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Decision-Making in Community Treatment Orders: A Comparison of Clinicians and Mental Health Review Board Members

Objective: The aim of this paper is to determine the level of consistency in decision-making between mental health clinicians and members of the Mental Health Review Board regarding Community Treatment Order (CTO) discharge. Method: Vignettes were composed by the first author and shown to 50 senior clinicians and 50 members of the Victorian Mental Health Review Board who were asked to indicate whether or not they would discharge the described patients from their current CTO and to justify their decision. Participants were also asked to comment on the usefulness of clinical guidelines which the first author developed to assist decision-making in this area. Results: In the main, there was concordance between the ratings of clinicians and VMHRB members. The guidelines were perceived to be useful. Conclusions: The agreement between clinicians and MHRB members suggests that the Mental Health Act in this area is clinically meaningful and able to be applied reliably.