Perspectives on their Quality of Life Provided by Persons with Serious Mental Illness who are on a Community Treatment Order: A Naturalistic Enquiry Involving 'Critical Case Sampling'

Method: A convenience sample of eight persons so afflicted, who were following a community care plan under a CTO, participated in the study. The sample included three males and five females, ranging in age from 32 to 55 years who had been previously hospitalized at the Regional Mental Health Care. A phenomenological approach suitable for uncovering salient themes in the lived experiences of this client group was used. To reduce bias due to interviewing style, each participant was interviewed using the Corring Quality of Life Interview Protocol with additional questions regarding CTO experiences. This method regulated the focus and depth of detail sought across interviews, carried out by four masters level students. Incisive probes and cues helped to reliably tease out symptom and environmental interactions using strategies such as ‗triangulation‘ of multiple perspectives, content saturation and peer de-briefing. Results: Major themes emerged from a constant comparative analysis (an inductive method that eschews trends from the context of each participant‘s experience). These included: the lack of knowledge regarding illness; the need for symptom management despite medication side-effects; the lack of contentment with current social relationships; lack of daily activities; desire for increased activity and meaningful occupation; insufficient awareness of personal strengths; a desire to help others; satisfaction with increased stability in their lives as a result of the planned intervention under a CTO including decreased hospitalizations (despite enduring regular supervision and the resulting loss of control). Conclusions: The results of this study demonstrate that multiple factors contribute to the perceived quality of life when working with persons on a CTO. It is imperative that clients are given the opportunity to discuss which factors have the most profound influence on them and the quality of their lives. The limitations of design including the ‗unblinded‘ methodology and the lack of information on all the services used by clients‘ pre and post-CTO are recognized.