The use of involuntary treatment is regulated by several statutes. These include the Rights of Patients and Health Service Users' Act, the Health and Care Services Act and the Mental Health Care Act.
These statutes aim wherever possible to avoid the use of force or compulsion in cases where patients are at risk of harming either themselves or others. Providing services to people in such circumstances requires humility and respect, as well as an understanding of their behaviour and background.
Involuntary treatment should be avoided but may be ordered
The statutory rules should be used to distinguish between situations where the use of force or compulsion is acceptable and those where it is not. It is essential that other solutions have been attempted before consideration is given to the use of involuntary treatment. This means that health services have a statutory duty to avoid the use of force or compulsion if at all possible. In cases where involuntary treatment is unavoidable, an order must be issued by the health service to this effect. Health services have a duty to undertake internal audits to ensure that involuntary treatment is applied only in conformity with statutory and regulatory requirements.
Involuntary treatment in mental health care
The the use of involuntary treatment in mental health care is subject to comprehensive regulation. Compliance with regulatory requirements is monitored by control commissions established specifically for this purpose. The law regulates all types of involuntary treatment: involuntary admission to mental health care, compulsory treatment and the use of coercive measures.
A person may be admitted involuntarily to mental health care only where admission to voluntary mental health care has been attempted without success or where it is clear that it is pointless to attempt to obtain the patient's consent.
Strict rules apply to involuntary admission to mental health care The patient must be suffering from a serious mental health disorder and must also fulfil criteria relating to either treatment or danger. To fulfil the treatment criteria, involuntary admission must be necessary either to prevent the patient from deteriorating or to ensure that potential for improvement is not impaired. To fulfil the danger criteria, involuntary admission must be necessary because the patient poses a threat either to his/her own or to others' life or health.
The County Governor may overturn an order for involuntary mental health treatment. The County Governor's decision may be appealed to the County Social Welfare Board, from where there is a final right of appeal to the district court. The County Governor also has a responsibility to supervise municipal activities in this respect.
Complaints about involuntary admissions, the use of coercive measures and measures that restrict the patient's rights should be addressed to the control commission, while complaints about involuntary treatment should be directed to the County Governor.