This is the fifth national census of the ethnicity of inpatients in NHS and independent mental health and learning disability services in England and Wales, conducted on 31 March 2009 and undertaken jointly by the Healthcare Commission, the Mental Health Act Commission (MHAC), the Care Services Improvement Partnership and the National Institute for Mental Health in England (NIMHE). While it follows a similar census carried out each year since 2005, this year it also includes all patients who were subject to a Community Treatment Order (CTO), which were introduced in 2008 following changes to the Mental Health Act 1983.