Compulsory Community Care in New Zealand Mental Health Legislation 1846-1992

Community treatment orders are considered a new development inmental health care and are consistent with current New Zealand mental health policy ofcare in the community. However, since its first adoption in 1846, New Zealand mentalhealth legislation has always made provision for compulsory mental health care out ofhospital. Analysis of the text of each of the five iterations of mental healthlegislation shows that an initial (1846) provision for a friend or relative to take acommitted patient into his or her care, as an alternative to committal to hospital,continued though various revisions until its current expression as a community treatmentorder. Using Rochefort’s model of change in mental health policy, we argue that a longstatic period until 1911 was followed by progressive change throughout the 20th century,although provision for compulsory out-of-hospital care has been continuous over the lifeof New Zealand’s legislation. In the late-20th century, compulsory mental health care istied to medical treatment and mental health service surveillance of the patient’s socialcircumstances. We conclude with recommendations for how reformed legislation maycontribute to future mental health policy by giving effect to agendas of positive rightsand social inclusion