A bit of a random post, but recently I was interviewed about my experiences of CETRs, and so I thought I’d explain a bit about them (and why the whole system needs sorting out!)!

Care, Education and Treatment Reviews, known as CETRs, are assessments that provide a list of recommendations for hospitals on how to adapt treatment and what accomodations to provide, in order to support a young person who is autistic or disabled. They’re meant to be carried out before or as soon as an individual is admitted to hospital, and the idea of them is to avoid the experience being distressing, or potentially damaging, for the young person.

When you have a CETR review, a panel of professionals and people with lived experience talk to you, your family, and the hospital staff, to discuss the support you might need, your treatment, and what is possible or not possible. It tends to last a few hours.

The panel, after listening to everyone’s views and opinions, create a list of recommendations. For example, some of mine were:

• Early discharge, because they acknowledged that the hospital would never be a positive environment for me long term
• To be allowed to eat later in the day – because I struggled with the timetable, which was not like my own, and this was causing me a lot of distress
• To be allowed to sleep on the floor – because, due to trauma, I find sleeping in a bed very distressing
• To be allowed hot milk – because I like my cereal soft and mushy, and this texture is something sensory wise I find very comforting, rather than it being an eating disorder behaviour
• Specific goals to be outlined and a timeline made so I can visualise my treatment, so it feels less overwhelming and unknown

What are the problems with them?
Unfortunately, when I was in hospital, the staff refused to do many of the recommendations, either delaying them, making up excuses, or sort of half-doing them. This meant that in reality, my treatment did not change much, and I continued to struggle. One of the biggest problems with CETRs is that no one checks they are enforced.
Another issue is how often they are carried out, and awareness of them. No one even discussed the idea of a CETR with me until my tenth long term admission, and it took over three months before it actually happened, by which time I was already very distressed.

What are the proposed changes?
In the current new proposals for the mental health act, CETRs will be required every 12 months.

Will things change?
Personally – I don’t think so. 12 months is still a very long interval, which means CETRs are likely to feel outdated and be ineffective when they’re actually needed. Furthermore – there’s still no legislation enforcing them, so hospital staff are able to ignore them, and not actually provide the incredibly important recommendations.

In principle, CETRs are a great idea – but right now, they’re just not doing what they’re meant to.
Have you heard of them before? What was your experience?