{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:57:50Z","timestamp":1785491870703,"version":"3.56.0"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100031616","name":"St Lawrence College","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031616","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persons involved in compulsory mental health treatment\u2014including clinicians, lawyers, service users, and family members\u2014frequently express dissatisfaction with how the system is regulated and administered. Policy discussions on improving the system often fail to consider the voices of service users and family members. Policy development must also grapple with the contested values of autonomy and wellbeing, and the associated disjuncture in professional views. Community treatment orders (CTOs) are a key mechanism of compulsory mental health treatment in Ontario, and many other jurisdictions. We studied views on CTOs in Ontario to identify agreement across groups about where and how the system ought to be improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted semi-structured individual interviews followed by mixed focus groups including 72 participants: healthcare professionals, lawyers, tribunal members, service users (\u201cclients\u201d), family members, and advocates. Interview data were analyzed to identify recurring concerns and inform focus group discussion topics. Focus groups explored potential areas of alignment across participant groups, with particular attention to points of consensus. A lived-experience advisory panel informed study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across participant groups, 6 main areas of agreement were visible. Participants identified the need for: (1) increased client involvement in treatment decisions, even within compulsory frameworks; (2) improved police involvement during CTO enforcement; (3) improved availability and quality of CTO-related data, enabling evaluation, accountability and attention to equity; (4) enhanced guidance and support for substitute decision-makers; (5) stronger oversight of medical decision-making, though preferred mechanisms varied; and (6) expanded community services\u2014particularly housing, addiction treatment and case management\u2014viewed as essential for CTOs to be able to have their intended benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows there is meaningful agreement on several areas requiring improvement in Ontario's CTO system. These points of convergence represent promising foundations for policy development, although translation into actionable reform will require further policy work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437261462694","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:02:51Z","timestamp":1784124171000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared Views on Improving Community Treatment Orders: A Qualitative Study in Ontario: Points de vue communs sur l\u2019am\u00e9lioration des ordonnances de traitement communautaire : une \u00e9tude qualitative r\u00e9alis\u00e9e en Ontario"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-5154","authenticated-orcid":false,"given":"Sam","family":"Boyle","sequence":"first","affiliation":[{"name":"Queensland University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Jager","sequence":"additional","affiliation":[{"name":"School of Health Sciences, St. Lawrence College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Laurent","family":"Domingue","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Perron","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Reforming the mental health act: research briefing","author":"Garratt K","year":"2024","unstructured":"Garratt K. 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