Tvangsinnleggelser og tvangsretensjon i psykiatriske institusjoner-en sammenligning av regelverk og praksis i de skandinaviske land

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Abstract
The present paper deals with compulsory admissions to psychiatric institutions in Scandina via. In the first part, some historical reflections are given. It seems that the mental health acts occur and are revised simultaneously in each country. Major reforms seem to follow periods of progress in medicine and are based on optimistic attitudes towards treatment possibilities. What the actual situation concerns, admission rates are discussed in relation to the existing mental health acts in the different countries. It is shown that these admission rates vary considerably between the Scandinavian countries, regarding total admissions and compulsory admissions. In Sweden the number of compulsorily admitted patients per 100,000 inhabitants is 248, in Norway 109 and in Denmark 26 (1982 figures). It is difficult to explain the differences demonstrated without including cultural aspects as well as different attitudes towards compulsion. Furthermore, procedures for carrying out compulsion as well as requirements for detention are discussed. It is worth mentioning that both in Sweden and Denmark voluntarily admitted patients can be retained involuntarily once inside the hospital, while this is impossible in Norway. The formal requirements for this retainment are extremely weak in Denmark. The opportunities offered to patients to oppose the decision on compulsory retainment are also discussed. Finally, some strategies for reducing compulsion are mentioned. To achieve this, one could narrow the criteria given in the mental health act, and exclude legislation that allows compulsory admissions for the reasons of the treatment possibilities given.

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