– I still shudder when I think about it. A few hours after I called for help, he took the life of a random person. I have trouble understanding it. Elisabeth Werp talks about what happened five years ago. One September day, she met her then 27-year-old friend at a restaurant at Frogner in Oslo. The man, who had a serious psychiatric diagnosis, appeared confused and scared. He wanted to eat his food on the floor, shook his hands and cried and screamed as she tried to calm him down. When the friend ran from the restaurant, Werp called 113. Shortly afterwards, she followed from a distance when a police patrol stopped him. Werp breathed a sigh of relief and went his way. The next day she learned that her friend had become a murderer. On Nakkholmen, it was the cabin resident Thoralf Eriksen (59) who was killed. Photo: Private Photo: Private – He was not taken or posted anywhere. Instead, he had to move on, got lost on board a boat and out to one of the islands in the Oslo Fjord. There he ended up killing a wild stranger. The victim was named Thoralf Eriksen and was a cabin resident on Nakkholmen. Eriksen’s closest relatives are aware that news is covering the case. They too are wondering how this type of assignment is solved on the streets in Norway’s largest city. The murder was committed at the ferry berth on Nakkholmen on 13 September 2017. Photo: Terje Pedersen / NTB scanpixPhoto: Terje Pedersen / NTB scanpix Wants a “psychic car” In the judgment from Oslo District Court, it appears that it was not only the police who assessed the man. “Eventually there will also be an ambulance, but they choose to let him go instead of presenting him for a medical examination, as according to the report he appeared calm and adequate,” the court writes. No one knows if employees in a so-called psychiatric ambulance would be able to prevent what happened. But even before this murder, the Oslo police had worked for five years to get a specially adapted unit for emergency response. Two other Norwegian cities had tried it out: Bergen and Stavanger. And Erna Solberg’s government had written in the Sundvolden declaration that it should be introduced in several places in the country. What are psychiatric ambulances? There are two things in particular that differentiate psychiatric ambulances from regular ambulances. In Bergen, the psychiatric ambulance is: Staffed with three employees, and not two, on all assignments. One ambulance worker and two nurses with psychiatric expertise. Decorated differently. There are no sharp edges, spacious around the patient seat and all equipment is in closed cabinets and shelves. More inquiries Neither in Oslo nor in other cities have psychiatric ambulances appeared after the government’s promise. Now the police in the capital are asking again where they have gone. – We are surprised that health is not able to get something like that in place, when we see the success in both Bergen and Stavanger, says police inspector Martin Strand. Police Inspector Martin Strand in Oslo wants a similar emergency unit as they have in Bergen and Stavanger. Photo: Anders Fehn / NRKPhoto: Anders Fehn / news When news this winter mapped all murders in Oslo over the past ten years, it emerged that more than half of the convicts had a serious mental illness when they committed the murder. In 2014, news conducted a similar survey which created a great deal of debate. Even then, one of the topics was the police’s many psychiatric assignments and the then Minister of Health Bent Høie (H) promised to introduce its own ambulances. Dealing with the mentally ill is not just a matter of competence. For the police, it is also about using resources. Across the country, the police are registering more and more health-related inquiries about moving out on assignments. All inquiries are registered in what is called the Police Operative System (PO). Over the course of five years, the annual number has increased from 37,000 to just over 53,000. The police have not moved out every time they have been called, but they believe that the increase is a clear indication that psychiatry is demanding more and more of them. – The police have scarce resources and try to manage these in the best possible way. When we get a lot of these assignments, it goes beyond other things, says Strand. May not use coercion In recent years, the regional health authorities have tried different solutions. The goal has been to ensure good and dignified transport of this type of patient. Former Prime Minister Erna Solberg (H) says that the experiences led to them not moving forward with their own psychiatric ambulances. – They showed that it is more important to have general competence in everyone in the ambulance service, instead of creating a new special ambulance. Oslo University Hospital is among those who have chosen to go for this solution. – We have trained all personnel to be able to handle these situations, says ambulance manager Ola Borstad. Ambulance manager Ola Borstad at Oslo University Hospital. Photo: Anders Fehn / news Photo: Anders Fehn / news He says there is a municipal team in Oslo, a so-called Social and Outpatient Emergency Service, which he believes solves many of the tasks a psychiatric ambulance would take. In addition, many situations will in any case require assistance from the police because health personnel are not allowed to use coercion outside the institution, according to Borstad. – It is a challenge when it comes to caring for patients who do not want to join, or who are a danger to themselves or to us. Therefore, we depend on good cooperation with the police. Success in the west Both in Bergen and in Stavanger, the psychiatric ambulances are described as a great success. They have had the offer since 2005 and 2010. Several big cities should try the same thing, says section manager Jarle Lexau at Haukeland University Hospital. Jarle Lexau has good experiences with the psychiatric ambulance service. Photo: Christine Fagerbakke / NRKPhoto: Christine Fagerbakke / news – I think there must be an absolute need in the largest places in the country. But how one chooses to organize must be up to each individual health trust, he says. Lexau cannot answer whether the psychiatric ambulance has helped to avert serious incidents such as murder. But he says they have averted many suicides. As many as 25 percent of the assignments are related to this, Lexau says. The police continue to assist Also in Bergen, the police often have to assist, and this happens on an ever-increasing proportion of assignments for the psychiatric ambulance. The proportion of assignments with the mentally ill in which the police have been involved has increased from every fifth assignment in 2014 to every third in 2021. One explanation may be that from 2019 there has been a 24-hour psychiatric ambulance on weekends, a time where intoxication and psychiatry are more often combined. Thus, there may be more need for police assistance. But when the psychiatric ambulance is involved, the police spend less time per assignment because they do not have to take care of the transport and follow-up. Therefore, the police in Bergen believe that the psychiatric ambulance is a good resource. – It solves many assignments on its own. It is resource-saving for the police and for the benefit of the patient. When there is a need for assistance, we have a good dialogue with the psychiatric ambulance around assignment solutions, says police superintendent Kjetil Øyri in the West police district. – Burdened with shame For Elisabeth Werp in Oslo, the incident from 2017 is still going on. In court, her friend was declared criminally insane after the murder on Nakholmen. He was sentenced to compulsory mental health care. – Even though he was psychotic, he managed to appear quite tidy to the patrol that stopped him on the street, Werp says. – We need trained personnel who see through such things. My friend later said he wished he had been taken care of that day. He experiences that he ruined the lives of all who were happy with the victim, and also his own life. He is burdened with shame and guilt. The man’s defender, Frode Sulland, has been presented with this article. He thinks it is a good reproduction of the hours before the murder. The perpetrator was in contact with the emergency services just before the murder on Nakholmen in 2017. Photo: ERLEND KINN / news news has asked Minister of Health and Care Services Ingvild Kjerkol (Labor Party) if she will fight for psychiatric ambulances in several places in the country. Kjerkol answers that the transport of the mentally ill is one of the things that she and the Minister of Justice collaborate on. – We are working on this and are looking at the possibility locally that you can try out ways to transport the mentally ill, in a better way and with the right competence. Kjerkol nevertheless emphasizes that it is the health trusts themselves who must consider which solutions are most appropriate. news has asked former Minister of Health Bent Høie for a comment on the case. Høie answers that he does not have the opportunity to say anything because of his new role as state administrator in Rogaland.
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The police in Oslo are still calling for their own psychiatric ambulances – news Oslo and Viken – Local news, TV and radio
