<?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>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%">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>