Sir: I think Professor Burns (Psychiatric Bulletin, November 1999, 23, 647-648) is quite right to point out that most psychiatrists can think of ‘a handful’ of patients who would truly benefit from a Community Treatment Order (CTO). The criticism though that Moncrieff & Smyth are posing the wrong question (Psychiatric Bulletin, November 1999, 23, 644-646) “How can psychiatry control antisocial behaviour?” is slightly unfair. The genesis of the currently proposed reforms can be traced back to Frank Dobson's widely publicised comments on the Michael Stone case, that community care had failed because psychiatrists had not been using their power to treat people in the community. Of course psychiatry possessed no such power at the time of Mr Dobson's ill-informed comments, but Mr Dobson never retracted this statement and the government has gone on to propose CTOs. College caveats aside, it is, therefore, correct to view the CTO as the Government's attempt to hold psychiatrists accountable for the behaviour of dangerous people who have had contact with psychiatric services.
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