The Psychiatric Crisis: Perhaps we should make room to allow people to live lives that many consider unworthy

Writing at UiT, Associate Professor Marius Storvik, depriving the mentally ill of their right to self-determination would be discriminatory, only because their impairment is classified as a mental disorder.

Post writer: Associate Professor Marius Storvik at UiT.
picture: Lars Adrian Geske

Once again we have challenges Psychiatry is on the agenda locally and nationally. In a subtle way, Itroumsu pointed out several actual challenges. The Consent Jurisdiction Act of 2017 has been cited as a causal explanation, and it is being discussed whether it should be changed. I will try to explain why this code is not the problem.

This is the situation:

Long-term psychiatry has been pared back over the years. This has increased pressure on the municipality and the police, who have no real alternative for the seriously mentally ill.
This is reflected in the statistics from the Troms Police District, where they seem to receive more reports of drug and psychiatric violence now than before.
Police often meet with perpetrators, who have previously been forcibly accepted by the health care system. Police should spend more resources on drugs and psychiatry.
The threshold for forced admission of patients increased, following a law change that strengthened patient rights in 2017.
At the same time, it has become easier to judge people to have mandatory mental health care through the judiciary, whereby a person can be judged not only for being a danger to himself or others, but also for being a nuisance to society.
Since 2008, the number of people sentenced to compulsory mental health care has exploded. There was a particularly large jump in the number of convicts from 2020 to 2021.
Security psychiatry is filled with defendants, who receive lengthy sentences, because treatment is not enough.
Seriously ill people who have not committed a crime must stand at the back of the waiting list.
Preventive work has been suspended.

in your discussion It has been argued that the patient’s right to self-determination outweighs the need for treatment and a decent life. Does this mean that all adults eligible for consent lose the right to self-determination in matters of health? Or should only persons eligible for consent be deprived of mental disorders the right to self-determination in matters of health? There are two examples that illustrate the difference.

curry has incurable cancer. Medications can reduce symptoms and prolong life, but they give side effects that Carey cannot accept. We accept that Carrie should be allowed to stop taking her medication, even if it leads to an increased burden on relatives, a less dignified life and a violation of doctors’ advice. why? Because Carrie will let her decide her life.

Peter has one incurable mental illness. Medicines can reduce symptoms, and (maybe) extend life, but they give side effects that Peter can’t accept. We accept that Peter should be allowed to stop taking his medication, even if it increased the burden on relatives, led to a less dignified life, and was against the advice of doctors. why? Because it will allow Peter to make a decision about his life.

from 2017 It has been the case that we do not impose health care on eligible consenting adults who do not pose a risk to others. It doesn’t matter whether doctors classify the need for health care as a mental illness, cancer or dementia. Since both Petter and Kari are eligible for consent, it does not matter which category their disease is placed in.

how will you be If Carrie’s cancer or Peter’s mental illness makes them unable to understand what consent implies? They may then lack eligibility to consent, and legislation permits, subject to additional conditions, to compel both to receive health care. I think this is a reasonable regulation.

What about Kari Or Peter is a danger to others? Legislation provides police, corrections, and psychiatric organizations with a sufficient legal basis to ensure the safety of others. In the field of anthropology, this legislation is unfortunately weak, but it has not been brought into the spotlight this summer either.

The right to self-determination In medical matters it is protected by both the constitution and human rights. Therefore, it would be illegal to deny consenting adults the right to self-determination in medical matters without further concrete assessments.

what if we Only denying the mentally ill the right to self-determination in medical matters? According to both the constitution and human rights, it is illegal to give bad treatment to people because of a disability or disability for example. This means that it is illegal to give inferior treatment to homosexuals and the mentally ill because of their condition or illness. This is called discrimination. It would be discriminatory to deny the mentally ill their right to self-determination, just because their disability is classified as a mental illness.

Change in the law in 2017 It was necessary to end the long-standing historical discrimination in mental health care. The patient group is particularly vulnerable, has been subject to legal discrimination and has been subjected to prohibited legislation based on stereotypes. This means that the group had a limited life unfolding and was deprived of individual assessment of abilities and needs. Previous legislation was inconsistent with the Constitution and human rights, and therefore could not be reintroduced.

I don “t think so Problems in psychiatry are solved by forcing eligible patients to agree to treatment or the family they do not want. Perhaps patients were mistakenly assessed as eligible for consent? Perhaps the solution is not more coercion anyway, but rather a therapeutic offer that the patient wants? Perhaps patients stop taking medication because they are associated with compulsion? Maybe municipal housing offers not worth?

Perhaps the interaction between Agencies not working well enough? Perhaps the model does not work with the division of responsibility between the municipality and the hospital? Perhaps the health care system calls the police too often unnecessarily? Perhaps the health care system should be legally equipped to carry out transportation missions? Maybe the problem isn’t legislation, but treatment options that aren’t good enough in general? Maybe we don’t have enough knowledge to provide a good treatment? Perhaps we should make room to allow people to live lives that many consider unworthy. These are challenges that both the professional field and the population must acknowledge, and where the increasing use of coercion is hardly a good answer.