title: Commitment without confinement. Outpatient compulsory care for substance abuse, and severe mental disorder in Sweden.
abstract: In Sweden, a person with severe substance abuse or a severe mental disorder may be committed to compulsory care according to two different legislations. Both acts include an option of providing involuntary care outside the premises of an institution - care in other forms (COF) and compulsory community care (CCC), respectively. As co-occurring disorders are commonplace many individuals will be subject to both types of compulsory care. The structures of both legislations and their provisions for compulsory care in the community are therefore scrutinized and compared. Based on a distinction between "least restrictive" or "preventative" schemes the article compares COF and CCC in order to determine whether they serve different purposes. The analysis shows that COF and CCC both share the same avowed aims of reducing time spent in confinement and facilitating transition to voluntary care and the community. But they also serve different purposes, something which is reflected in disparate scopes, eligibility criteria, rules, and practices. Overall, COF was found to be a more "least restrictive" and CCC a more "preventative" scheme. The distinction is associated with COF being an established part of legislation on compulsory care for substance abuse with a universal scope and CCC being a recent addition to compulsory psychiatric care legislation with a selective character.
authors.affiliation: National Board of Institutional Care, Statens institutionsstyrelse, Box 30224, S-104 25, Stockholm, Sweden; Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, S-106 91, Stockholm, Sweden. Electronic address: therese.reitan@stat-inst.se.
authors.forename: Therese
authors.initials: T
authors.lastname: Reitan
mesh_terms: D002961:Civil Rights / Q000331:legislation & jurisprudence; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D006806:Human Rights / Q000331:legislation & jurisprudence; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013548:Sweden
keywords: Comparative legislative analysis; Compulsory treatment orders; Involuntary treatment; Mental health law; Substance abuse law; Sweden