The Community Treatment Order? As I understand it it is used to force
medication on a human being in the community. These medications are used
for a variety of reasons but for many people there may be other options
to control behaviour. I think this is all the system is interested in in
this respect.
The problem is the medication harms people. It creates real illnesses
and some of them, like the drug clozapine, can kill a person within the
first six months of taking it (even with the blood monitoring). Others
cause all sorts of other physical illness as well as suppress the
existence of a human type. (Peter Breggin or who ever wrote Toxic
Psychiatry is one of the main sources of information to back up this
assertion).
I would guess that people with dangerous personality disorders (a
non-codified diagnosis but what is part of the thinking behind the
amended MHA 1983), schizophrenics and perhaps others who don't want to
take medication are those which have it forced on them in the community.
It was originally designed to solve the problem of "revolving doors
patients" and forcibly drugging them in the community was a cheaper
option than repeated hospitalisations.
I assume home treatment treatments are an alternative and there are
several non-pharmacological methods of behavioural modification.
It is important on a philosophical sort of level that types of human
being are not suppressed. If I remember right the CTO is over used on
people with black coloured skin. This is to suppress the expression of
the schizophrenic type. This is about the suppression and subjugation of
the mad, a type of human being which has existed for generations but was
inappropriately labelled as an illness with biological cause (then
evidence was applied by years of abuse of science by the psychiatric
profession). Brain and behavioural difference can be called a deficit if
science is misapplied to the human condition. The fundamental diagnoses
have been about behaviour, emotion, experience of soncisousness and
stuff like that - the biology stuff is just used to justify the
application of the paradigm of illness to unwanted stuff. The
medications don't heal the biological problem so it's not strictly
treatment. The drugs are used to suppress behaviour arbitarily deemed as
unacceptable by a psychiatrist (I know it's more complex than that but
I'm trying to keep this short).
The Community Treatment Order also means some people who would otherwise
be sectioned and incarcerated can live semi-normal lives in the
community. Those at risk of committing a serious crime but have not
committed one....that's a very tricky legal area. I always thought it
was innocent until proven guilty. Clearly those rules are set aside for
the medico-legal framework. While a person can exist in the community
they're not really existing as they are and they'd like to be. The
choice individuals on a CTO make is to be off medication. There's a
reason they make that choice.
People shouldn't be drugged into docility and an early grave unless they
want to. This is idealistic though and may not be pragmatic. Perhaps
modern technology offers options for alternatives as well as advances in
behavioural modification without drugs. Communities, of course, need to
be able to relearn that the mad are an important part of the human race
and should be allowed to exist as freely as anyone else. The centuries
of oppression and subjugation must end. Humanity has lost too much from
suppressing the potential of these incorrectly pathologised humans,
humans who have a right to be just as much as any other. They may be
loud and annoying and crap at looking after themselves. They may be
filthy and nasty and whatever else. They may spout gibberish. I guess
the biggest problem is if they're at risk of harming themselves or, more
importantly, someone else. (The treatment of suicide...well that's a
bigger question than the CTO.)
The key problem, of course, is why the Zito Trust existed. Perhaps those
at risk of committing a serious crime (specifically I mean violent
crimes like murder) could become research subjects. I don't know how
many of these people there are but their lives and life history (and all
the other stuff of the (spirituo)biopsychosocial model of cause of how
people become) could be better understood by learning how these people
become. The social contact with researchers may also offer health
benefits. I know this last idea is one of those crazy ones that probably
doesn't make sense and there are probably alternatives but...well I can
explain my thinking down the pub sometime. :-)
The European Survivors and Ex-Users of Psychiatry might have other
ideas. Perhaps a technology or design company might have some solutions
too. The solutions I've offered are expensive ones but there are many
benefits. The bit which needs more thinking is the problem of death. No
one needs to die.
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