ArticleBMC health services research2022
Increased autonomy with capacity-based mental health legislation in Norway: a qualitative study of patient experiences of having come off a community treatment order.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- 'Traumatic to Say the Least; It Still Affects Me': Consumer Perspectives on Community Treatment Orders in Australia.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Using a quality improvement framework to evaluate the feasibility of implementing a patient-reported outcome measure for recovery in an office-based treatment setting for opioid use disorder.Addiction science & clinical practice · 2025Article
- Assessing decision-making capacity in clinical practice in Norway: a qualitative exploration of stakeholder perspectives.BMC psychiatry · 2025Article
- Impact of introducing a capacity-based mental health law in Norway: qualitative exploration of multi-stakeholder perspectives.BJPsych open · 2025Article
- Patients' experiences with coercive mental health treatment in Flexible Assertive Community Treatment: a qualitative study.BMC psychiatry · 2023Article
- Capacity-based legislation in Norway has so far scarcely influenced the daily life and responsibilities of patients' carers: a qualitative study.BMC psychiatry · 2023Article
- Epistemic citizenship under structural siege: a meta-analysis drawing on 544 voices of service user experiences in Nordic mental health services.Frontiers in psychiatry · 2023Review
- Article
- Law and psychiatry-current and future perspectives.Frontiers in public health · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCapacity-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.
methodIndividual in-depth interviews were conducted from September 2019 to March 2020 with twelve people with experience as CTO patients. Interviews were transcribed and analysed using thematic analysis inspired by hermeneutics.
resultsAlmost all interviewees were receiving the same health care over two years after their CTO was terminated. Following the new legislation, they found it easier to be involved in treatment decisions when off a CTO than they had done in periods without a CTO before the amendment. Being assessed as having capacity to consent had enhanced their autonomy, their dialogues and their feeling of being respected in encounters with health care personnel. However, several participants felt insecure in such encounters and some still felt passive and lacking in initiative due to their previous experiences of coercion. They were worried about becoming acutely ill and again being subjected to involuntary treatment.
conclusionThe introduction of capacity-based mental health legislation seems to have fulfilled the intention that treatment and care should, as far as possible, be provided in accordance with patients' wishes. Systematic assessment of capacity to consent seems to increase the focus on patients' condition, level of functioning and opinions in care and treatment. Stricter requirements for health care providers to find solutions in cooperation with patients seem to lead to new forms of collaboration between patients and health care personnel, where patients have become more active participants in their own treatment and receive help to make more informed choices.
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