Advocacy Coalitions and Mental Health Policy: The Adoption of Community Treatment Orders in Ontario

In Canada, the provincial level of government is primarily responsible for the provision of mental health-care services. In 2000, the Ontario government introduced community treatment orders (CTOs) as a new instrument for treating the mentally ill. CTOs were more coercive than prevailing practices, allowing mentally ill individuals to be compelled to receive treatment for their mental illness, including pharmacological treatment, on an outpatient basis. Using the advocacy coalition framework, this article explains the introduction of CTOs by identifying the prevailing advocacy coalitions in the Ontario mental health policy subsystem and by examining the power resources available to them in their efforts to influence policy decision makers. Ultimately, the pro-CTO coalition was successful because it had public opinion, information, and credibility advantages that the anti-CTO coalition simply could not match.