| dc.description.abstract | ABSTRACT Understanding and interpreting the process behind compulsory admissions Research question I will investigate how healthcare professionals that make decisions regarding compulsory admissions to mental institutions understand and interpret the criterions listed in the act of mental healthcare , their attitudes and believes regarding the use of force upon patients and lastly their thoughts on the reasons behind the differences in the practicing of compulsory admissions. Background The act of mental healthcare which defines the criterions that have to be present before a person can be committed to treatment is the subject of individual interpretation. There are huge regional differences in the use of compulsory admissions to psychiatric hospitals in Norway ranging from 8 for every 10 000 inhabitants in Førde to 34 for the University Hospital of Northern-Norway. This indicates that the practices could differ. Analytical framework I have used paternalism as my theory for explaining the process behind compulsory admissions. Paternalism revolves around a situation where someone makes decisions for someone else, against that persons wish, but in the person s interest. The person in question is in this connection considered as being irrational, not able to make informed choices. Method and sample 10 relevant healthcare professionals that have responsibilities for taking decisions regarding compulsory admissions where interviewed. The interviews were qualitative and semi-structured and lasted between 60 and 90 minutes. Findings My informants knew the contents of the law well, but their interpretations of the criterions and when too apply them varied. Their attitude towards the benefits and consequences regarding the use of compulsory mental healthcare influences their decisions in the matter. This is related to paternalism, different opinions regarding what is in the best interest of a patient will give different practices. A variety of possible reasons for the differences was presented. Unreliable numbers, distance to hospital, different routines, socio-economic factors, differences is the interpretation of the law, not knowing the law, conflicting signals from government and county doctors, consciously breaking the law in cases with suicidal patients, professional environment etc. Conclusion My informants were all well informed regarding the «act of mental healthcare», but found it challenging to interpret. The interviews gave me the clear impression that the attitudes and believes of the individual healthcare professional regarding the use of compulsory admissions influences their practices. A variety of factors seems to influence the differences in the use of compulsory admissions, the most striking to me is that forced observation after §3-2 often are used even if the main criterion of serious mental disorder is not present. This is a situation where paternalism goes before the law. | eng |