<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Olav Nyttingnes</style></author><author><style face="normal" font="default" size="100%">Jūratė Šaltytė Benth</style></author><author><style face="normal" font="default" size="100%">Tore Hofstad</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The relationship between area levels of involuntary psychiatric care and patient outcomes: a longitudinal national register study from Norway</style></title><secondary-title><style face="normal" font="default" size="100%">BMC Psychiatry (Open Access)</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Alvorlige psykiske lidelser</style></keyword><keyword><style  face="normal" font="default" size="100%">Coercion</style></keyword><keyword><style  face="normal" font="default" size="100%">Compulsion</style></keyword><keyword><style  face="normal" font="default" size="100%">Involuntary care</style></keyword><keyword><style  face="normal" font="default" size="100%">Mental health legislation</style></keyword><keyword><style  face="normal" font="default" size="100%">Psykisk helse-lovgivning</style></keyword><keyword><style  face="normal" font="default" size="100%">Register study</style></keyword><keyword><style  face="normal" font="default" size="100%">Registerstudie</style></keyword><keyword><style  face="normal" font="default" size="100%">Severe mental disorders</style></keyword><keyword><style  face="normal" font="default" size="100%">tvang</style></keyword><keyword><style  face="normal" font="default" size="100%">Tvangstiltak</style></keyword><keyword><style  face="normal" font="default" size="100%">Ufrivillig omsorg</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2023</style></year><pub-dates><date><style  face="normal" font="default" size="100%">02/2023</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://link.springer.com/article/10.1186/s12888-023-04584-4</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">23</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Background&lt;/h3&gt;&lt;p&gt;Mental health legislation permits involuntary care of patients with severe mental disorders who meet set legal criteria. The Norwegian Mental Health Act assumes this will improve health and reduce risk of deterioration and death. Professionals have warned against potentially adverse effects of recent initiatives to heighten involuntary care thresholds, but no studies have investigated whether high thresholds have adverse effects.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Aim&lt;/h3&gt;&lt;p&gt;To test the hypothesis that areas with lower levels of involuntary care show higher levels of morbidity and mortality in their severe mental disorder populations over time compared to areas with higher levels. Data availability precluded analyses of the effect on health and safety of others.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Methods&lt;/h3&gt;&lt;p&gt;Using national data, we calculated standardized (by age, sex, and urbanicity) involuntary care ratios across Community Mental Health Center areas in Norway. For patients diagnosed with severe mental disorders (ICD10 F20-31), we tested whether lower area ratios in 2015 was associated with 1) case fatality over four years, 2) an increase in inpatient days, and 3) time to first episode of involuntary care over the following two years. We also assessed 4) whether area ratios in 2015 predicted an increase in the number of patients diagnosed with F20-31 in the subsequent two years and whether 5) standardized involuntary care area ratios in 2014&amp;ndash;2017 predicted an increase in the standardized suicide ratios in 2014&amp;ndash;2018. Analyses were prespecified (ClinicalTrials.gov NCT04655287).&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Results&lt;/h3&gt;&lt;p&gt;We found no adverse effects on patients&amp;rsquo; health in areas with lower standardized involuntary care ratios. The standardization variables age, sex, and urbanicity explained 70.5% of the variance in raw rates of involuntary care.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Lower standardized involuntary care ratios are not associated with adverse effects for patients with severe mental disorders in Norway. This finding merits further research of the way involuntary care works.&lt;/p&gt;</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Tore Hofstad</style></author><author><style face="normal" font="default" size="100%">Tonje Lossius Husum</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Bjørn Morten Hofmann</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Geographical variation in compulsory hospitalisation – ethical challenges</style></title><secondary-title><style face="normal" font="default" size="100%">BMC Health Services Research (Open Access)</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Autonomi</style></keyword><keyword><style  face="normal" font="default" size="100%">autonomy</style></keyword><keyword><style  face="normal" font="default" size="100%">Beneficence</style></keyword><keyword><style  face="normal" font="default" size="100%">Coercion</style></keyword><keyword><style  face="normal" font="default" size="100%">Ethical analysis</style></keyword><keyword><style  face="normal" font="default" size="100%">Etisk analyse</style></keyword><keyword><style  face="normal" font="default" size="100%">Involuntary hospitalisation</style></keyword><keyword><style  face="normal" font="default" size="100%">Justice</style></keyword><keyword><style  face="normal" font="default" size="100%">Non-maleficence</style></keyword><keyword><style  face="normal" font="default" size="100%">Rettferdighet</style></keyword><keyword><style  face="normal" font="default" size="100%">Right care</style></keyword><keyword><style  face="normal" font="default" size="100%">Riktig omsorg</style></keyword><keyword><style  face="normal" font="default" size="100%">Service delivery variation</style></keyword><keyword><style  face="normal" font="default" size="100%">small area analysis</style></keyword><keyword><style  face="normal" font="default" size="100%">Småområdestatistikk</style></keyword><keyword><style  face="normal" font="default" size="100%">tvang</style></keyword><keyword><style  face="normal" font="default" size="100%">Ufrivillig sykehusinnleggelse</style></keyword><keyword><style  face="normal" font="default" size="100%">Variasjon i tjenesteleveranse</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">12/2022</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://link.springer.com/article/10.1186/s12913-022-08798-2</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">22</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Background&lt;/h3&gt;&lt;p&gt;Compulsory hospitalisation in mental health care restricts patients&amp;rsquo; liberty and is experienced as harmful by many. Such hospitalisations continue to be used due to their assumed benefit, despite limited scientific evidence. Observed geographical variation in compulsory hospitalisation raises concern that rates are higher and lower than necessary in some areas.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Methods/discussion&lt;/h3&gt;&lt;p&gt;We present a specific normative ethical analysis of how geographical variation in compulsory hospitalisation challenges four core principles of health care ethics. We then consider the theoretical possibility of a &amp;ldquo;right&amp;rdquo;, or appropriate, level of compulsory hospitalisation, as a general norm for assessing the moral divergence, i.e., too little, or too much. Finally, we discuss implications of our analysis and how they can inform the future direction of mental health services.&lt;/p&gt;</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>32</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Tore Hofstad</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Geographical variation in compulsory hospitalisation in Norway 2014-2018</style></title><secondary-title><style face="normal" font="default" size="100%">Universitetet i Oslo</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Geografisk varasjon</style></keyword><keyword><style  face="normal" font="default" size="100%">Tvangsinnleggelse</style></keyword><keyword><style  face="normal" font="default" size="100%">tvangsinnleggelsesrate</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.duo.uio.no/bitstream/handle/10852/98205/1/PhD-Hofstad-2022.pdf</style></url></web-urls></urls><publisher><style face="normal" font="default" size="100%">UiO</style></publisher><pub-location><style face="normal" font="default" size="100%">Oslo</style></pub-location><volume><style face="normal" font="default" size="100%">PhD</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Denne avhandlingen gir en omfattende beskrivelse og analyse av geografisk variasjon i tvangsinnleggelser i psykisk helsevern. Den inneholder viktig ny kunnskap som kan bidra til å redusere uønsket geografisk variasjon, samt bruk av tvangsinnleggelser.&lt;/p&gt;&lt;p&gt;Tvangsinnleggelse innebærer frihetsinnskrenkning og skal kun brukes som siste&amp;nbsp;utvei, og i pasientens beste interesse. Ved å analysere registerdata fra alle som var&amp;nbsp;tvangsinnlagt i Norge mellom 2014 og 2018 tallfestes omfanget av geografisk variasjon. Forskjeller i tvangsinnleggelser kan måles på ulike måter basert på hendelser, personer eller varighet. Dette resulterer i ulike mønstre av geografisk variasjon. Gjennomsnittlig tvangsinnleggelsesrate i studieperioden var seks ganger høyere i det høyest rangerte området, sammenlignet med det laveste. Pasientratene varierte med 3.2, mens variasjonen var åtte ganger større for døgn med tvangsinnleggelse.&lt;/p&gt;&lt;p&gt;&lt;br /&gt;Variasjon innenfor ensartede områder, utover det man kan forvente på bakgrunn av berettigede faktorer, kan antyde at tvang brukes mer enn nødvendig i noen områder. Men det reiser også spørsmål om noen områder greier seg med mindre&lt;br /&gt;tvang enn forventet fordi helsetjenestene bidrar til å redusere behovet for tvangsinnleggelse. I avhandlingen utforskes det derfor hvordan kommunale tjenester for psykisk helse og avhengighet kan bidra til å forklare variasjonen. Ved hjelp av&lt;br /&gt;flernivåanalyse av panel data påvises det sammenhenger mellom tvangsinnleggelsesratene og ulike trekk ved de kommunale tjenestene, både når kommunene sammenlignes med hverandre, og når de sammenlignes med seg selv over tid. Færre&lt;br /&gt;tvangsinnleggelser var forbundet med økt bemanning innen psykisk helse og avhengighet, samt flere fastleger og psykiatriske sykepleiere sammenlignet med gjennomsnittsverdien i kommunene. Områder med flere fastleger og kommunale boliger&lt;br /&gt;per innbygger hadde i snitt færre tvangsinnleggelser. Disse funnene støtter tanken&amp;nbsp;at bruk av tvangsinnleggelser kan reduseres. Men de antyder også at tilfanget av&amp;nbsp;lokale tjenester er forbundet med hvorvidt en tvangsinnleggelse oppfattes som&amp;nbsp;nødvendig.&lt;/p&gt;</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Tore Hofstad</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Solveig Osborg Ose</style></author><author><style face="normal" font="default" size="100%">Olav Nyttingnes</style></author><author><style face="normal" font="default" size="100%">Solveig Helene Høymork Kjus</style></author><author><style face="normal" font="default" size="100%">Tonje Lossius Husum</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Service Characteristics and Geographical Variation in Compulsory Hospitalisation: An exploratory random effects within-between analysis of Norwegian municipalities 2015-2018</style></title><secondary-title><style face="normal" font="default" size="100%">Frontiers in Psychiatry</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Geografisk varasjon</style></keyword><keyword><style  face="normal" font="default" size="100%">tjenestetilbud</style></keyword><keyword><style  face="normal" font="default" size="100%">Tvangsinnleggelse</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2021</style></year><pub-dates><date><style  face="normal" font="default" size="100%">12/2021</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737698/full?</style></url></web-urls></urls><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt;&amp;nbsp;Compulsory hospitalisation in mental healthcare is contested. For ethical and legal reasons, it should only be used as a last resort. Geographical variation could indicate that some areas employ compulsory hospitalisation more frequently than is strictly necessary. Explaining variation in compulsory hospitalisation might contribute to reducing overuse, but research on associations with service characteristics remains patchy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives:&lt;/strong&gt;&amp;nbsp;We aimed to investigate the associations between the levels of compulsory hospitalisation and the characteristics of primary mental health services in Norway between 2015 and 2018 and the amount of variance explained by groups of explanatory variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;&amp;nbsp;We applied random-effects within&amp;ndash;between Poisson regression of 461 municipalities/city districts, nested within 72 community mental health centre catchment areas (&lt;i&gt;N&lt;/i&gt;&amp;nbsp;= 1,828 municipality-years).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt;&amp;nbsp;More general practitioners, mental health nurses, and the total labour-years in municipal mental health and addiction services per population are associated with lower levels of compulsory hospitalisations within the same areas, as measured by both persons (inpatients) and events (hospitalisations). Areas that, on average, have more general practitioners and public housing per population have lower levels of compulsory hospitalisation, while higher levels of compulsory hospitalisation are seen in areas with a longer history of supported employment and the systematic gathering of service users&amp;#39; experiences. In combination, all the variables, including the control variables, could account for 39&amp;ndash;40% of the variation, with 5&amp;ndash;6% related to municipal health services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt;&amp;nbsp;Strengthening primary mental healthcare by increasing the number of general practitioners and mental health workers can reduce the use of compulsory hospitalisation and improve the quality of health services.&lt;/p&gt;</style></abstract><label><style face="normal" font="default" size="100%">Tvangsinnleggelse</style></label></record></records></xml>