Community Treatment Orders
Michael Riley is warm, bright, gentle giant in his late 30’s. He is currently employed at a union and is the loving father of a four-and-a-half year old daughter who starts school this year. While Michael lives, works and is socially engaged in the community, he is subject to a Community Treatment Order (CTO) which has been consistently renewed for 14 years. Michael does not agree with nor does he consent to this order. His diagnosis is one of Schizoaffective Disorder - a diagnosis he rejects.
Michael does not have a criminal record and has no history of violent behaviour. His only contact with the police has been sparked by his CTO on the isolated occasions on which he is essentially arrested on the grounds that he is a danger to his own reputation. At times, these arrests have been carried out with such force that Michael has required hospital treatment (see ‘About Michael’ for the full story). Despite his gentle nature, Michael’s experience at the hands of the police and mental health authorities has resulted in him feeling as though he is being treated like a criminal. This is a common experience for people with mental illness and an ongoing concern for Justice Action.
Michael’s case highlights how vulnerable a person diagnosed with a mental illness is at the hands of mental health authorities. The broad powers of the CTO take away his right to decide what treatment he wants, as well as making his liberty conditional on compliance with the terms of the CTO (s 57). In addition, a mental health team is able to medicate Michael without his consent (s 57). The power vested in mental health staff to forcibly remove Michael from the community for a breach of the CTO, transport him to a declared mental health facility (s 58) and keep him there against his will (s 61) is alarming. Perhaps most disturbing, though, is the ability of the police to intervene in Michael’s life despite the absence of any criminality.
Any resistance displayed by Michael to the terms of the CTO or the treatment forced upon him is seen as a lack of capacity or insight into what is in his best interests. Such objections are taken as confirmation of his diagnosis and act to reinforce the initial justification for the use of force. The CTO essentially takes away Michael’s ability to make his own decisions regarding his treatment and his life while a failure to comply results in his liberty being taken away.
Outraged at his brutalisation at the hands of the mental health authorities and the systemic stripping away of his fundamental human rights, Michael is prepared to talk about his experiences in order to raise awareness of the problems he has encountered in the mental health system. After years of indignity, Michaels’ frustration finally came to a head in November 2013 when his CTO was again renewed, despite the presentation of an advanced directive that had been put together to provide Michael with a community-based, supportive and therapeutic alternative to the strict and overly intrusive CTO.
He is able to clearly and articulately state his resistance to the abuses of power he has experienced. But even this choice could not be made without a battle. Due to the structure of the Mental Health Act, Michael was required to ask the Mental Health Review Tribunal for consent to use his own name in discussing his experiences – a fundamental right that is taken away under the legislation (s 68). The blanket prohibition imposed by the Act is supposedly in place for the protection of the patient who is assumed to be incapable of fully comprehending the damage they may cause themselves by associating their name with a mental illness in the public sphere. In reality, however, this prohibition, which also applies to Tribunal members, functions to reduce the accountability and transparency of the MHRT’s proceedings (see Right to Identity – s 162 Application for more information).
It is this lack of accountability and transparency that Michael is most passionate about exposing and hopefully reforming. He and Justice Action feel that unless there is a significant change in this area, people who are already at a social and often financial disadvantage will continue to have their rights and autonomy taken away from them with little avenue for effective recourse. People who are diagnosed with a mental illness require support and deserve to have their dignity maintained. Paternalistic, interventionist and overbearing systems are more likely to damage their mental state than help to nurture or repair it.