Community Treatment Orders

What to do if you’re recalled to hospital under a Community Treatment Order (CTO). (T123)


If you’ve been detained in hospital, you might be told you can leave by a Community Treatment Order (CTO).

But a CTO gives your psychiatrist the power to recall you to hospital if necessary for your safety or the safety of others.

Appeal a CTO

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

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

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 psychiatrist
  • a third member with knowledge and experience of people who have mental health difficulties

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

Your case will also be referred at 3-year intervals if you make no application.

If you are 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 using Form T128: Options for your tribunal referral hearing. You’ll have to do this by the date given to you by the tribunal.

The tribunal can then decide your case by reading the reports.

If you want your CTO to be discharged you should attend the hearing. The tribunal will ask for reports from your psychiatrist, and from the team that provides your care in the community.

What the tribunal will consider

The supervising hospital must satisfy the tribunal that:

  • 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 psychiatrist 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 in a hospital in private, 7 to 10 weeks after the application or referral is received by the tribunal office. It will take about an hour.

The tribunal will give written medical and social circumstances reports to tribunal members, and to you or your representative. It will do this on the day of the hearing, if not before.

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 tell a solicitor to advise and represent you at the hearing. Your hospital or care coordinator should have access to a list of solicitors in your area who specialise in mental health law. You might be able to get free help.

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.

If you do not attend

If you do not attend, the tribunal can decide to go ahead without you. It will then decide your case on the basis of reports, witnesses and any other evidence.

The decision

The tribunal will usually tell you the decision on the day of the hearing, if you attend.

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

Appeal a 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 & 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
Last updated 21 March 2019 + show all updates
  1. Email address amended.

  2. First published.