Michelle Elisabeth Myklebust (28) is admitted to a closed ward in psychiatry. She was admitted under compulsion, and expected to be released after a few days. Now almost two years have passed. She is still there. She has also previously been a patient in mental health care, either for longer or shorter periods. During her stay, she has experienced forced drug use several times. Like her body being held down by two, three or four employees. She says she feels vulnerable and powerless. – When several people hold my body tight, it sometimes feels like a real assault. Afterwards I am often stiff and stiff. I may have bruises around my wrists or arms. But I have usually always understood that it was necessary. Doubling since 2015 Staff in psychiatry can use coercive measures if it is “absolutely necessary to prevent the person concerned from harming themselves or others, or to prevent significant material damage”. Short-term detention is one of these coercive measures. It means that one or more people hold the body until the patient has calmed down. In the last six years, there has been a large increase in reported decisions on short-term detention, statistics from the Directorate of Health show. The Directorate does not know why the number has changed, and indicates that there may be several reasons. The biggest increase occurred from 2015 to 2017. It has been more even since then. The coercive measure became law in 2006. It can be used against both voluntarily admitted people and those who are under compulsory protection. Short-term detention is one of four types of coercive measures in mental health care: Isolation: The patient is put behind a locked door without staff present. This means of coercion is the least used. The number of decisions has increased over the past six years. Short-acting medicine: The patient is given medicine to be calm or sedated. The number of decisions has been fairly stable over the past six years. Mechanical restraints: The patient is restrained with, for example, a belt or dressed in special clothing. The number of decisions has been fairly stable over the past six years. Considered less invasive Michelle Elisabeth Myklebust was admitted because she was considered psychotic. The 28-year-old says she may have a different perception of the world than healthy people, and that professionals think she must therefore be careful. According to her, she has been detained by employees two to four times a month. Michelle Elisabeth Myklebust says the staff where she has been hospitalized use short-term restraints to gain control over her. Photo: Michelle Elisabeth Myklebust – In my case, it’s often because I’m so restless and outgoing that I run loose on furniture. Or that I am so lost that I attack someone around me, because I am trying to defend myself from something that is not there. – We have worked to reduce the use of coercion in all healthcare facilities and in the entire professional area. The statistics may be an indication that we are moving towards less intrusive coercive use, says psychiatrist Marianne Kvamsdahl. She is head of the emergency psychiatric department at Akershus University Hospital. – In contrast to the use of mechanical restraints, short-term detention takes place over a shorter period of time. One often sits close to the patient and can talk and calm them down. It seems less invasive to the vast majority of people. But not for everyone. Psychiatrist Marianne Kvamsdahl does not work in the same healthcare company that Myklebust is affiliated with. – What could be the reason why there has not been a decrease in the other coercive measures in parallel with the increase in short-term detention? – I think there could be two reasons. It may be that you try short-term restraint first, but then it does not close and still ends up with the use of mechanical means of coercion. The second could be that more people are admitted under compulsion. There is a perception that patients are sicker when they are admitted, and that they need a bit more time in the ward, says Kvamsdahl. Dangerous method used to regain control Michelle Elisabeth Myklebust is among those who do not believe that short-term detention is necessarily less invasive. – Although I don’t want to be in a belt or held down by employees, it feels the worst when two, three or four people are on top of me. The detention must have happened several times when she has been forcibly medicated with antipsychotics. She has complained about the forced medication. She was supported, shows the reply from the State Administrator. Myklebust understands that coercive drug use is sometimes necessary. – Then it is important to think about what it does to a person to be subjected to coercion. It can have consequences in the short term, but also in the long term. Earlier this year, she started what turned out to be a harmful fasting regimen, which she saw in connection with the fact that she was in the belt for several hours. According to her journal, she lost over 20 kilos in less than two months. It says she was severely malnourished with a risk of renutrition syndrome. She had to be fed via tube. – I felt I had to take control myself to compensate for the control the staff took over me and my body. Clear on what should happen after coercive drug use Myklebust praises the institution she is at for having a sort of debrief between patient and staff after coercive drug use. – Then we as patients get the “right to vote” again. We get the opportunity to tell about what we experienced and think the staff should have done differently. We get to talk to those who were involved in the situation to hear their thoughts and reasoning. news has spoken to one of the employees at the institution who works most closely with Michelle. He says it is very difficult to be the one who has to use coercion, and calls it a brutal power imbalance. Less mystery Many of us will experience one form or another of mental suffering during our lives. The range is large. From mild conditions to serious illness. In 2020, around 15 per cent of all Norwegian men and 22 per cent of all Norwegian women were in contact with a GP or emergency room with psychological symptoms, according to the Norwegian Institute of Public Health. Myklebust wants more openness and less mystery around being a psychiatric patient. Earlier this year, she published the poetry collection “Psychically locked doors” with poems she wrote in the closed ward. Coercive drug use is a theme in several of the poems. Fourteenth day My stomach knots when I see that day. Another round of compulsion. And I don’t agree, even. I want to let go this time, but there are quite a few. I’d rather have a fresh wound, not another stab in my thigh. Every fortnight there will be shameful detention, fights and more. I scream in a small voice: “Stop being so mean!” They don’t listen, I fight for the wrong. No one is on my side. This is not my day. “Complain, can you do it!” But they won’t listen. I try to shout again. But I’ve lost my voice. Poems by Michelle Elisabeth Myklebust
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Michelle Elisabeth Myklebust about what it’s like to experience forced labor – news Trøndelag
