Abstract
The article focuses on two conditions related to the use of coercion vis-á-vis persons with intellectual disabilities in Norway. The first condition concerns the widespread use of exemptions from legally binding educational requirements. Based on three independent sources we claim that exemptions from educational requirements were made for 80% of the individuals affected by the decisions, and in 2007 only 3% of all applications were rejected by the county governor’s office. The second condition relates to a five-fold increase in decisions regarding the use of coercion between 1999 and 2008. We have used registry data from The Norwegian Board of Health Supervision concerning notifications and decisions related to the use of force and coercion that was gathered between 1999 and 2008. Second, we carried out a pilot study in which we considered a sample of the notifications and decisions involving the use of coercion between 2007 and 2008. Third, we have carried out a telephone survey where all 19 county governors were asked questions about their routines regarding notifications to The Norwegian Board of Health Supervision in 2009. Our findings are that use of coercion and restraint, and the lack of legally binding qualifications, are closely related. Furthermore, the dominant practice of exemptions from legally binding educational requirements weakens the rule of law.
Highlights
Was it wishful thinking to believe that the transition from institutional services to community-based services would reduce the use of and demand for coercion and restraint vis-a-vis persons with intellectual disabilities? Reactions to such changes (Odelsting Proposition no. 49. 1987Á88, 13) ensured that the initial legal proposals (NOU 1991:20) were never adopted
The Norwegian Board of Health Supervision has developed a special form to be used by the county governors in their reporting of coercion and force implemented in accordance with Chapter 4A of The Social Services Act
When the increase in the use of coercion is not matched by upgraded skills on the part of the service providers, which at worst reveal a stagnant and declining tendency, this could result in serious legal challenges
Summary
Was it wishful thinking to believe that the transition from institutional services to community-based services would reduce the use of and demand for coercion and restraint vis-a-vis persons with intellectual disabilities? Reactions to such changes (Odelsting Proposition no. 49. 1987Á88, 13) ensured that the initial legal proposals (NOU 1991:20) were never adopted. In 1993, The Ministry of Health and Care Services initiated a survey (Ot.prp.nr. (1994Á95), 10) indicating that as many as 600 persons with intellectual disabilities had experienced situations involving the use of force on at least one occasion. When it comes to the two other categories Á planned and repeated use (b) and protection of fundamental needs (c) Á figures show a fivefold increase in the use of coercion from 2000 (247) to 2008 (1369 approved decisions) affecting 696 persons in 2008 This means that approximately 10% of persons with intellectual disabilities in Norway had been subjected to the use of coercion and restraint by state employees in the social services in 2008.
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