Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order

Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Nina Camilla Wergeland [verfasserIn] Åshild Fause [verfasserIn] Astrid Karine Weber [verfasserIn] Anett Beatrix Osnes Fause [verfasserIn] Henriette Riley [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences

Übergeordnetes Werk:	In: BMC Health Services Research - BMC, 2003, 22(2022), 1, Seite 10
Übergeordnetes Werk:	volume:22 ; year:2022 ; number:1 ; pages:10

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12913-022-07892-9

Katalog-ID:	DOAJ009344039

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520			\|a Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices.
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700	0		\|a Henriette Riley \|e verfasserin \|4 aut
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allfields	10.1186/s12913-022-07892-9 doi (DE-627)DOAJ009344039 (DE-599)DOAJ1381e235c0e04295b556e3ab6334e3d2 DE-627 ger DE-627 rakwb eng RA1-1270 Nina Camilla Wergeland verfasserin aut Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine Åshild Fause verfasserin aut Astrid Karine Weber verfasserin aut Anett Beatrix Osnes Fause verfasserin aut Henriette Riley verfasserin aut In BMC Health Services Research BMC, 2003 22(2022), 1, Seite 10 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:22 year:2022 number:1 pages:10 https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/article/1381e235c0e04295b556e3ab6334e3d2 kostenfrei https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 10
spelling	10.1186/s12913-022-07892-9 doi (DE-627)DOAJ009344039 (DE-599)DOAJ1381e235c0e04295b556e3ab6334e3d2 DE-627 ger DE-627 rakwb eng RA1-1270 Nina Camilla Wergeland verfasserin aut Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine Åshild Fause verfasserin aut Astrid Karine Weber verfasserin aut Anett Beatrix Osnes Fause verfasserin aut Henriette Riley verfasserin aut In BMC Health Services Research BMC, 2003 22(2022), 1, Seite 10 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:22 year:2022 number:1 pages:10 https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/article/1381e235c0e04295b556e3ab6334e3d2 kostenfrei https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 10
allfields_unstemmed	10.1186/s12913-022-07892-9 doi (DE-627)DOAJ009344039 (DE-599)DOAJ1381e235c0e04295b556e3ab6334e3d2 DE-627 ger DE-627 rakwb eng RA1-1270 Nina Camilla Wergeland verfasserin aut Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine Åshild Fause verfasserin aut Astrid Karine Weber verfasserin aut Anett Beatrix Osnes Fause verfasserin aut Henriette Riley verfasserin aut In BMC Health Services Research BMC, 2003 22(2022), 1, Seite 10 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:22 year:2022 number:1 pages:10 https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/article/1381e235c0e04295b556e3ab6334e3d2 kostenfrei https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 10
allfieldsGer	10.1186/s12913-022-07892-9 doi (DE-627)DOAJ009344039 (DE-599)DOAJ1381e235c0e04295b556e3ab6334e3d2 DE-627 ger DE-627 rakwb eng RA1-1270 Nina Camilla Wergeland verfasserin aut Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine Åshild Fause verfasserin aut Astrid Karine Weber verfasserin aut Anett Beatrix Osnes Fause verfasserin aut Henriette Riley verfasserin aut In BMC Health Services Research BMC, 2003 22(2022), 1, Seite 10 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:22 year:2022 number:1 pages:10 https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/article/1381e235c0e04295b556e3ab6334e3d2 kostenfrei https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 10
allfieldsSound	10.1186/s12913-022-07892-9 doi (DE-627)DOAJ009344039 (DE-599)DOAJ1381e235c0e04295b556e3ab6334e3d2 DE-627 ger DE-627 rakwb eng RA1-1270 Nina Camilla Wergeland verfasserin aut Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices. Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine Åshild Fause verfasserin aut Astrid Karine Weber verfasserin aut Anett Beatrix Osnes Fause verfasserin aut Henriette Riley verfasserin aut In BMC Health Services Research BMC, 2003 22(2022), 1, Seite 10 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:22 year:2022 number:1 pages:10 https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/article/1381e235c0e04295b556e3ab6334e3d2 kostenfrei https://doi.org/10.1186/s12913-022-07892-9 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 10
language	English
source	In BMC Health Services Research 22(2022), 1, Seite 10 volume:22 year:2022 number:1 pages:10
sourceStr	In BMC Health Services Research 22(2022), 1, Seite 10 volume:22 year:2022 number:1 pages:10
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topic_facet	Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences Public aspects of medicine
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container_title	BMC Health Services Research
authorswithroles_txt_mv	Nina Camilla Wergeland @@aut@@ Åshild Fause @@aut@@ Astrid Karine Weber @@aut@@ Anett Beatrix Osnes Fause @@aut@@ Henriette Riley @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
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The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. 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spellingShingle	Nina Camilla Wergeland misc RA1-1270 misc Coercion misc Community treatment order misc Outpatient commitment misc Capacity to consent misc The Mental Health Care Act misc Patient experiences misc Public aspects of medicine Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order
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topic_title	RA1-1270 Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order Coercion Community treatment order Outpatient commitment Capacity to consent The Mental Health Care Act Patient experiences
topic	misc RA1-1270 misc Coercion misc Community treatment order misc Outpatient commitment misc Capacity to consent misc The Mental Health Care Act misc Patient experiences misc Public aspects of medicine
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title	Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order
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title_full	Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order
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title_sort	increased autonomy with capacity-based mental health legislation in norway: a qualitative study of patient experiences of having come off a community treatment order
callnumber	RA1-1270
title_auth	Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order
abstract	Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices.
abstractGer	Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices.
abstract_unstemmed	Abstract Background Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights. The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation. Method Individual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics. Results Almost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment. Conclusion The introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients’ wishes. Systematic assessment of capacity to consent seems to increase the focus on patients’ condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices.
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title_short	Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order
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Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order

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