<?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%">Tonje Lossius Husum</style></author><author><style face="normal" font="default" size="100%">Irene Wormdahl</style></author><author><style face="normal" font="default" size="100%">Solveig H. H. Kjus</style></author><author><style face="normal" font="default" size="100%">Trond Hatling</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%">Something Happened with the Way We Work: Evaluating the Implementation of the Reducing Coercion in Norway (ReCoN) Intervention in Primary Mental Health Care</style></title><secondary-title><style face="normal" font="default" size="100%">MDPI</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">co-creation</style></keyword><keyword><style  face="normal" font="default" size="100%">complex intervention</style></keyword><keyword><style  face="normal" font="default" size="100%">Deltakende forskning</style></keyword><keyword><style  face="normal" font="default" size="100%">implementation research</style></keyword><keyword><style  face="normal" font="default" size="100%">Implementeringsforskning</style></keyword><keyword><style  face="normal" font="default" size="100%">Involuntary admission</style></keyword><keyword><style  face="normal" font="default" size="100%">Kompleks intervensjon</style></keyword><keyword><style  face="normal" font="default" size="100%">Mental health services</style></keyword><keyword><style  face="normal" font="default" size="100%">participatory research</style></keyword><keyword><style  face="normal" font="default" size="100%">Primary mental health care</style></keyword><keyword><style  face="normal" font="default" size="100%">Primær psykisk helseomsorg</style></keyword><keyword><style  face="normal" font="default" size="100%">process evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Prosessevaluering</style></keyword><keyword><style  face="normal" font="default" size="100%">psykiske helsetjenester</style></keyword><keyword><style  face="normal" font="default" size="100%">reducing coercion</style></keyword><keyword><style  face="normal" font="default" size="100%">Redusere tvang</style></keyword><keyword><style  face="normal" font="default" size="100%">Samskaping</style></keyword><keyword><style  face="normal" font="default" size="100%">Ufrivillig innleggelse</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2024</style></year><pub-dates><date><style  face="normal" font="default" size="100%">04/2024</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.mdpi.com/2227-9032/12/7/786</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;Background: Current policies to reduce the use of involuntary admissions are largely oriented towards specialist mental health care and have had limited success. We co-created, with stakeholders in five Norwegian municipalities, the &amp;lsquo;Reducing Coercion in Norway&amp;rsquo; (ReCoN) intervention that aims to reduce involuntary admissions by improving the way in which primary mental health services work and collaborate. The intervention was implemented in five municipalities and is being tested in a cluster randomized control trial, which is yet to be published. The present study evaluates the implementation process in the five intervention municipalities. To assess how the intervention was executed, we report on how its different elements were implemented, and what helped or hindered implementation. Methods: We assessed the process using qualitative methods. Data included detailed notes from quarterly progress interviews with (i) intervention coordinators and representatives from (ii) user organisations and (iii) carer organisations. Finally, an end-of-intervention evaluation seminar included participants from across the sites. Results: The majority of intervention actions were implemented. We believe this was enabled by the co-creating process, which ensured ownership and a good fit for the local setting. The analysis of facilitators and barriers showed a high degree of interconnectedness between different parts of the intervention so that success (or lack thereof) in one area affected the success in others. Future implementation should pay attention to enhanced planning and training, clarify the role and contribution of service user and carer involvement, and pay close attention to the need for implementation support and whether this should be external or internal to services. Conclusions: It is feasible to implement a complex intervention designed to reduce the use of involuntary admissions in general support services, such as the Norwegian primary mental health services. This could have implications for national and international policy aimed at reducing the use of involuntary care.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">Healthcare 2024</style></issue></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%">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>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Georg Høyer</style></author><author><style face="normal" font="default" size="100%">Olav Nyttingnes</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Ekaterina Sharashova</style></author><author><style face="normal" font="default" size="100%">Tone Breines Simonsen</style></author><author><style face="normal" font="default" size="100%">Anne Høye</style></author><author><style face="normal" font="default" size="100%">Henriette Riley</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study</style></title><secondary-title><style face="normal" font="default" size="100%">BJPsych Open</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">community treatment orders</style></keyword><keyword><style  face="normal" font="default" size="100%">CTO</style></keyword><keyword><style  face="normal" font="default" size="100%">Effekt</style></keyword><keyword><style  face="normal" font="default" size="100%">impact</style></keyword><keyword><style  face="normal" font="default" size="100%">legislation</style></keyword><keyword><style  face="normal" font="default" size="100%">lov</style></keyword><keyword><style  face="normal" font="default" size="100%">lovendring</style></keyword><keyword><style  face="normal" font="default" size="100%">TUD</style></keyword><keyword><style  face="normal" font="default" size="100%">tvungent vern uten døgnopphold</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%">01/2022</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.cambridge.org/core/journals/bjpsych-open/article/impact-of-introducing-capacitybased-mental-health-legislation-on-the-use-of-community-treatment-orders-in-norway-case-registry-study/8C1302C4705F3887004051947463A7F6</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">8</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background&lt;/p&gt;&lt;p&gt;In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs).&lt;/p&gt;&lt;p&gt;Aims&lt;/p&gt;&lt;p&gt;The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs.&lt;/p&gt;&lt;p&gt;Method&lt;/p&gt;&lt;p&gt;This retrospective case register study included two catchment areas serving 16% of the Norwegian population (aged &amp;ge;18). In total, 760 patients subject to 921 CTOs between 1 January 2015 and 31 December 2019 were included to compare the use of CTOs 2 years before and 2 years after the legal reform.&lt;/p&gt;&lt;p&gt;Results&lt;/p&gt;&lt;p&gt;CTO incidence rates and duration did not change after the reform, whereas prevalence rates were significantly reduced. This was explained by a sharp increase in termination of CTOs in the year of the reform, after which it reduced and settled on a slightly higher leven than before the reform. We found an unexpected significant increase in the use of involuntary treatment orders for patients on CTOs after the reform.&lt;/p&gt;&lt;p&gt;Conclusions&lt;/p&gt;&lt;p&gt;The expected impact on CTO use of introducing a capacity-based criterion in the Norwegian Mental Health Act was not confirmed by our study. Given the existing challenges related to defining and assessing decision-making capacity, studies examining the validity of capacity assessments and their impact on the use of coercion in clinical practice are urgently needed.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue><label><style face="normal" font="default" size="100%">tud</style></label></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%">Irene Wormdahl</style></author><author><style face="normal" font="default" size="100%">Trond Hatling</style></author><author><style face="normal" font="default" size="100%">Tonje Lossius Husum</style></author><author><style face="normal" font="default" size="100%">Sloveig Kjus</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Dorte Brodersen</style></author><author><style face="normal" font="default" size="100%">Signe Dahl Christensen</style></author><author><style face="normal" font="default" size="100%">Petter Sundt Nyborg</style></author><author><style face="normal" font="default" size="100%">Torstein Borch Skolseng</style></author><author><style face="normal" font="default" size="100%">Eva Irene Ødegård</style></author><author><style face="normal" font="default" size="100%">Anna Margrethe Andersen</style></author><author><style face="normal" font="default" size="100%">Espen Gundersen</style></author><author><style face="normal" font="default" size="100%">Rise, Marit B.</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The ReCoN intervention: a co-created comprehensive intervention for primary mental health care aiming to prevent involuntary admissions</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%">Coercion</style></keyword><keyword><style  face="normal" font="default" size="100%">Involuntary admission</style></keyword><keyword><style  face="normal" font="default" size="100%">Primary mental health care</style></keyword><keyword><style  face="normal" font="default" size="100%">primærhelsetjenesten</style></keyword><keyword><style  face="normal" font="default" size="100%">Reducing</style></keyword><keyword><style  face="normal" font="default" size="100%">reduction</style></keyword><keyword><style  face="normal" font="default" size="100%">reduksjon</style></keyword><keyword><style  face="normal" font="default" size="100%">tvang</style></keyword><keyword><style  face="normal" font="default" size="100%">Tvangsinnleggelse</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%">07/2022</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08302-w</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;Reducing involuntary psychiatric admissions is a global concern. In Norway, the rate of involuntary admissions was 199 per 100,000 people 16&amp;thinsp;years and older in 2020. Individuals&amp;rsquo; paths towards involuntary psychiatric admissions usually unfold when they live in the community and referrals to such admissions are often initiated by primary health care professionals. Interventions at the primary health care level can therefore have the potential to prevent such admissions. Interventions developed specifically for this care level are, however, lacking. To enhance the quality and development of services in a way that meets stakeholders&amp;rsquo; needs and facilitates implementation to practice, involving both persons with lived experience and service providers in developing such interventions is requested.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Aim&lt;/h3&gt;&lt;p&gt;To develop a comprehensive intervention for primary mental health care aiming to prevent involuntary admissions of adults.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Methods&lt;/h3&gt;&lt;p&gt;This study had an action research approach with a participatory research design. Dialogue conferences with multiple stakeholders in five Norwegian municipalities, inductive thematic analysis of data material from the conferences, and a series of feedback meetings were conducted.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Results&lt;/h3&gt;&lt;p&gt;The co-creation process resulted in the development of the ReCoN (Reducing Coercion in Norway) intervention. This is a comprehensive intervention that includes six strategy areas: [1] Management, [2] Involving Persons with Lived Experience and Family Carers, [3] Competence Development, [4] Collaboration across Primary and Specialist Care Levels, [5] Collaboration within the Primary Care Level, and [6] Tailoring Individual Services. Each strategy area has two to four action areas with specified measures that constitute the practical actions or tasks that are believed to collectively impact the need for involuntary admissions.&lt;/p&gt;&lt;h3 data-test=&quot;abstract-sub-heading&quot;&gt;Conclusions&lt;/h3&gt;&lt;p&gt;The ReCoN intervention has the potential for application to both national and international mental health services. The co-creation process with the full range of stakeholders ensures face validity, acceptability, and relevance. The effectiveness of the ReCoN intervention is currently being tested in a cluster randomised controlled trial. Given positive effects, the ReCoN intervention may impact individuals with a severe mental illness at risk of involuntary admissions, as more people may experience empowerment and autonomy instead of coercion in their recovery process.&lt;/p&gt;</style></abstract><label><style face="normal" font="default" size="100%">Tvangsinnleggelse</style></label></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><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%">Henriette Riley</style></author><author><style face="normal" font="default" size="100%">Ekaterina Sharashova</style></author><author><style face="normal" font="default" size="100%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Olav Nyttingnes</style></author><author><style face="normal" font="default" size="100%">Tore Buer Christensen</style></author><author><style face="normal" font="default" size="100%">Ann-Torunn Andersen Austegard</style></author><author><style face="normal" font="default" size="100%">Maria Løvsletten</style></author><author><style face="normal" font="default" size="100%">Bjørn Lau</style></author><author><style face="normal" font="default" size="100%">Georg Høyer</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Out-patient commitment order use in Norway: incidence and prevalence rates, duration and use of mental health services from the Norwegian Outpatient Commitment Study</style></title><secondary-title><style face="normal" font="default" size="100%">BJPsych Open</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Community Treatment Order</style></keyword><keyword><style  face="normal" font="default" size="100%">OCT</style></keyword><keyword><style  face="normal" font="default" size="100%">Outpatient commitment</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">09/2019</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.sciencedirect.com/science/article/abs/pii/S0160252718301900</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;h3 id=&quot;sec_a1title&quot;&gt;Background&lt;/h3&gt;&lt;p id=&quot;__p1&quot;&gt;Norway authorised out-patient commitment in 1961, but there is a lack of representative and complete data on the use of out-patient commitment orders.&lt;/p&gt;&lt;h3 id=&quot;sec_a2title&quot;&gt;Aims&lt;/h3&gt;&lt;p id=&quot;__p2&quot;&gt;To establish the incidence and prevalence rates on the use of out-patient commitment in Norway, and how these vary across service areas. Further, to study variations in out-patient commitment across service areas, and use of in-patient services before and after implementation of out-patient commitment orders. Finally, to identify determinants for the duration of out-patient commitment orders and time to readmission.&lt;/p&gt;&lt;h3 id=&quot;sec_a3title&quot;&gt;Method&lt;/h3&gt;&lt;p id=&quot;__p3&quot;&gt;Retrospective case register study based on medical files of all patients with an out-patient commitment order in 2008&amp;ndash;2012 in six catchment areas in Norway, covering one-third of the Norwegian population aged 18 years or more. For a subsample of patients, we recorded use of in-patient care 3 years before and after their first-ever out-patient commitment.&lt;/p&gt;&lt;h3 id=&quot;sec_a4title&quot;&gt;Results&lt;/h3&gt;&lt;p id=&quot;__p4&quot;&gt;Annual incidence varied between 20.7 and 28.4, and prevalence between 36.5 and 48.9, per 100 000 population aged 18 years or above. Rates differed significantly between catchment areas. Mean out-patient commitment duration was 727 days (s.d. = 889). Use of in-patient care decreased significantly in the 3 years after out-patient commitment compared with the 3 years before. Use of antipsychotic medication through the whole out-patient commitment period and fewer in-patient episodes in the 3 years before out-patient commitment predicted longer time to readmission.&lt;/p&gt;&lt;h3 id=&quot;sec_a5title&quot;&gt;Conclusions&lt;/h3&gt;&lt;p id=&quot;__p5&quot;&gt;Mechanisms behind the pronounced variations in use of out-patient commitment between sites call for further studies. Use of in-patient care was significantly reduced in the 3 years after a first-ever out-patient commitment order was made.&lt;/p&gt;&lt;h3 id=&quot;sec_a6title&quot;&gt;Declaration of interest&lt;/h3&gt;&lt;p id=&quot;__p6&quot;&gt;None.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">Sep; 5(5): e75</style></issue><label><style face="normal" font="default" size="100%">TUD</style></label></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%">Jorun Rugkåsa</style></author><author><style face="normal" font="default" size="100%">Olav Nyttingnes</style></author><author><style face="normal" font="default" size="100%">Tone Breines Simonsen</style></author><author><style face="normal" font="default" size="100%">Jūratė Šaltytė Benth</style></author><author><style face="normal" font="default" size="100%">Bjørn Lau</style></author><author><style face="normal" font="default" size="100%">Henriette Riley</style></author><author><style face="normal" font="default" size="100%">Maria Løvsletteng</style></author><author><style face="normal" font="default" size="100%">Tore Buer Christensen</style></author><author><style face="normal" font="default" size="100%">Ann-Torunn Andersen Austegard</style></author><author><style face="normal" font="default" size="100%">Georg Høyer</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The use of outpatient commitment in Norway: Who are the patients and what does it involve?</style></title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Coercion</style></keyword><keyword><style  face="normal" font="default" size="100%">Community psychiatry</style></keyword><keyword><style  face="normal" font="default" size="100%">Community Treatment Order</style></keyword><keyword><style  face="normal" font="default" size="100%">Outpatient commitment</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2018</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.sciencedirect.com/science/article/pii/S0160252718301900</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;div&gt;Purpose&lt;/div&gt;&lt;div&gt;Despite one of the longest histories of using Outpatient Commitment (OC), little is known about the use in the Norwegian context. Reporting from the Norwegian Outpatient Commitment Study, this article aims to: establish the profile of the OC population in Norway; ascertain the legal justification for the use of OC and what OC involves for patients; investigate possible associations between selected patient and service characteristics and duration of OC, and; explore potential differences based on gender or rurality.&lt;/div&gt;&lt;div&gt;&amp;nbsp;&lt;/div&gt;&lt;div&gt;Methods&lt;/div&gt;&lt;div&gt;A retrospective multi-site study, extracting data from the medical records of all patients on OC in six large regional hospitals in 2008&amp;ndash;12, with detailed investigation over 36 months of the subsample of patients on first ever OC-order in 2008&amp;ndash;09. We use descriptive statistics to establish the profile of the OC population and the legal justification for and the content of OC, and logistic regression to examine factors associated with duration of OC over 36 months.&lt;/div&gt;&lt;div&gt;&amp;nbsp;&lt;/div&gt;&lt;div&gt;Results&lt;/div&gt;&lt;div&gt;1414 patients were on OC over the 5 years, and 274 had their first OC in 2008&amp;ndash;09. The sample included more men than woman, and three-quarters were diagnosed with schizophrenia. They had long service histories, including involuntary admissions. The legal justification for all OC-orders was the need for treatment, and 18% were additionally justified by dangerousness. The option to initiate OC directly from the community was not used in any of the 274 first ever OC-orders. While 98% of patients were prescribed psychotropic medication, under half had an Involuntary Treatment Order, which under the Norwegian OC regime is required in addition to the OC-order to oblige patients to accept treatment (usually medication). 60% of patients had &amp;ge;2 clinical contacts monthly. There were some gender differences in descriptive analyses with men generally being worse off, but no clear pattern in terms of rurality. Patients in the sample had been on OC between one week and 20 years. The median duration of OC over 36 months was 365 days. Three factors contributed to longer duration: the use of the dangerousness criterion; a diagnosis of schizophrenia disorder, and; considerable problems with substance abuse.&lt;/div&gt;&lt;div&gt;&amp;nbsp;&lt;/div&gt;&lt;div&gt;Conclusion&lt;/div&gt;&lt;div&gt;The characteristics of the OC population in Norway are very similar to that reported in other jurisdictions. Medication seems to be the central focus of OC, yet additional Involuntary Treatment Orders are imposed for less than half of patients. While all OC-orders were justified by the need to ensure treatment, risk seems to be a concern for a subgroup of patients who are kept on for longer. How the 2017 amendment to the mental health act, which precludes compulsion for competent patients unless danger is present, will affect OC use, remains to be seen. Further studies should specifically focus on variation in the use of OC, including at the level of individual clinicians.&lt;/div&gt;</style></abstract><label><style face="normal" font="default" size="100%">TUD</style></label></record></records></xml>