Sundheds- og Forebyggelsesudvalget 2014-15 (1. samling)
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Dato: 21. maj 2014
Enhed: Primær Sundhed
Sagsbeh.: SUMLFI
Sags nr.: 1400434
Dok. nr.: 1458278
Remarks of the Danish Ministry of Health with reference to the prelimi-
nary observations presented on psychiatry by the CPT on 13 February
2014.
Regarding the staffing situation and the incidents with the police at Psykiatrisk
Center Amager and Psykiatrisk Center Sct. Hans, Region Hovedstadens Psyk-
iatri (The Capital Region of Denmark – Psychiatry) has informed the Ministry of
Health that calling the police only happens in very rare situations as staff is
educated in managing patients acting violently. But the police are of course
contacted in situations with high risks for other patients and/or staff. At Sct.
Hans this on average happens once every second month and at Amager, eve-
ry third month. Situations where the police use force only happens once every
second or third year.
Regarding the Secure Department of Nykøbing Sjælland Psychiatric Hospital,
the description in the sentence ”Staff were under constant time pressure
which, as they themselves admitted, could at times lead them to resort to the
use of means of restraint, notably locking-up of patients, when such a measure
might not have been necessary” gives rise to the following comments: Region
Sjælland (Region Zealand) specifies that according to the law, patients at this
hospital can be locked-up in their rooms because of danger to him/herself or
staff or to secure the patient against too many stimuli. The decision of locking-
up a patient in his/her room has to be taken by a doctor and on the basis of a
concrete situation or incident. It also happens that patients themselves ask to
be locked in their room, e.g. in situations where they become paranoid.
./.
Regarding the staffing situation at the Secure Department of Nykøbing Sjæl-
land Psychiatric Hospital we can inform, that staff counts approximately 100
persons. These persons are healthcare staff (doctors, nurses etc) and social
workers. The hospital in addition has a contract with a security company
providing a certain amount of security personnel. Doctors are in charge of the
Secure Department at all times. For reasons of security a more detailed ac-
count of staff and their work schedules can not be provided.
Regarding the ”walking restraint”, the Danish Health and Medicines Authority
has recently send a report to the Ministry of Health. In this report it is recom-
mended that the possibility of using walking restraint is made permanent, as
the experiences for the patients, who have been involved, are very good.
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Side 2
In this connection it should be mentioned that in autumn 2014 the Government
will introduce a bill to change the Mental Health Act in order to ensure better
rights for psychiatric patients, who are subject to detention or coercion, includ-
ing measures to reduce mechanical restraint. This bill is expected to contain
permanent rules regarding the use of walking restraint. Further it should be
mentioned that the Ministry of Health collaborates with the Danish Institute for
Human Rights to ensure that the bill will be consistent with the international
conventions on human rights.
As noted in the text of the CPT preliminary observations, several measures
designed to tackle the problem of frequent and prolonged use of restraint are
undertaken by the authorities and the hospitals in order to reduce the use of
coercion.
The Government has declared the goal to improve conditions for people with
mental illness, including a reduction in the use of coercion. On 15 May 2014
the Government presented a comprehensive long-term action plan for the fu-
ture development and expansion of the services to people with mental illness.
This plan includes e.g. targets for reducing coercion in psychiatry, including
mechanical restraint, and will support the new framework and direction for
psychiatry that has been recommended by the Commission on mental health.
The keyword for the plan is ”equal effort”. Psychiatric patients must receive the
same effort, have the same rights and get the same high quality in treatment
and rehabilitation as patients with physical illness. Expectedly 1.6 billion Dan-
ish kroner will be reserved for an increase of capacity in psychiatry, e.g. in
outpatient psychiatry and closed wards.
Link to the action plan (in Danish):
http://www.sum.dk/Aktuelt/Nyheder/Psykiatri/2014/Maj/~/media/Filer%20-
%20Publikationer_i_pdf/2014/Ligevaerd-psykiatriplan-maj-
2014/Psykiatri_handlingsplan-netudgave.ashx
Currently the Government enters partnerships with the regions responsible for
progression on the reduction of coercion in psychiatry. The Government has
permanently allocated 50 million Danish Kroner per year to these partnerships.
There has been allocated 74 million Danish kroner over four years (2014-
2017) to experiment with force-free units in psychiatry and 100 million Danish
Kroner in 2014 to create a better physical environment at hospitals to support
a reduction of coercion.
Med venlig hilsen
Helle Schnedler
/ Louise Filt