised to see that use of community treatment orders has increased in recent years, when people have been calling for a reduction in coercive practices," Mr Wano said.

"We also know that more Māori are subject to CCTOs than other populations in Aotearoa. The inequitable use of orders is unacceptable and must be addressed."

"When mental health law is re-written we expect it to be in line with Te Tiriti o Waitangi, human rights and best practice so people are supported to make decisions about their treatment. Because the new law won’t come into force for several years, we need changes to cultural and other practices to be made now," Mr Wano said.