On the night of 25 June, two people were killed and several injured when a man opened fire in the center of Oslo. The focus quickly became on what was the motive for the attack, and on the perpetrator’s state of mental health. The PST has had accused Zaniar Matapour on its radar since 2015, partly because he allegedly supported the ideology of extreme Islamism. At the latest in May this year, they conducted a concern interview with him. At the same time as he was in the police spotlight, it was highlighted in several court documents that Matapour has struggled with his mental health. It is not known how the collaboration between the health system and PST has been in Matapour’s case. But on a general basis, PST says that changes to regulations may be necessary, so that they can more easily obtain information from the healthcare system in the cases they work with. Zaniar Matapour pictured by a surveillance camera at a restaurant in Oslo. Photo: The police – PST may wish that the healthcare system is given a better opportunity to share information relevant to preventing serious crime to the PST and the police. This sharing of information must of course not be recorded so that the person concerned can see that something has been shared, says senior advisor Martin Bernsen. PST: – No obligation to obtain health information PST does not comment on Matapour’s case. The questions news has sent are about what kind of information PST requests from the healthcare system, and what they have the opportunity to get, in the cases they work with. Bernsen says that there is no automaticity in the fact that PST is familiar with the health history of people they follow. – PST is not obliged to obtain health information about people we have on our radar, or people with whom we carry out concern interviews. People on PST’s radar can be many, and they are assessed individually, says Bernsen. He says that PST must continuously make thorough assessments of which people they should follow most closely. Where imminent terror is suspected, PST tries to collect as much information as possible. Suspect’s mental health Terror suspect Zaniar Matapour, who killed two and injured many more in the mass shooting in central Oslo on the night of 25 June, has previously had serious mental problems. It appears in several previous judgments. Defendant Bernt Heiberg at the Elden law firm has confirmed to news that the client was previously diagnosed as paranoid schizophrenic, but that he claims to be healthy now. Three court-appointed experts must assess his mental health both at the time of the offense and at the present time and whether he is criminally sane. This week they announced that they still want a forced observation of the accused, since the cooperation with him in prison has not provided sufficient grounds for an assessment of his sanity. It is up to healthcare personnel to assess The challenge is that not all information is possible to obtain. – It is the healthcare system that must decide whether they want to share information with us. It is up to them to make an assessment of what they can share, based on the duty of confidentiality and the regulations today. A bit of the challenge lies here. PST does not necessarily have wider access to health information than other agencies, says Bernsen. According to Bernsen, PST can, on the basis of the Police Register Act, hand over information the other way. So if someone on their radar is suspected of having mental health challenges, it is “natural” for PST to share information with the healthcare system, he explains. Martin Bernsen is a senior advisor in PST. He is speaking on a general basis, and not about the case related to Zaniar Matapour. – At the same time, we are not healthcare personnel, so we cannot necessarily make that assessment alone. But there is no problem for PST to contact the healthcare system in such cases. It is not unusual, although there is no automaticity in our doing it. – It is probably more common that we share information with the healthcare system, than that they come to us with information, continues Bernsen. Healthcare personnel must consider One of the reasons why the healthcare system cannot share information freely is the duty of confidentiality they have towards patients. Among other things, it must ensure that patients feel safe when they give information to healthcare personnel. – The considerations and interests that argue for setting aside the duty of confidentiality must weigh significantly more heavily than the considerations that argue for maintaining silence, writes the Directorate of Health in an e-mail. What kind of information healthcare personnel can nevertheless share with the police and PST is governed by the Healthcare Personnel Act. It allows, among other things, for them to share information to prevent serious harm, and for them to share information when there may be a danger to human life. – The rationale for passing on information will be to counteract the risk of damage of a certain extent, writes the Directorate of Health further. This is what the law on confidentiality says. The Health Personnel Act regulates the exchange of confidential information from the health service to the police and PST. According to Section 31 of the Health Personnel Act, health personnel have a duty to report to the police if necessary to prevent serious injury. In such cases, they can hand over confidential information about a person, even if the person does not consent. According to §23, fourth paragraph of the Health Personnel Act, health personnel have the opportunity to provide information to the police when it is reasonable for “overriding private or public interests”, for example when there is a danger to human life. According to §23, sixth paragraph of the Norwegian Health Insurance Act, information can also be passed on when it is established or clearly assumed in other regulations that the duty of confidentiality shall not be an obstacle to this. A circular has been prepared for healthcare personnel’s right and duty to hand over patient information to the police. A circular has also been drawn up for the health service’s and the police’s responsibility for the mentally ill. The Directorate of Police and the Directorate of Health are now working on updating this circular. In the old circular it says: “Both for the sake of society and for the sake of the individual patient, it is important that the police and the healthcare system strive for communication to the extent that the legislation allows for this. The need for communication is particularly relevant in situations where mentally ill people may pose a risk to their own safety or that of others.” Employees in the healthcare system must assess on a case-by-case basis what to share with PST. And if there is a good enough reason to share. – It requires, to a certain extent, discretionary assessments in the individual situation. The health service itself must answer what routines the individual business has for such assessments. news has not yet received a response from health services in Oslo about how employees experience these regulations in practice. Martin Bernsen in PST is clear that cooperation is important for the security service’s preventive work. At the same time, the responsibility does not rest on them alone. – The understanding of how terror can be prevented in society has moved towards the fact that it is not only PST that must fight terror. It is the responsibility of the whole society. – It is important to ensure that PST has the resources they need, says Minister of Justice Emilie Enger Mehl (Sp). Photo: Ole Berg-Rusten / NTB – In the process of editing a circular Justice Minister Emilie Enger Mehl (Sp) says that there are many considerations to be taken, including when it comes to privacy. She adds that there are no simple assessments in such matters. Mehl says that she has worked together with Health Minister Ingvild Kjerkol over the past year on the sharing of information between health and the police. – We are in the process of revising a circular that deals with this type of incident. We are also open to rule changes if there is a need for it, says Mehl. She says that it is important that we do not generalize and make mental illness in itself a problem, because there are many people who will come across it during their lives. – We must find a balance and protect those who have health challenges without raising suspicion, but at the same time catch those who are at risk of violence, says the Minister of Justice.
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