Blurred boundaries: Community treatment orders as instruments of racial surveillance

The Mental Health Act 1983 (MHA) authorizes the compulsory detention and treatment of people with mental disorders who are perceived to pose a risk to themselves or to others. Since its enactment, there have been concerns that the coercive powers of the Act have been disproportionately used for Black people with mental disorders. This disproportionate impact of the MHA on Black people is most clearly seen in the excessive use of Community Treatment Orders (CTOs). Although there is limited evidence on the effectiveness of CTOs, they continue to be used increasingly in the care of Black people, with latest data showing that Black people are over seven times more likely to be issued CTOs than White people (National Health Service Digital, 2024). This is particularly concerning as CTOs are commonly perceived as intrusive and have been described as a form of racial surveillance. In this paper, we explore the idea of CTOs as instruments of racial surveillance and argue that their continued use in the care of Black people with mental disorders is an extension of the intrusive powers of the State and might constitute a form of racial injustice.