Appeal a community treatment order

How to appeal if you disagree with a community treatment order (CTO) made by your responsible clinician.


If you’ve been detained in hospital, you might be told you can live in the community on a community treatment order (CTO).

However, a CTO gives your responsible clinician (usually your community doctor) the power to recall you to hospital if necessary for your own health and safety, or the safety of others.

Appeal a CTO

If you do not think your responsible clinician should be able to recall you, you can appeal by applying to the First-tier Tribunal (Mental Health) to ‘discharge’ (cancel) the CTO.

If the CTO is discharged, your responsible clinician will not be able to recall you to hospital.

Find out how to apply to the Mental Health Tribunal.

The role of the tribunal

The tribunal is an independent panel that will consider whether the CTO should apply to you.

The tribunal includes:

  • a judge
  • a consultant psychiatrist
  • a specialist member (such as a mental health social worker who has substantial experience of mental health cases)

If 6 months have passed since you were first placed on the CTO and the tribunal has not reviewed the case, then your case must be referred to a tribunal.

Your case will also be referred to the tribunal every 3 years if you do not make an application.

If you are aged 18 or over, you can decide that you do not want to attend or be represented at a referral hearing.

After you apply or your case is referred

The tribunal office will tell you when it has received your application and send you information about your options for the referral hearing.

You or your representative should tell the tribunal office which option you prefer for your tribunal referral hearing. You’ll have to do this by the date given to you by the tribunal.

You can choose to:

  • attend on your own or with a representative
  • not attend but ask a representative to attend on your behalf
  • neither attend yourself nor ask a representative to attend

If you decide not to attend nor send a representative, the tribunal can decide your case by reading the reports.

However, if you want your CTO to be discharged, it would be helpful for you to attend the hearing to give your views.

The tribunal will ask for reports from your responsible clinician and from the team providing your care in the community.

What the tribunal will consider

The supervising hospital must satisfy the tribunal that:

  • you have a mental disorder
  • your mental disorder needs medical treatment
  • medical treatment is necessary for your health and safety or the protection of others
  • appropriate medical treatment is available for you
  • it’s necessary for your responsible clinician to have the power to recall you to hospital

If the supervising hospital does not convince the tribunal on all these points, the tribunal must discharge your CTO.

The hearing

The hearing will usually take place 7 to 10 weeks after the tribunal receives the application or referral.

In person hearings will probably take place where your responsible clinician or community team are based or at another suitable community location.

If you have a video hearing you may be asked to attend a suitable community location or another venue arranged by your representatives, to use a suitable device and internet connection. If you want, you can make your own arrangements to join the hearing remotely by video.

The tribunal will read written medical and social circumstances reports. You or your representative (if you have one) will be sent these reports before the hearing.

The tribunal will hear evidence from witnesses. You and your representative (if you have one) will have a chance to speak to the tribunal. Any other witnesses attending on your behalf may also get an opportunity to speak.

Representation and support

You can have a legal representative with you at the hearing. You do not have to pay for your legal representative but they must be qualified in mental health law. Your hospital or care coordinator should have access to a list of legal representatives in your area who specialise in mental health law.

You can choose to be represented by someone who is not legally qualified instead, as long as they’re not a patient also subject to the Mental Health Act.

You can bring a friend or relative to support you at the hearing.

The decision

The tribunal will usually tell you the decision on the day of the hearing, if you attend and are present for the announcement of the decision.

If you do not attend, you’ll usually be sent a copy of the decision within one week.

Appeal the decision

In certain circumstances you can ask for permission to appeal the decision or ask the tribunal to review it. The tribunal will explain your rights when it sends you the decision.


Customer Service Team
HM Courts and Tribunals Service First-tier Tribunal (Mental Health)
PO Box 8793
5th Floor

Telephone: 0300 123 2201


Find out more about the First-tier Tribunal (Mental Health).

Published 1 April 2014