Georg Høyer

Universitetet i Tromsø, Tromsø, Troms, Norway

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Publications (13)25.65 Total impact

  • Georg Høyer
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    ABSTRACT: Forfatteren er cand. med. og forskningsstipendiat NAVF, og har siden 1979 vart tilknyttet sosialpsykiatrisk seksjon ved Institutt for Samfunnsmedisin, Universitetet i Tromso. For tiden arbeider han med et større prosjekt angående grunnlaget for retensjon i psykiatriske institusjoner og rettssikkerhetsproblemer knyttet til slik retensjon. Artikkelen tar opp psykisk sykdom og ansvarlighet for kriminelle handlinger i et historisk perspektiv. Det biir gitt eksempler fra straffesaker i gammel tid der tiltalte på grunn av sinnslidelse ble unndratt ordinaer straff. Den skjebne disse sinnslidende lovovertrederene fikk, blir drøftet. Videre blir utviklingen av det rettspsykiatriske system vi har i Norge i dag beskrevet. Det blir lagt saerlig vekt på de faglige forutsetningene innen psykiatrien og kriminologien, som rundt siste århundreskifte lå til grunn for den vesentlige reform som den gang fant sted i strafferettspleien overfor sinnslidende lovbrytere. Artikkelen hevder det synspunkt at etter denne reformen ble rettspsykiaterens bidrag i retten nødvendig for å legitimere uforholdsmessig lange frihetsberøvelser av sinnslidende. Viktige sider ved de planlagte endringer i særreaksjonene overfor sinnslidende lovovertrede i Norge tas opp i dette perspektivet, og de konsekvensene endringsforslaget har for psykiatrien nevnes.
    Nordic Journal of Psychiatry 07/2009; 39(1):13-21. DOI:10.3109/08039488509098625 · 1.50 Impact Factor
  • Prof. Georg Høyer
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    ABSTRACT: Background: Published figures on civil commitment rates in Europe show large differences between countries. All such rates are based on public register data, and it has been questioned to what extent such data can be trusted. Aims: To present an update on our current knowledge about involuntary hospitalization, with special emphasis on research issues related to time trends in its use, the impact of legislation, and that of service structure and ideology on variations in involuntary hospitalization rates. Methods: Literature review. Results: How civil commitment rates have been computed is rarely accounted for in the literature, and rates will vary substantially according to the methods used. The quality of public register data does also vary, and few studies have looked at the quality of public registers. Conclusions: We still have insufficient knowledge about the use of involuntary hospitalization. Given the varying quality of the data, it is problematic to draw any firm conclusions about the extent, time trends and variations in the use of civil commitment. Comparison of civil commitment rates between countries should for this reason be interpreted with caution.
    Journal of Mental Health 07/2009; 17(3):281-292. DOI:10.1080/09638230802156723 · 1.40 Impact Factor
  • Knut Ivar Iversen · Georg Høyer · Harold C Sexton
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    ABSTRACT: Civil commitment rates to psychiatric hospitals in Norway are among the highest in Europe. However, published rates are based on registry data of uncertain quality. Civil commitment at four psychiatric hospitals were examined and the quality of registry data assessed. We examined 2043 admissions, recorded the duration of deprivation of liberty and calculated incidence rates for civil commitment. The overall study generated incidence rate for civil commitment based on "involuntary referrals", "treatment periods" and persons involved were 259, 209 and 186 per 100,000 adults/year, respectively. For patients admitted for involuntary observation only, the mean duration of deprivation of liberty was 8.5 days, compared with 34.3 days for those admitted for long-term detention, representing 37.8% and 86.6% of the total inpatient period, respectively. The submitted records to the Norwegian Patient Registry (NPR) were incomplete and had missing information at two of the four hospitals. Moreover, when official civil commitment rates based on the NPR data were computed, almost 30% of all admissions were routinely excluded. Civil commitment in this study was higher than corresponding figures based on registry data. In general, civil commitment rates as reported by the NPR seem to be an underestimate.
    Nordic journal of psychiatry 03/2009; 63(4):301-7. DOI:10.1080/08039480902730607 · 1.50 Impact Factor
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    BMC Psychiatry 12/2007; 7(Suppl 1). DOI:10.1186/1471-244X-7-S1-S142 · 2.24 Impact Factor
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    BMC Psychiatry 12/2007; 7(Suppl 1). DOI:10.1186/1471-244X-7-S1-S141 · 2.24 Impact Factor
  • Knut Ivar Iversen · Georg Høyer · Harold C Sexton
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    ABSTRACT: Legal-, perceived- and objective coercion were examined both separately and together as a measure of accumulated coercion, to determine how coercion affected patient satisfaction in patients admitted for acute psychiatric care. Accumulated coercive events significantly reduced both overall satisfaction, and satisfaction in four of five subscales evaluating different aspects of treatment. Neither legal status nor perceived coercion affected patient satisfaction, while objective coercion had a significant negative effect on overall satisfaction when these measures were analysed separately. Overall patient satisfaction reported at discharge was low, while satisfaction with different aspects of treatment showed considerable variation. The observation that perceived coercion in the admission process did not affect satisfaction significantly underlines the need to further explore the interaction between subjective and objective measures for coercion. It appears that multiple measures for coercion should be used in future studies.
    International Journal of Law and Psychiatry 11/2007; 30(6):504-11. DOI:10.1016/j.ijlp.2007.09.001 · 1.19 Impact Factor
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    ABSTRACT: International variation in compulsory admissions to psychiatric care has mainly been studied in terms of civil commitment rates. The objectives of this study were to compare and analyse the levels of perceived coercion at admission to psychiatric in-patient care among the Nordic countries and between centres within these countries, in relation to legal prerequisites and clinical practice. From one to four centres each in Denmark, Iceland, Norway, Finland and Sweden, a total of 426 legally committed and 494 formally voluntarily admitted patients were interviewed within 5 days from admission. The proportion of committed patients reporting high levels of perceived coercion varied among countries (from 49% in Norway to 100% in Iceland), and in Sweden, only, among centres (from 29 to 90%). No clear variations in this respect were found among voluntary patients. A wide concept of coercion in the Civil Commitment Act and no legal possibility of detention of voluntary patients were associated to low levels of perceived coercion at admission among committed patients. For committed patients, differences in national legal prerequisites among countries were reflected in differences in perceived coercion. The results from Sweden also indicate that local care traditions may account for variation among centres within countries.
    Social Psychiatry 04/2006; 41(3):241-7. DOI:10.1007/s00127-005-0024-0 · 2.58 Impact Factor
  • European Psychiatry 05/2002; 17:88-89. DOI:10.1016/S0924-9338(02)80405-9 · 3.44 Impact Factor
  • European Psychiatry 05/2002; 17:89-89. DOI:10.1016/S0924-9338(02)80406-0 · 3.44 Impact Factor
  • European Psychiatry 05/2002; 17:88-88. DOI:10.1016/S0924-9338(02)80402-3 · 3.44 Impact Factor
  • International Journal of Law and Psychiatry 03/2002; 25(2):93-108. DOI:10.1016/S0160-2527(01)00108-X · 1.19 Impact Factor
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    ABSTRACT: Several studies suggest that the patient's experience of being coerced, during the admission process to mental hospitals, does not necessarily correspond with their legal status. Rather, perceived coercion appears to be associated with having experienced force and/or threats (negative pressures), as well as feeling that their views were not taken into consideration in the admission process (process exclusion). We investigated perceived coercion, among patients admitted both voluntarily and involuntarily, to acute wards in Norway. We used a visual analogue scale (the Coercion Ladder, CL) and the MacArthur Perceived Coercion Scale (MPCS), a five-item questionnaire, to measure perceived coercion. Two hundred and twenty-three consecutively admitted patients to four acute wards were included and interviewed within 5 days of admission. Many patients reported high levels of perceived coercion in the admission process, with the involuntary group experiencing significantly higher levels than the voluntary group. However, 32% of voluntarily admitted patients perceived high levels, and 41% of involuntarily admitted patients perceived low levels of coercion. Legal status did not significantly predict perceived coercion on either the MPCS or the CL after taking negative pressures and process exclusion into account. Applying a visual analogue scale (CL) seems to provide a useful measure of patients' perception of coercion and one that largely parallels the MPCS.
    Nordic Journal of Psychiatry 02/2002; 56(6):433-9. DOI:10.1080/08039480260389352 · 1.50 Impact Factor
  • G Høyer
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    ABSTRACT: This paper explores some of the controversies in the debate regarding the justification of civil commitment. The sometimes conflicting values reflected in the mental health legislation, human rights principles, moral philosophy and psychiatric professional standards are discussed. In spite of the often substantial use of civil commitment in many countries, there are almost no scientifically sound studies addressing the outcome of coercive treatment. The paper establishes that the traditional arguments in favour of civil commitment, like lack of insight and competence as well as the effectiveness of civil commitment, are poorly founded. The paper concludes that there seems to be a general agreement that civil commitment of patients who are dangerous to themselves or others should be the responsibility of the mental health care system, while civil commitment for treatment purposes is more controversial and hard to justify.
    Acta psychiatrica Scandinavica. Supplementum 02/2000; 399:65-71. DOI:10.1111/j.0902-4441.2000.007s020[dash]16.x