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Differences in perceived coercion at admission to psychiatric hospitals in the Nordic countries

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Abstract

Background

International variation in compulsory admissions to psychiatric care has mainly been studied in terms of civil commitment rates. The objectives of this study were to compare and analyse the levels of perceived coercion at admission to psychiatric in-patient care among the Nordic countries and between centres within these countries, in relation to legal prerequisites and clinical practice.

Method

From one to four centres each in Denmark, Iceland, Norway, Finland and Sweden, a total of 426 legally committed and 494 formally voluntarily admitted patients were interviewed within 5 days from admission.

Results

The proportion of committed patients reporting high levels of perceived coercion varied among countries (from 49% in Norway to 100% in Iceland), and in Sweden, only, among centres (from 29 to 90%). No clear variations in this respect were found among voluntary patients. A wide concept of coercion in the Civil Commitment Act and no legal possibility of detention of voluntary patients were associated to low levels of perceived coercion at admission among committed patients.

Conclusion

For committed patients, differences in national legal prerequisites among countries were reflected in differences in perceived coercion. The results from Sweden also indicate that local care traditions may account for variation among centres within countries.

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Authors and Affiliations

  1. Psychiatric Research Centre, P.O.Box 1613, Örebro, 701 16, Sweden

    Lars Kjellin

  2. Institute of Community Medicine, Tromsø, Norway

    Georg Høyer

  3. Institute of Public Health, Aarhus, Denmark

    Marianne Engberg

  4. Tampere School of Public Health, Tampere, Finland

    Rittakerttu Kaltiala-Heino

  5. Blakstad Psychiatric Hospital, Asker, Norway

    Maria Sigurjónsdóttir

Authors
  1. Lars Kjellin
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  2. Georg Høyer
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  3. Marianne Engberg
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  4. Rittakerttu Kaltiala-Heino
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  5. Maria Sigurjónsdóttir
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Corresponding author

Correspondence to Lars Kjellin.

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Kjellin, L., Høyer, G., Engberg, M. et al. Differences in perceived coercion at admission to psychiatric hospitals in the Nordic countries. Soc Psychiat Epidemiol 41, 241–247 (2006). https://doi.org/10.1007/s00127-005-0024-0

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