Compulsory Psychiatric Treatment at Home in the Netherlands: A Case Report

Area of Science:

• Mental Health Law
• Psychiatry
• Public Health Policy

Background:

• The 2020 Dutch mental health act aims to shift focus from hospitalization to community-based treatment.
• Compulsory treatment at home (CTH) is a novel provision unique to the Netherlands, differing from compulsory community treatment (CCT).

Purpose of the Study:

• To report on the feasibility and patient-centered outcomes of compulsory treatment at home (CTH) as an alternative to hospitalization.
• To evaluate the impact of CTH on patient autonomy, therapeutic relationships, and safety.

Main Methods:

• A case report detailing a patient's experience with CTH, including compulsory medication, to avoid hospitalization.
• Retrospective evaluation of CTH by the patient and the mental health treatment team.

Main Results:

• The patient successfully recovered at home through CTH, avoiding hospitalization.
• Both the patient and the treatment team positively assessed CTH, noting less restriction on autonomy compared to hospitalization.
• CTH did not negatively impact the therapeutic relationship or compromise participant safety.

Conclusions:

• Compulsory treatment at home (CTH) can be an effective alternative to hospitalization in specific mental health cases.
• Careful assessment of appropriateness, clear preconditions, and open dialogue with patients and their families are crucial for implementing CTH.
• CTH demonstrates potential for patient-centered care within mental health policy reforms.