ABSTRACT Community Treatment Orders (CTOs) have developed rapidly in England and Wales to become a substantial legal intervention. Mixed methods were used to analyse CTOs as one intervention in a complex mental health system and its relationship with social factors. CTOs are used more than expected, with a high number of revocations and renewals. Less than half of CTOs are discharged on time. Service users experience multiple social disadvantages and isolation. They value the stability of a relationship with a care coordinator, but are ambivalent about medication, and can have negative feelings about coercion. Those experiencing recovery tend to initiate social activities, but have poor engagement in care plans, tribunals and reviews. CTOs reduce compulsory hospitalisation, but give rise to human rights issues in the community. Without major social investment to support those with chronic mental health conditions, CTOs may remain the best compromise to balance the demands and requirements of legal and health policy.

中文翻译：

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社区治疗令和社会因素：心理健康系统中的复杂旅程

摘要 社区治疗令 (CTO) 在英格兰和威尔士迅速发展，成为一项实质性的法律干预措施。使用混合方法分析 CTO 作为对复杂心理健康系统的一种干预及其与社会因素的关系。CTO 的使用比预期的要多，撤销和续约的次数很多。不到一半的 CTO 按时出院。服务使用者经历多种社会劣势和孤立。他们重视与护理协调员关系的稳定性，但对药物治疗持矛盾态度，并且可能对胁迫产生负面情绪。那些经历康复的人倾向于发起社交活动，但在护理计划、法庭和审查方面的参与度很低。CTO 减少了强制住院治疗，但会引起社区的人权问题。