Norway's Initial Report



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Measures to increase the number of voluntary admissions in the mental health care service


128. A national strategy to increase the level of voluntary admissions in the mental health care service is currently in progress (2012‒2015). The strategy includes 14 national measures, which are divided into three main areas: 1) competence and quality assurance; 2) documentation; and 3) knowledge development and research. The national measures are intended to support regional and local actions plans. Cooperation between the specialist health service and the primary health service, integrated clinical pathways, and alternative solutions for voluntary admission that are as equitable as possible for users, relatives and health care professionals constitute key elements in efforts to reduce the use of coercion. Increasing the level of voluntary admissions has much to do with prevention, and with seeking treatment as early as possible so that coercion can be avoided or reduced as far as possible. Most of the national measures have already been implemented. The main priorities for the final part of the strategy period are to complete guidance material to personnel in the mental health care service, prepare guidance material on voluntary and user-controlled services including medication-free services, and improve data quality to increase knowledge about the use of coercion.
129. In line with the Ministry's requirements regarding the content of regional and local plans to increase the number of voluntary admissions in the mental health care service, the assignment document for 2015 stipulated that patients in mental health care service must also be able to choose between different treatment options as far as possible, including options that do not entail medication. These treatment options must be designed in close cooperation with user organisations. The assignment document asked the regional health authorities to report on plans for how this is to be implemented, and this matter is now being followed up in all the health care regions.

Transport of persons with mental illness


130. The health service has responsibility for transporting persons with mental illness. One goal is to establish a dignified and professionally sound transport service where the police only provide assistance when necessary for security reasons. The Ministry of Justice and Public Security has allocated NOK 10 million from its budget to allow specially trained health care professionals to transport persons with mental illness. The four regional health authorities have been tasked with establishing projects over a three-year period conditional on annual budgetary allocations made by the Storting. In 2015 the allocation was increased by NOK 10 million to NOK 20 million.


Prison

131. The Convention sets a requirement for "reasonable accommodation" to be provided to persons with disabilities when deprived of their liberty. When it comes to executing sentences, this is resolved in practice by attempting to place persons with disabilities in institutions that have implemented some degree of accommodation, such as adapted cells. Sometimes institutions have been adapted for a specific prisoner; see Article 9 for more details. When no adapted cells are available, the law allows scope for transferring prisoners to institutions outside the Norwegian Correctional Service to serve their sentence, within certain limits. The prison health service has responsibility for following up medical issues that may arise when persons with disabilities are deprived of their liberty.


Article 15 Freedom from torture or cruel, inhuman or degrading treatment or punishment

132. Under Article 93, second paragraph of the Constitution and several treaties to which Norway is a signatory, the prohibition against torture or cruel, inhuman or degrading treatment or punishment protects persons with disabilities on an equal basis with others. The Optional Protocol of 2002 to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT) was ratified by Norway in 2013. Following ratification of the OPCAT, the Storting designated the Parliamentary Ombudsman as the National Preventive Mechanism against Torture and Inhuman Treatment, which was established in spring 2014.



Medical and health research


133. Under the Health Research Act, consent must be obtained from participants in medical and health research studies unless otherwise prescribed by law. Consent must be informed, voluntary, express and documented. Consent must be based on specific information about a concrete research project, unless there is a case for granting broad consent; see the Health Research Act, section 14. If the research participant can be regarded as being in a relationship of dependency with the person requesting consent, meaning that the research participant might feel pressured to give their consent, informed consent must be obtained by another person with whom the research participant does not have this kind of relationship. In the event of substantial changes to the research project, new consent must be obtained in accordance with section 13 if the changes are deemed to have consequences for the participant’s consent. Consent to take part in a research project may be withdrawn at any time. If participants withdraw their consent, research on their biological material or personal health data must stop. Participants who withdraw their consent may demand that their biological material be destroyed and personal health data deleted or surrendered within 30 days.

Article 16 Freedom from exploitation, violence and abuse

134. In Norway, penal provisions that protect individuals against personal violations apply in principle to everyone. However, some penal provisions afford specific protection for certain vulnerable groups, among them persons with disabilities.



Hate speech


135. Persons with disabilities constitute one of several groups that are protected against hate speech under section 135 a of the General Civil Penal Code. This provision applies to anyone who publicly makes discriminatory remarks. By discriminatory or hateful remarks is meant utterances that threaten or ridicule someone or that incite hate, persecution or contempt for someone based because of their disability. Both wilful and negligible violations are punishable. This provision has been incorporated into section 185 of the General Civil Penal Code of 2005.

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