Capacity-based legislation in Norway has so far scarcely influenced the daily life and responsibilities of patients' carers: a qualitative study

Abstract

Background - When capacity-based mental health legislation was introduced in Norway in 2017, there was concern about the consequences of change in the law for patients’carer whose community treatment order was revoked as a result of being assessed as having capacity to consent. The concern was that the lack of a community treatment order would increase carers’ responsibilities in an already challenging life situation.<p>

<p>The aim of this study is to explore carers’ experiences of how their responsibility and daily life were affected after the patient’s community treatment order was revoked based on capacity to consent.<p>

<p>Method - We conducted individual in-depth interviews from September 2019 to March 2020 with seven carers of patients whose community treatment order was revoked following assessment of capacity to consent, based on the change in the legislation. The transcripts were analysed with inspiration from reflexive thematic analysis.<p>

<p>Results - The participants had little knowledge about the amended legislation, and three out of seven did not know about the change at the time of the interview. Their responsibility and daily life were as before, but they felt that the patient was more content, without relating this to the change in the law. They had found that coercion was necessary in certain situations, which made them worry whether the new legislation would make it more difficult to use coercion.<p>

<p>Conclusion - The participating carers had little or no knowledge of the change in the law. They were involved in the patient’s everyday life as before. The concerns prior to the change about a worse situation for carers had not affected them. On the contrary, they found that their family member was more satisfied with life and the care and treatment provided. This may suggest that the intention of the legislation to reduce coercion and increase autonomy was fulfilled for these patients, without resulting in any significant change in carers’ lives and responsibilities.