FNF scholar updates us on his research into the use and impact of community treatment orders on service users


Lee Marklew is a case manager in the Assertive Outreach Team, St Marys Hospital, Leeds & York Partnerships NHS Foundation Trust, and is currently in his fourth year of a PHD titled Making sense of Community Treatment Orders: the experience of service users. Community Treatment Orders (CTOs) were introduced in November 2008 and are a measure that allows mental health teams to impose compulsory supervision on a patient after they have been discharged from an involuntary stay in hospital. Failure to comply with a CTO may result in a recall to hospital and enforced treatment for the individual in question. Since the introduction of CTOs, over 15,000 have been issued.

Lee aims to provide research and analysis into the meaning, understanding and purpose of CTOs for service-users as he feels there has been insufficient in-depth qualitative work on the impact of service-users’ lives in the past.

Lee has completed 10 semi-structured interviews with individuals who have been subject to CTOs. Once he has cross-analysed his data, he will be able to make recommendations of strategies that he hopes will optimise the service-user experience and guide clinicians towards effective interventions. Lee aims to analyse the remaining data by the end of the academic year and hopes his findings will continue to become more widely recognised within the local research and clinical communities.

A notable finding from the research so far has been how each participant has used metaphorical expression to describe the important and emotionally testing experiences of Supervised Community Treatment. As a result of these findings, a paper is being prepared entitled Metaphor and Mental Disorder. The paper suggests that many patients suffering from mental disorders use metaphor as a bridge to describe their feelings because they are unable to re-live their painful experiences.

We will keep you updated on his progress and findings over the coming months as the analysis stage continues.

About the author

NHS Professionals administrator

NHS Professionals manages the temporary staffing needs of around 66 NHS Trusts across England. An integral part of the NHS, it aims to reduce Trusts’ spending on flexible workers without compromising quality, by providing greater transparency of demand and supplying bank staff at the best possible rate. Its bank of more than 40,000 flexible workers comprises general and specialist nurses, doctors, midwives, admin/clerical , allied health professionals, healthcare scientists, support services among other healthcare professionals.

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