What is it all about? An explorative study of patients' experiences with medication free treatment.

Background: As a response to the political decision by the Norwegian Ministry of Health and Care Services to establish some kind of "medication free treatment" for patients with severe mental illness throughout the country, a 6-bed ward unit dedicated to offer such treatment was in 2017 established in Tromsø, Norway by the North Norway Health Care Region. The aim of the present study was to explore the experiences of patients admitted to this ward unit.

Method: Semi-structured interviews were conducted with 19 persons who had received treatment from the ward during the period January 2017 to October 2021.

Exploring the unconventional: health professionals' experiences into medication-free treatment for patients with severe mental illness.

Background: In January 2017, the Norwegian government mandated the establishment of an inpatient unit for "medication-free treatment" for patients with severe mental illness at the University Hospital of North Norway in Tromsø. This study aims to explore the employees' experiences with this unit.

Method: Focus group interviews were conducted October 2021 - February 2022.

Why do patients want medication free treatment for psychosis? An explorative study on reasons for applying to medication free programs.

Background: A focus on patient's and service user's perspectives regarding long-term antipsychotic treatment led to a declaration from the Norwegian Ministry of Health in 2015 to offer treatment without psychotropic medication in mental health as a voluntary option in all four health care regions. In the northernmost region, a 6-bed inpatient ward unit was established, uniquely designed to give people with severe mental illness the possibility to choose such treatment. Only voluntary admissions were accepted.

Capacity-based legislation in Norway has so far scarcely influenced the daily life and responsibilities of patients' carers: a qualitative study.

Background: When capacity-based mental health legislation was introduced in Norway in 2017, there was concern about the consequences of change in the law for patients'carer whose community treatment order was revoked as a result of being assessed as having capacity to consent. The concern was that the lack of a community treatment order would increase carers' responsibilities in an already challenging life situation. The aim of this study is to explore carers' experiences of how their responsibility and daily life were affected after the patient's community treatment order was revoked based on capacity to consent.

Health professionals' experience of treatment of patients whose community treatment order was revoked under new capacity-based mental health legislation in Norway: qualitative study.

Background: Norway introduced capacity-based legislation in mental healthcare on 1 September 2017 with the aim of increasing patient autonomy and legal protection and reducing the use of coercion. The new legislation was expected to be particularly important for patients under community treatment orders (CTOs).

Aims: To explore health professionals' experiences of how capacity-based legislation affects healthcare services for patients whose compulsory treatment order was revoked as a result of being assessed as having capacity to consent.

Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order.

Background: Capacity-based mental health legislation was introduced in Norway on 1 September 2017. The aim was to increase the autonomy of patients with severe mental illness and to bring mental health care in line with human rights.  The aim of this study is to explore patient experiences of how far the new legislation has enabled them to be involved in decisions on their treatment after they were assessed as capable of giving consent and had their community treatment order (CTO) revoked due to the change in the legislation.

Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study.

Background: In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs).

Aims: The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs.

Out-patient commitment order use in Norway: incidence and prevalence rates, duration and use of mental health services from the Norwegian Outpatient Commitment Study.

Background: Norway authorised out-patient commitment in 1961, but there is a lack of representative and complete data on the use of out-patient commitment orders.

Aims: To establish the incidence and prevalence rates on the use of out-patient commitment in Norway, and how these vary across service areas. Further, to study variations in out-patient commitment across service areas, and use of in-patient services before and after implementation of out-patient commitment orders.

The use of outpatient commitment in Norway: Who are the patients and what does it involve?

Purpose: Despite one of the longest histories of using Outpatient Commitment (OC), little is known about the use in the Norwegian context. Reporting from the Norwegian Outpatient Commitment Study, this article aims to: establish the profile of the OC population in Norway; ascertain the legal justification for the use of OC and what OC involves for patients; investigate possible associations between selected patient and service characteristics and duration of OC, and; explore potential differences based on gender or rurality.

Methods: A retrospective multi-site study, extracting data from the medical records of all patients on OC in six large regional hospitals in 2008-12, with detailed investigation over 36 months of the subsample of patients on first ever OC-order in 2008-09.

Patients on outpatient commitment orders in Northern Norway.

Background: In recent years, an increasing number of countries have introduced outpatient commitment orders (OC), which imply that patients can be subject to compulsory follow-up and treatment while living in the community. However, few studies on how OC is practised have been published.

Method: Retrospective case register study based on medical files of all patients receiving an OC order in 2008-2012.

Community treatment orders - what are the views of decision makers?

Background: Community treatment orders (CTOs) are being increasingly used in Western countries. The scheme implies that mental health patients can live outside a hospital, but still be subject to coercive care to ensure compliance with their treatment. There is limited knowledge of how the scheme is practised.

'When coercion moves into your home'--a qualitative study of patient experiences with outpatient commitment in Norway.

The use of coercion on people with mental health problems is a serious intervention, and a reduction in its use is a declared goal in mental healthcare. Yet, many countries have introduced expanded powers of coercion in recent years, including outpatient commitment (OC). However, the evidence of the effectiveness of OC is inconclusive, and little is known about how patients experience OC schemes.