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Family members will be more involved before involuntary hospitalizations, promises the Psychiatric Clinic after criticism from the Norwegian Board of Health.
– This case of supervision has taught us that we must ask the right questions of relatives, says the director of the clinic, Brede Aasen. Photo: Eirik Brekke (archive)
In November, the final report from the Norwegian Board of Health came after Sotra’s double murder. Health Bergen had violated the law, stated the Norwegian Board of Health.
– Inadequate medical care
First, a bit of history: A man who is now 42 years old was sentenced this fall to mandatory mental health care after the murder of his parents last summer.
The 42-year-old man had been admitted to a psychiatric clinic (Sandviken) with a diagnosis of paranoid schizophrenia and was released three days before the murders.
Doctors thought that the conditions for involuntary hospitalization were met, but the 42-year-old man appealed the forced decision to the control commission, which reversed it.
The Norwegian Board of Health carried out an inspection at the clinic and concluded that the 42-year-old did not receive adequate medical care. It also doesn’t make other psychosis patients need compulsory mental health care.
The audit also concludes that Helse Bergen did not fulfill its obligations to the patient’s relatives.
Will change routines
Helse Bergen has now made a seven-point plan where they will change routines to prevent similar things from happening again.
One point is about collaboration with family members.
The law states that when someone must be admitted by force, family members have the right to express themselves before the decision is made.
– We have also contacted family members before, but we have mainly focused on informing about the right to complain. This case of supervision has taught us that we also need to ask the right questions of family members, says the clinic’s director, Brede Aasen.
Therefore, the clinic has created a series of questions to be used when the hospital calls a spouse, parents, or other family members. For example: Do they feel that the patient is a danger to themselves or to others? Has the patient changed recently and is he taking his medication?
Answers should be entered in the patient’s medical record. Once the decision is made, family members should be contacted again.
The new routine will not only ensure that the hospital complies with the requirements of the law and that those who make enforcement decisions are well informed about the case. New routines can also improve relationships with family members, Aasen believes.
– A forced admission can be experienced dramatically. When we make contact in this way, we think it can be a good start for collaboration, he says.
– A big step forward
– This is a big step forward, says Carl Fredrik Aas, who is deputy director of the National Association of Relatives in Mental Health (LPP).
LPP sent a letter to Health Minister Bent Høie, asking him to remind the hospital that relatives have the right to speak before a forced decision.
– We know of several cases in which it has not been done. What Helse Bergen is doing now is a step in the right direction, says Aas.
LPP is also concerned that family members are involved during mandatory treatment.
– What we know can be useful for therapists. And after all, we are the ones who take the patient home afterward, Aas says.
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Following criticism from the Norwegian Board of Health, a task force has been appointed to analyze the treatment of psychotic patients. The work is led by Deputy Executive Director Randi-Luise Møgster.
Randi-Luise Møgster will examine the treatment of 20 randomly selected psychosis patients. Photo: Katrine Sunde, Helse Bergen
The Norwegian Board of Health says that too long has passed since the 42-year-old patient was transferred from the emergency department to the special ward for psychotic patients.
The audit also believes that cooperation between departments can be improved.
The evaluation team will interview the managers and employees of both departments. Additionally, the team will review the records of 20 randomly selected patients who have been admitted with the same disorders as the 42-year-old.
The group will analyze why and on what legal basis the 20 were admitted, how long it was before receiving treatment, how long the treatment lasted and internal communication along the way.
The team has little time, because already on January 11, its conclusions will be presented to the clinic’s management.
