When open psychiatric compulsory care transitions to closed compulsory care

Charlie Taylor

Briefly about when open psychiatric compulsory care is transferred to closed compulsory care

When we have had some questions about this topic lately, I felt that it would be good if you could give an explanation for this.

A person who is cared for in accordance with the Compulsory Psychiatric Care Act ("LPT") can receive care in two ways: through open psychiatric compulsory care, or inpatient care. Closed psychiatric involuntary care usually takes place in a locked psychiatric ward in a hospital or other care facility. The patient must not leave the care center without the chief physician's approval, and often not without the company of staff.

Open care
In some cases, when the patient is perceived to have absorbed the treatment at the care center in a sufficiently good way, the care can be transferred to what is called open psychiatric compulsory care. This usually means that the patient is given the opportunity to live at home, and return to their everyday life as it looked before admission. A change in care in this way is, however, usually subject to special conditions – e.g. that the patient must come to a care facility and take their medicine at set times, that one should refrain from alcohol or drugs, that one must have contact with a care provider, or that one must not have contact with a certain or certain people. The patient and the chief physician agree on the terms together, but it is of course the chief physician who has the final say in the matter. If the patient does not follow these conditions, the chief physician has the right to decide that the outpatient care will be closed again.

The differences in different compulsions
However, it is important to go through the difference between coercion and coercion. In closed psychiatric compulsory care, doctors have the right to make decisions that restrict one's personal freedom, e.g. by belting or compulsive medication. They do not have the right to do this in order to get a person receiving outpatient care to follow the conditions that come with outpatient care. So you can not force a patient to comply with the conditions by physical coercion. However, there is a way to indirectly force one to comply with the conditions – namely the underlying and often unspoken threat of readmission. It goes without saying that a person who does not want to be stuck in a closed psychiatric ward will do his best to follow the conditions that exist so that you are not forced back to the ward.

Who decides?
The chief physician may thus decide on a transition from outpatient care to inpatient care if the patient does not follow the conditions that are set for the care to be open, because the patient by violating the conditions does not receive the care he needs. If a person e.g. do not take their medicine according to the conditions, there is a risk that the person will again get worse in their mental illness. And then it is considered that you have an inevitable need for inpatient care, to ensure that the medication is taken and that your illness does not worsen.

This may feel like a punishment, but it is important to remember that the individually set conditions for inpatient care to be transferred to the open are there for a reason, and that a transition from inpatient to outpatient care is to be considered a privilege more than a right. A long-term parallel can be the possibility of conditional release from an institution – if you violate the conditions of the release, there is a great risk that you will end up in an institution again.

//Jur.Kand Alexandra Nekrassova

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