What Clinicians Say About the Experience of Working With Individuals on Community Treatment Orders
Bibliographic record
Abstract
OBJECTIVE: Community treatment orders (CTOs) refer to a variety of legal schemes that require a person with a serious mental illness to follow a plan of treatment and supervision while living in the community. Use of CTOs has been controversial, and they have been the subject of a considerable amount of quantitative and qualitative research. This article reports the results of a systematic review of qualitative studies focused on understanding the views and experiences of clinicians who work with individuals on CTOs. METHODS: Relevant databases and gray literature were searched for articles that used a qualitative methodology for data collection and analysis to examine clinicians' perspectives. CTOs were defined as various legal schemes, including court-ordered outpatient commitment and renewable conditional-leave provisions initiated while a person is an inpatient in a psychiatric unit. Mandatory treatment and supervision required after a person has been charged with or convicted of committing a criminal offense was not considered. RESULTS: Fourteen articles met inclusion criteria. They represented the views of more than 700 clinicians from six international jurisdictions. Three themes were identified: endorsement of the benefits of CTOs despite tensions both within and between clinicians concerning several aspects of CTOs; belief that medication compliance is a central aspect of CTOs; and acknowledgment that there is room for improvement in CTO implementation, monitoring, and administration. Strategies for reducing tensions and improving administration of CTOs are discussed. CONCLUSIONS: Clinicians view CTOs as providing benefits to their clients but struggle with the coercive nature of these tools.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.111 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.006 | 0.011 |
| Scholarly communication | 0.012 | 0.011 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.006 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".