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CTO Recall Criteria — MRCPsych Paper B MCQ

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HardMental Health LawCTO Recall CriteriaMRCPsych Paper B

A 35-year-old man with schizophrenia is subject to a community treatment order (CTO) in England. One condition requires him to attend a community clinic for routine administration of his depot antipsychotic. He misses one such appointment; this was not an appointment to make himself available for medical examination in relation to CTO extension or a Part 4A certificate. He remains contactable, is not acutely unwell and denies suicidal or violent intent. His responsible clinician is considering recall under section 17E of the Mental Health Act 1983. Which condition must be satisfied for recall on the basis of this missed appointment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — He requires medical treatment in hospital for mental disorder and there would be a risk of harm to his health or safety, or to other persons, if he were not recalled

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

B is correct. On the clinical ground in section 17E(1), the responsible clinician must consider both that the patient requires medical treatment in hospital for mental disorder and that there would be a risk of harm to the patient's health or safety, or to others, if he were not recalled. A is the classic error: non-compliance with a condition may be taken into account, but the Act expressly states that recall is neither confined to nor triggered by breach alone — the clinical test must still be met, and here the man is not acutely unwell. E invents a non-existent 'two strikes' rule. C and D fail because recall is a power personal to the responsible clinician, exercised by written notice (Form CTO3); relatives and GPs have no such power, although their concerns may inform risk assessment. The separate ground of non-compliance with a mandatory condition to be available for examination is excluded by the stem.

Reference: Mental Health Act 1983, sections 17B(6)–(7) and 17E (power to recall a community patient to hospital), as inserted by the Mental Health Act 2007, Part 1 Chapter 4 — legislation.gov.uk. https://www.legislation.gov.uk/ukpga/2007/12/part/1/chapter/4