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dc.contributor.authorHofstad, Tore
dc.contributor.authorRugkåsa, Jorun
dc.contributor.authorOse, Solveig Osborg
dc.contributor.authorNyttingnes, Olav
dc.contributor.authorKjus, Solveig Helene Høymork
dc.contributor.authorHusum, Tonje Lossius
dc.identifier.citationFrontiers in Psychiatry. 2021, 12 1-11.en_US
dc.description.abstractBackground: Compulsory hospitalisation in mental healthcare is contested. For ethical and legal reasons, it should only be used as a last resort. Geographical variation could indicate that some areas employ compulsory hospitalisation more frequently than is strictly necessary. Explaining variation in compulsory hospitalisation might contribute to reducing overuse, but research on associations with service characteristics remains patchy. Objectives: We aimed to investigate the associations between the levels of compulsory hospitalisation and the characteristics of primary mental health services in Norway between 2015 and 2018 and the amount of variance explained by groups of explanatory variables. Methods: We applied random-effects within–between Poisson regression of 461 municipalities/city districts, nested within 72 community mental health centre catchment areas (N = 1,828 municipality-years). Results: More general practitioners, mental health nurses, and the total labour-years in municipal mental health and addiction services per population are associated with lower levels of compulsory hospitalisations within the same areas, as measured by both persons (inpatients) and events (hospitalisations). Areas that, on average, have more general practitioners and public housing per population have lower levels of compulsory hospitalisation, while higher levels of compulsory hospitalisation are seen in areas with a longer history of supported employment and the systematic gathering of service users' experiences. In combination, all the variables, including the control variables, could account for 39–40% of the variation, with 5–6% related to municipal health services. Conclusion: Strengthening primary mental healthcare by increasing the number of general practitioners and mental health workers can reduce the use of compulsory hospitalisation and improve the quality of health servicesen_US
dc.description.sponsorshipThe study is part of the ReCoN—Reducing Coercion in Norway research project, which was funded by the Research Council of Norway (project no. 273546).en_US
dc.publisherFrontiers Mediaen_US
dc.relation.ispartofseriesFrontiers in Psychiatry;December 2021 | Volume 12 | Article 737698
dc.rightsNavngivelse 4.0 Internasjonal*
dc.subjectCompulsory hospitalisationen_US
dc.subjectGeographical variationsen_US
dc.subjectService characteristicsen_US
dc.subjectNested generalised linear mixed modelsen_US
dc.subjectRandom effects within-between modelsen_US
dc.titleService Characteristics and Geographical Variation in Compulsory Hospitalisation: An Exploratory Random Effects Within–Between Analysis of Norwegian Municipalities, 2015–2018en_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.rights.holder© 2021 Hofstad, Rugkåsa, Ose, Nyttingnes, Kjus and Husumen_US
dc.source.journalFrontiers in Psychiatryen_US
dc.relation.projectNorges forskningsråd: 273546en_US

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