Compulsory Mental Health Care Act

Compulsory care can take place in several places: in a psychiatric hospital, an addiction clinic or at the outpatient clinic. It may mean that the client is obliged to take medication, comply with counselling appointments or be admitted. In some cases, compulsory care can also be provided at home. We only do this if it is safe for the client, their loved ones and the care providers. The practitioner discusses with the client what the content of the care authorization or crisis measure is. It states which care from the judge or mayor must be accepted. The practitioner regularly consults with the client and any loved ones whether the client is still receiving the right care. The client's preferences are taken into account as much as possible. Compulsory care is only provided if it is really necessary.

The mayor can apply compulsory care in a crisis situation. This is when immediate action is required because of the risk to the client and/or their environment. The mayor can decide to proceed with the crisis measure after the advice of a psychiatrist. This psychiatrist is not involved in the treatment. The mayor must also give the client the opportunity to tell his or her story. This is also called 'hearing'.

A crisis measure lasts three days, but can be extended by a judge to a maximum of three weeks. This is decided by the judge during a hearing. During this hearing, those involved are also allowed to tell their story. A lawyer is also assigned for this hearing to ensure that the rules are properly complied with. The client can also seek advice from the patient confidential adviser (PVP).

If there is no acute crisis, but there is sufficient reason to oblige someone to undergo treatment, this is done through a care authorization. A care plan is required for a care authorization. In a care plan, the practitioner writes down which care is needed and suits the client's situation. The client may also indicate his/her preference, and family and loved ones who are important to the client may also indicate what they think of the situation. The practitioner may also consult with other care providers who are involved with the client, for example the general practitioner. The care authorization also requires a medical certificate from a psychiatrist who is not involved in the treatment.

At the beginning of the process, a lawyer is assigned to the client. He ensures that everything runs according to the rules. In addition, the client can ask for advice and assistance from the patient confidant (PVP). Before a care authorization is issued, a hearing takes place in which the judge talks to the client and others about the situation and the documents. After the hearing, the judge will make a decision. The care authorization states exactly which mandatory care may be provided. The judge also indicates how long the care authorization lasts.

On a care card, the client indicates what kind of care he wants to receive when certain circumstances arise. The care card describes the client's vision, to which the care plan can fit in as closely as possible.

If the situation allows, the client may also make a Plan of Action to improve the situation and prevent serious harm to themselves or others due to psychological problems. The client may be helped by family, volunteers, the lawyer or the practitioner. The medical director assesses whether this plan provides sufficient help. If the client makes a good plan of his own, it may be that compulsory care is not necessary after all.

Here you will find a guide to support you in drawing up the plan of action.

In a self-binding statement, the client indicates which forms of compulsory care he commits himself, when he is not doing well and he refuses necessary care. The self-binding statement is especially suitable for people with a varying clinical picture who have previously received (compulsory) care due to a mental disorder. In this way, the client can ensure that the least severe compulsory care is applied in situations that can be foreseen on the basis of previous experiences.

The self-commitment statement is drawn up together with the care manager and is accompanied by a care plan. In order to draw up a self-binding statement, the client must understand what the self-binding statement entails and oversee its consequences. This is determined by an independent doctor or expert by means of a mental capacity assessment.

For complaints, the client can contact the regional complaints committee. More information about this can be found in the vwggz complaints leaflet.