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Community Treatment Order

This is information has been mostly reproduced with kind permission from the Sydney Local Health District


What is a Community Treatment Order (CTO)?


A CTO is a legal Order made by the Mental Health Review Tribunal. It provides a community based alternative to involuntary hospitalisation, for people deemed able to be effectively treated out of hospital, and requires a person to accept medication, therapy, rehabilitation or other services for up to 12 months. A CTO can now be issued either in hospital or while living in the community.


CTO's may be renewed if the treating team considers that it is necessary and the Tribunal approves the application. An application for a renewal of a CTO must be presented to the Tribunal before the existing CTO expires. The Tribunal will inform the person in writing of the Hearing and encourage them to attend, but can renew a CTO in the person's absence.


What happens if a person on a CTO refuses treatment?

If the treating team decides that there is a significant risk of deterioration in the mental condition of a person subject to a CTO if they do not receive treatment, then mental health staff can commence a 'breach' process. This involves verbal and written warnings to the person that they must comply with the CTO. If this is unsuccessful, the assistance of the police may be obtained to transport the person to hospital and subsequently to be assessed, treated, admitted or released.




  1. Understanding The Mental Health Act, (September 2011) © 2015 Sydney Local Health District. Available from: (accessed on 23/11/2015)

  2. Centre for Mental Health, Mental Health Act Guide Book (Amended May 2003) © NSW Department of Health 2003.                                                                                                                                     Available from: (accessed on 23/11/2015)


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