Stakeholder experiences with compulsory treatment at home: A focus-group study

IF 1.4 4区医学 Q1 LAW

International Journal of Law and Psychiatry Pub Date : 2025-02-20 DOI:10.1016/j.ijlp.2025.102072

D.A. de Waardt , C.L. Mulder , G.A.M. Widdershoven

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Abstract

Background

Since 2020, Dutch mental health legislation has provided scope for compulsory treatment at home (CTH). Unlike compulsory community treatment (CCT), CTH allows for the use of compulsion in a patient's home, and thus not only in hospital.

Aim

To examine several stakeholders' experiences and views regarding CTH and its implementation.

Methods

Four focus-groups were performed: one with patients, one with significant others, one with psychiatrists, and one with a mixed group of stakeholders. The transcripts were analyzed thematically.

Results

We identified three themes and 16 subthemes. The first theme concerned the potential benefits of CTH, one of which was avoiding admission to hospital. The second theme focused on preconditions for the delivery of CTH, mainly on communication between mental health workers, patients, and significant others; and the importance of a dialogue well in advance of any compulsory care. With regard to the third theme, considerations regarding the delivery of CTH, all stakeholder groups believed that CTH would be most suitable for patients who had a longer history with their treatment team: between them, they would be able to draw up a plan for compulsory care.

Conclusion

Stakeholders felt that CTH can work for patients with a longer treatment history whose home situation allows for treatment at home. They regard an advance dialogue and jointly drawing up a crisis plan as important preconditions. Overall, CTH can be regarded as an extra option for enabling an individually tailored approach.

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家庭强制治疗的利益相关者经验：焦点小组研究

自2020年以来，荷兰精神卫生立法为强制在家治疗（CTH）提供了范围。与强制社区治疗（CCT）不同，CTH允许在患者家中强制使用，因此不仅仅是在医院。目的探讨几个利益相关方在CTH及其实施方面的经验和观点。方法进行了四个焦点小组：一个是患者小组，一个是重要他人小组，一个是精神科医生小组，一个是利益相关者混合小组。对抄本进行了主题分析。结果我们确定了3个主题和16个子主题。第一个主题是关于CTH的潜在益处，其中之一是避免住院。第二个主题侧重于提供CTH的先决条件，主要是精神卫生工作者、患者和重要他人之间的沟通；以及在任何强制医疗之前进行对话的重要性。关于第三个主题，关于提供CTH的考虑，所有利益相关者团体都认为CTH最适合与治疗团队有较长历史的患者：他们之间可以制定强制医疗计划。结论利益相关者认为CTH可用于治疗史较长且家庭情况允许在家治疗的患者。双方把提前对话和共同制定危机预案作为重要前提。总的来说，CTH可以被视为一种额外的选择，以实现个性化定制的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Law and Psychiatry Multiple-

CiteScore

4.70

自引率

8.70%

发文量

审稿时长

41 days

期刊介绍： The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.