Addicts with mental illness often fall through the cracks. Now it is proposed that care be merged, which means that addicts can be belted.
– It is a serious restriction on a person’s freedoms and rights, says Gunilla Bergerén at JO.
Today, it is legal in psychiatric compulsory care to fasten the patient to a bed with a belt if there is a risk that he would seriously injure himself or others. But even addicts could be subjected to such a coercive measure, if the proposals in a new investigation become reality.
– Being physically restrained against one’s will is extremely stressful, as many testify, says Gunilla Bergerén, head of unit at the Judicial Ombudsman, JO.
The investigation aims to coordinate care for people who have both mental illness and harmful use or addiction. That group has often bounced between psychiatry and substance abuse treatment, without getting help with both of their problems at the same time. Therefore, the investigator has proposed, among other things, to merge the law on compulsory psychiatric treatment, LPT, and the law on treatment of drug addicts in certain cases, LVM.
But the investigator does not analyze why addicts would have to be subjected to coercive measures such as restraint with a belt, when the addiction treatment has not had to use it before, JO points out in his referral response.
– It is a serious restriction on a person’s freedoms and rights and then you need to think about whether there is a need, says Gunilla Bergerén.
More are critical
The State Board of Institutions (Sis) and the National Board of Health and Welfare also question the lack of an analysis regarding the fact that addicts could be fastened with a belt, and also subjected to forced medication, if LVM and LPT are merged.
But investigator Anders Printz does not share the view that it would be a completely new patient group.
– But they have largely been cared for in psychiatric inpatient care, he says.
At the same time, only 40 percent of the group has been cared for in LPT. When asked why the remaining 60 percent would have to be treated under compulsory care legislation, which means that they are at risk of being belted, Anders Printz replies that the investigation has several suggestions on how to reduce coercion in psychiatry in general.
He also highlights that people with harmful use and addiction will not have to be locked up for as long if they are cared for according to LPT instead of LVM.
– But these are two heavy referral bodies and then of course the government can choose to take this into account, says Anders Printz.
Positive
Apart from the criticism of the coercive measures, both the National Board of Health and Welfare and the JO are positive about the investigation’s work in coordinating care and support for addicts who also have mental illness.
Sis agrees that the aim of the investigation is good, but believes that addicts with mental illness risk being kicked around even more than today if the regions take over compulsory care for addicts. Instead, Sis believes that they should have continued responsibility for the group and that care could be improved through more resources and increased cooperation with the health and medical services.
FACT Coercive measures
It is legal to use certain coercive measures against patients in psychiatric care under duress, including:
Within the Act for the care of drug addicts, LVM, separation is permitted in some cases, but not the other two coercive measures. Within the Correctional Service, belting and seclusion are permitted, but forced medication is not.
Source: National Board of Health and Welfare and JO
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