The Mental Health Act 1983 (MHA) is a coercive piece of legislation that authorises 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 MHA have been disproportionately used for Black people with mental disorders. Even though Black people constitute only 4.2% of the population in England and Wales, data on the use of the MHA in 2021-22 shows that they are over four and a half times more likely to be detained in hospitals under the MHA than White people, and are more likely to be detained more than once. 

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. We shall contend that since there is limited evidence as to the benefits of CTOs to patients broadly and Black patients in particular, the proposed changes to CTOs in the ongoing process of legal reform will not suffice. What is required, we argue, is an abolition of CTOs.