Excessive use of community treatment orders has changed how patients view community psychiatric nurses, the Care Quality Commission has said.
CTOs are used to force mental health patients to take their medication when being cared for in the community.
In a report last week, the CQC found the number of CTOs being applied had risen 10 fold since their introduction in November 2008 to an average 367 a month.
The inspectorate found that, in a sample of CTO patients, 30 per cent had no history of refusing to take medication or of not cooperating with community services.
The finding suggests that, in contrast to original intentions to use the orders only when patients are at risk of not complying with their medication, in about one third of cases they were being used as a precautionary or preventative measure.
As a patient’s compliance with a CTO is often monitored by a community psychiatric nurse, the CQC said the orders had changed the way patients perceived their nurses, as well as how nurses perceived themselves – turning them into a more authoritarian than caring figure.
The report’s main author policy analyst Mat Kinton told Nursing Times that in some cases CTOs bred “complacency” as mental health trusts felt that, as long as a patient was being forced to take their medication, their duty of care was at an end.
“The very worst ones we have seen are where people come into a clinic once a month to pick up their pills or get a jab and that is the entire extent of the engagement with them,” he said.
The report also found black and minority ethnic patients were being disproportionately subjected to CTOs – a finding Mr Kinton described as “very worrying”.
“We are concerned that there are more patients from some of the BME groups placed on a CTO, ” he said.