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Severe mental disorder as a basic commitment criterion for minors.

Riittakerttu Kaltiala-Heino1, Sari Fröjd

  • 1Psychiatric Treatment and Research Unit for Adolescent Intensive Care (EVA), Tampere University Hospital Pitkäniemi, 33380 Pitkäniemi, Finland. Riittakerttu.Kaltiala-Heino@uta.fi

International Journal of Law and Psychiatry
|December 8, 2006
PubMed
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Finnish child psychiatrists generally agree on defining severe mental disorders for involuntary psychiatric care in minors. They emphasize developmental and functional impairment over specific diagnostic categories for commitment.

Area of Science:

  • Child and Adolescent Psychiatry
  • Mental Health Law
  • Forensic Psychiatry

Background:

  • Finland permits broader involuntary psychiatric care for minors than adults since 1991.
  • Minors can face involuntary treatment for "severe mental disorders" without a formal diagnosis, unlike adults.
  • An increase in involuntary treatment for minors post-1991 legislation raised concerns about the vagueness of "severe mental illness" criteria.

Purpose of the Study:

  • To assess agreement among Finnish child and adolescent psychiatrists on defining "severe mental illness" for involuntary commitment.
  • To determine if interpretations of "severe mental illness" ensure equal treatment for minors under the Mental Health Act.
  • To explore how psychiatrists interpret the criteria for involuntary psychiatric treatment of minors.

Main Methods:

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  • Conducted semi-structured, reflexive dyadic interviews with 44 child and adolescent psychiatrists in Finland.
  • Employed qualitative content analysis to examine the interview data.
  • Focused on psychiatrists' perspectives regarding the definition and application of "severe mental disorder" criteria.

Main Results:

  • General consensus was found among psychiatrists regarding the definition of "severe mental disorder" justifying involuntary treatment for minors.
  • Psychiatrists indicated that involuntary treatment for minors should not be solely based on specific diagnostic categories.
  • The prevailing view was to assess severity through developmental and functional impairment, considering the minor's environmental interactions.

Conclusions:

  • Child and adolescent psychiatrists in Finland demonstrate a shared understanding of "severe mental disorder" for involuntary commitment.
  • The current practice leans towards a functional and developmental assessment rather than strict diagnostic criteria for involuntary psychiatric care in minors.
  • This approach aims to ensure equitable application of the Mental Health Act for minors requiring involuntary psychiatric treatment.