The case in summary: • A mother believes that forced treatment is necessary for her drug-addicted daughter to survive, despite the fact that the number of forced decisions has decreased in the last ten years.• The daughter has been addicted to drugs for over ten years and has tried several times to take her own life. She has been in for detoxification several times, but all attempts to become drug-free have been unsuccessful.• The daughter believes that it is not the addiction that is the problem, but the mental disorders she is struggling with. She feels she is not being heard when she says this.• The number of forced decisions under section 10-2 has decreased from 157 decisions in 2013 to 84 forced decisions in 2023. There is uncertainty about why the numbers have decreased and whether forced treatment actually helps.• A research project at Sørlandet Hospital followed 202 patients, of whom 65 were involuntarily hospitalized. Three out of four people forcibly hospitalized answered that they later understood why they were forcibly hospitalized.• The mother believes that forced hospitalization without treatment is no help, and that the daughter needs the right help to get her life back. The summary is made by an AI service from OpenAi. The content is quality assured by news’s journalists before publication. She cannot shake the thought that she might be able to help her daughter, who has been saved from several suicide attempts. – You never get used to such things like mum. What she tells me is that she is not worth anything, says “Berit”. Around the clock, she thinks that something could happen. news has chosen to anonymize the mother’s name and the municipality she lives in out of consideration for her daughter. The daughter has been informed that the mother has been interviewed and has not objected. She herself does not want to meet news. The daughter has been in for detox several times. The motivation to become drug-free can fluctuate during the course of a day. The mother believes forced treatment is the solution, although attempts have been made to do so in the past. But the number of enforcement decisions in Norway has decreased and there is little knowledge about the effect. Several people are worried Berit’s daughter has been addicted to drugs for over ten years. In recent years, she has been linked to a home for drug addiction and psychiatry in a municipality in Østerdalen. So far, all attempts to become drug-free have been unsuccessful. But Berit will not give up. – It is very difficult. It is my daughter who I am very fond of, she says. Photo: Anne Kari Løberg / news The daughter believes that it is not the drug that is the problem. She feels she is not heard when she says it is the mental disorders she needs help for. Several times in the past year there have been calls to prevent her from ending her life. Early this summer at the latest. – I think it’s a cry for help, says Berit, who has daily contact with her daughter by phone. She says her daughter wants to get out of the situation she is in now. Berit and her daughter talk on the phone every day, sometimes several times a day. Photo: Anne Kari Løberg / news Berit hoped for another compulsory decision. She complained to the State Administrator about what she believed to be a lack of measures that work. news has obtained access to the State Administrator of the Interior in the response from the municipality. We do not reproduce details in the answer and anonymise the municipality to avoid the daughter being identified. The municipality has read the response news publishes. The municipality replies that the daughter has been offered close follow-up by FACT with a therapist and psychiatrist. They write that it is difficult because she is often intoxicated or does not want to meet FACT. And that she does not accept the help she is offered. They also indicate that the daughter has had enforcement decisions several times without it having had an effect. Don’t know if it works. It is the County Boards for Child Protection and Social Affairs that decide who is to be forcibly committed. They do so following a request from the municipality in collaboration with the specialist health service. This is a coercive decision by drug addicts: Section 10-2 of the Health and Care Services Act: If someone puts their physical or mental health at risk through extensive and persistent abuse, and if relief measures are not sufficient, it can be decided that the person in question can be taken into a institution designated by the regional health authority for examination and arranging treatment, and is detained there for up to three months. Decisions pursuant to the first paragraph must be made by the Child Protection and Health Board. The tribunal’s decision according to the first paragraph can only be implemented if the institution is professionally and materially able to offer the person in question satisfactory help in relation to the purpose of admission to the institution. The municipality can refrain from implementing a decision if the circumstances so require. If the decision is not put into effect within six weeks, it will lapse. A temporary decision according to the first paragraph can be made by the municipality if the interests the provision is to protect can be significantly damaged if the decision is not made and implemented immediately. Otherwise, the rules in the Child Protection Act §§ 14-22 and 14-23 apply. If a temporary decision has been made, a proposal for a final decision must be sent to the tribunal within two weeks. If the case has not been sent to the tribunal within this deadline, the decision will lapse. (source: Lovdata) The number of compulsory decisions under section 10-2 has decreased from 157 decisions in 2013 to 84 compulsory decisions in 2023. This shows figures that professor at the University of Bergen (UiB) Karl Harald Søvig sits on. He has worked extensively with issues related to coercive measures in welfare law. news has had the figures confirmed by the Central Unit for Child Welfare and Health. Søvig believes that no one knows for sure why the numbers have decreased. There have been no changes to the regulations. – Perhaps it has something to do with how the municipalities handle these matters. There won’t be a case of coercion if the municipality doesn’t ask for it, he says. It is often the next of kin who ask the municipality to put forward a proposal for compulsory hospitalization. – It is very understandable, because the relatives are in a desperate situation. If we were sure that coercion would lead to lasting improvement, we would use coercion more. But we know that coercion is not always the right tool against drug addiction, says Søvig. Law professor Karl Harald Søvig believes the purpose of the enforcement clause is not clear enough. Photo: Sølve Rydland / news He believes that there is too little knowledge about enforcement decisions that really helps. If it helps many people, he says it is disturbing that they are used against so few. But if it has little effect, he believes it is a challenge that so many people are exposed to it. Søvig believes that resources should be allocated to researching who it works for and who it doesn’t work for. He believes the purpose of the legislation relating to coercion is not clear enough. – Should the person be forcibly hospitalized to prevent an overdose tomorrow, or should the person be forcibly hospitalized so that they can be drug-free after discharge, the professor wonders. Almost every third injured patient who receives treatment at Norwegian trauma hospitals is under the influence of drugs. Read about the study here. So an improvement Professor at the Center for Drug and Addiction Research (SERAF) at the University of Oslo, Thomas Clausen, says there are many dilemmas related to coercion. – It is not that it is not possible to get into a treatment position or get good results if you start treatment by force, he says. He took part in a research project at Sørlandet Hospital in the period 2013 to 2017 where they followed 202 patients. 137 were treated voluntarily and 65 were involuntarily admitted. At follow-up six months after discharge, half of the voluntary patients were drug-free, while a quarter of the involuntary patients were. But three out of four people who were forcibly hospitalized answered that they had an understanding afterwards that they were forcibly hospitalized. They were glad that someone cared and took responsibility. – In any case, it shows that it is possible and there is a potential in compulsory treatment, says Thomas Clausen. He says that those who are forcibly admitted often have a worse starting point, with more problematic substance abuse and social situations, than those admitted voluntarily. Therefore, the results are also somewhat worse when compared directly with voluntarily admitted patients. Professor at SERAF Thomas Clausen has researched the use of forced hospitalization of drug addicts. Photo: Roy Pettersen / news Clausen believes it is important that a lot of work is done to establish a relationship with the patient so that it is not experienced as a punishment, but rather an opportunity. And that there is a clear plan with close follow-up between several agencies after the patient has been discharged from the compulsory stay. – I think both large and small municipalities struggle with this, says Clausen. He says it is not unusual for the patient to end up going in and out of treatment for several rounds. This applies both after voluntary but also after forced treatment. New hope in autumn During the weeks news has been working on this case this summer, the situation for Berit’s daughter has changed several times. In late summer, she saw new hope for her daughter. She agreed to voluntary detoxification in order to enter a treatment center for drug addicts elsewhere in the country. But it ended with discharge after a day. Now she is waiting to see if the detoxification institution will take her in again. Berit is unable to give up hope that her daughter can become drug-free. Photo: Anne Kari Løberg / news If it ends up as the last, the mother thinks coercion is the only right thing. But she believes that coercion without treatment is no help. – They’re not out on the streets to get high anymore, of course, but a bed and food don’t make people feel better, she says. – Have you ever thought that now she has to fend for herself? – Yes, but I’m not made that way, says Berit. She believes that if her daughter gets the right help, it is possible that she will get her life back. Published 23.08.2024, at 20.32
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Decisions on compulsory hospitalization of drug addicts have been halved, but no one knows why – news Innlandet – Local news, TV and radio
