<p>The Swedish and the Finnish compulsory care legislation that regards abusers differ in several ways. The arguments for compulsory care and for the time which one will receive compulsory care are dissimilar. The aim of this thesis is to describe and analyse which arguments for compulsory care and the length of the care time that has been expressed in the Swedish and the Finnish laws and in the statutes. The tools were an argumentation analysis, which is a form of qualitative text analysis method, combined with a hermeneutic scientific position. We have investigated the arguments that try to justify compulsory care and the care time that has been expressed in the laws and the statutes. The next step has been to analyse the text on the basis of an argumentation analysis and the theories. The theoretical starting point has been Michel Foucault's concept of power and discipline, the paternalistic and utilitarian values and four ethical perspectives. Important conclusions are that Sweden’s arguments for applying compulsory care are to inhibit, in particular the young abusers, from destroying their lives. The care time, on maximum 6 months, is justified with the arguments that motivation for continued voluntary treatment will be provoked. The arguments in Finland has focused on removing the abuser from the society during an acute stage of the abuse, where the abuser’s life or somebody else’s life in the abusers environment is in danger, this can take place for maximum 30 days. Our results have pointed out that Sweden has a more paternalistic view to the compulsory care of abusers than Finland.</p>

<p>In this dissertation, I explore a quite unique legal situation, namely administrative court hearings relating to coercive interventions: the Care of Young Persons Act (LVU), Care of Abusers (Special Provisions) Act (LVM), and the Compulsory Psychiatric Care Act (LPT). There are three central participatory roles in the court hearings: The official party is the authority who files the application for coercive intervention – either a chief psychiatrist or a social welfare board (typically represented by a social worker or sometimes a lawyer assisted by a social worker), whereas the citizen party is the person about whom the application is brought. The citizen party is represented by a legal representative. The professionals represent two different logics: therapeutic and judicial.</p><p>The purpose of this dissertation has been to study the tension between therapeutic and judicial logic in court hearings relating to compulsory care. With theoretical concepts from Scott (1995) and Wetherell & Potter (1998), it is possible to say that the therapeutic and judicial logics are built up by institutional elements that are communicated through interpretative repertoires. Three questions are central:</p><p>1. How do professional participators handle the different role expectations embedded in therapeutic and judicial logic? In this case, I am particularly interested in role conflicts faced by social workers and psychiatrists.</p><p>2. How do different institutional elements (regulative, normative/cognitive) play out in the court hearings?</p><p>3. To what extent can these court hearings be considered a scrutinizing order of discourse, where the arguments of official party are subjected to critical examination?</p><p>In my analysis I am inspired by both critical discourse analysis and organizational theory, more precisely, new institutionalism. These two perspectives provide useful insights and make it possible to combine the micro- and macro levels in the analysis. Data for the analysis consist of 43 court hearings and 31 interviews, gathered from two different county administrative courts in Sweden. All written documents used and produced by the courts are also part of our data.</p><p>The dissertation consists of five studies that indicate that the court hearings hardly can be described as a scrutinising order of discourse. In spite of this, the court constantly finds that the legal criteria for coercive intervention are satisfied. Neither the official party nor the legal representative argue according to a judicial logic. Instead, therapeutic logic dominates the order of discourse. When the arguments for compulsory care are therapeutic, they are not explicitly related to the criteria in the law. In my interpretation, the reason why the conflict between therapeutic and judicial logic is not realised can be found in the existence of a logic of normalisation. This ideological logic of normalisation can be found in most of the institutions in the Swedish society and are built on the idea of traditional welfare norms.</p>

The Swedish and the Finnish compulsory care legislation that regards abusers differ in several ways. The arguments for compulsory care and for the time which one will receive compulsory care are dissimilar. The aim of this thesis is to describe and analyse which arguments for compulsory care and the length of the care time that has been expressed in the Swedish and the Finnish laws and in the statutes. The tools were an argumentation analysis, which is a form of qualitative text analysis method, combined with a hermeneutic scientific position. We have investigated the arguments that try to justify compulsory care and the care time that has been expressed in the laws and the statutes. The next step has been to analyse the text on the basis of an argumentation analysis and the theories. The theoretical starting point has been Michel Foucault's concept of power and discipline, the paternalistic and utilitarian values and four ethical perspectives. Important conclusions are that Sweden’s arguments for applying compulsory care are to inhibit, in particular the young abusers, from destroying their lives. The care time, on maximum 6 months, is justified with the arguments that motivation for continued voluntary treatment will be provoked. The arguments in Finland has focused on removing the abuser from the society during an acute stage of the abuse, where the abuser’s life or somebody else’s life in the abusers environment is in danger, this can take place for maximum 30 days. Our results have pointed out that Sweden has a more paternalistic view to the compulsory care of abusers than Finland.

Svensk barnavård och tvångsvård av barn och unga har diskuterats och problematiserats av flertalet forskare och har även varit lagstadgat sedan början av 1900-talet. Lagen och hur samhället ser på problembeteende och skyddsbehov har sedan dess förändrats. Exempelvis så var den dominerande synen, innan 1900-talet, att samhället hade en viss skyldighet att skydda och hjälpa barn och unga i nöd men präglades snarare av ett samhällsskyddande synsätt. Även vad som anses vara ett problem har förändrats över tid och korrigerats inom lagstiftningen. Hur vi människor kommer överens om vad som är normalt eller normbrytande görs dels genom sociala processer men också genom språk där vi konstruerar en gemensam verklighet som vi förhåller oss till. Lagstiftningen som sådan är en, av människan skapad, konstruktion av vad vi gemensamt anser är de normer som vi ska förhålla oss till. Därav anser vi att det är intressant att se hur barn och ungdomars normbrytande beteende skrivs fram, framställs eller konkretiseras i domar som berör tvångsvård av barn. Studiens syfte är att undersöka hur ett barns skyddsbehov och problembeteenden konstrueras i domar rörande 3 § lagen (1990:52) med särskilda bestämmelser om vård av unga (LVU). För att besvara studiens syfte har följande frågeställning varit vägledande; vilka problembeteenden och skyddsbehov framställs i domar som avser vård enligt 3 § LVU? Ett kvalitativt angreppssätt har använts för att svara på studiens syfte och frågeställning. Studiens empiri består av 33 förvaltningsrättsdomar mellan åren 2012 och 2017 från en, för studien, specifik kommun. Studiens teoretiska utgångspunkt är socialkonstruktionism och tematisk analys används som analysverktyg. Studien analyseras med stöd av socialkonstruktivistisk teori och med stöd av tankar från bland andra Johanna Schiratzki, Anna Hollander, Astrid Schlytter, Lina Ponnert, Pernilla Leviner och Titti Mattsson, för att nämna några. Resultatet presenteras med stöd av fem huvudteman; brottslig verksamhet, missbruk av beroendeframkallande medel, något annat socialt nedbrytande beteende, påtaglig risk och samtycke. Samt fem subteman utifrån rekvisitet socialt nedbrytande beteende; olämpliga miljöer, missbruk, bristande skolgång, kriminalitet och sist neuropsykiatriska diagnoser och/eller annan psykisk variation. Studiens resultat visar på att de ungas skyddsbehov och problembeteende skrivs fram genom rekvisiten inom LVU lagstiftningen och att konstruktionen av dessa börjar i och med socialsekreterarens LVU-utredning och socialnämndens ansökan om vård med stöd av LVU. Resultatet visar även på att förvaltningsrätten som oftast bifaller socialnämndens ansökan om vård och i studiens empiriska material avslås endast två ansökningar. I studiens avslutande kapitel förs en diskussion om studiens slutsatser men också om vidare forskning kring konstruktionen gällande barn och ungdomars skyddsbehov och problembeteende. / Swedish child welfare and compulsory care for children and adolescents has been discussed and problematized by most researchers and been statutory since the beginning of the 20th century. The law and the way Swedish society views problem behavior, child and adolescent delinquency and the need to care and protect the children with such needs has changed over time. For example, the dominant view, before the 20th century, was that society had a certain obligation to protect and help children and young in need, but rather was characterized by a community-protection approach. What society considers to be a problem behavior has changed over time and been corrected multiple times within the law. How people agree on what is a normal or problematic behavior, when it comes to children and adolescents, is through social processes and language. Through our common social processes and languages we construct a common reality to which we can relate. Legislation as such is a man-made construction of what we commonly consider to be the norms that we should follow. Therefore, we find it interesting to understand how children and adolescents problem behavior is expressed, produced or concretized in judgments relating to compulsory care.  The purpose of the study is to investigate how a child’s or young person’s problem behaviors and protection needs are constructed in judgments relating to 3 § of the care of young people (special provision) act (LVU). In order to answer the purpose of the study the following questions should be asked; what problem behaviors and protection needs are constructed in judgments relating to care under 3 § of the LVU? A qualitative approach has been used to answer the study’s purpose and questions. The empirical study consists of 33 court judgments between 2012 and 2017 from one specific municipality. The theoretical basis of the study is social constructionism and thematic analysis is used as an analytical tool. The study is analyzed on the basis of social constructivist theory and supported by research from, to name a few, Johanna Schiratzki, Anna Hollander, Astrid Schlytter, Lina Ponnert, Pernilla Leviner and Titti Mattsson.  The results of the study indicate that the problem behavior and protection needs of children and young people are constructed through the LVU-legislation process and that the social construction begins with the Social Welfare Committee's LVU investigation and application for care with the support of LVU. The result also shows that law most often approves of the Social Welfare Committee's application compulsory care. In the empirical material of the study, only two applications were rejected. The study's final chapter discusses the conclusions of the study, but also on further research on the construction of children and young people's problem behavior and protection needs.

Denna uppsats skall genom granskningar av domstolsprotokoll, och dess beslutsgrundande motiveringar, undersöka hur tvångsingripande åtgärder vid missbruk enligt LVM-lagstiftningen tillämpas. Intentionen är försöka finna de underliggande och uppbyggda formuleringar som rättfärdigar den svenska staten, att via socialtjänst och förvaltningsrätter frihetsberöva och tvångsvårda medborgare mot den enskildes vilja. Är det inte den fria medborgarens rättighet att leva sitt liv som den önskar även om det anses som ett destruktivt leverne? Empirin är av mig uppbyggd utifrån de diskurser som blottläggs vid undersökningen. Syftet med sammanställningen av de olika diskurserna och begreppen som förekommer i dessa domstolsbeslut är att ge insyn i en verksamhet som med stor säkerhet går allmänheten förbi. Detta kan förklaras med att detta rör en sådan i periferin existerande grupp av människor. Jag vill vidare påvisa ett kritiskt tänkande kring fenomenet och slutligen ge förslag till en förändring av företeelsen. / This investigation will examine, through audits of court protocols, and its motivational reasons, how enforcement measures are applied in the event of abuse under the LVM legislation. To try to find the underlying and also the case-formulated formulations that justify the Swedish state, through its municipalities' social services and administrative rights, to the detention of the individual's detention and coercion for citizens. Is not it the free citizen's right to live his life as it wishes even if it is  considered a destructive delivery? The empirin is built on the basis of the discourses exposed to the investigation. The intention of compiling the different discourses and concepts contained in these court decisions is to provide insight into an activity that surely passes the public when it comes to such a peripheral group of people as well as to demonstrate critical thinking about the phenomenon and finally suggest a change of the phenomenon

According to the regulations contained in the Social Services Act (SFS 2001:453), Swedish social services have a legal responsibility to provide support, care, and treatment for individuals with substance use problems.  This law mandate those who are responsible to provide treatment to motivate drug users to actively seek treatment on a voluntary basis, ensuring an end to their dependence on drugs. Studies have shown that although the treatment system largely focuses on promoting abstinence, about two-thirds of client’s relapse into substance use within one year after completing treatment. This dissertation focuses broadly on clients who repeatedly enter and use treatment for substance use disorders in the Swedish addiction treatment system. The aim of this thesis is to examine and identify the population groups who are repeated treatment users of the Swedish treatment system for substance use disorder, including both the voluntary treatment and compulsory care. This thesis was based on three national level databases. The results showed that clients with a higher degree of problems and problems in different areas of life also had an increased risk of having treatment for substance use disorder repeatedly. Clients who were older, men, reported more years of polydrug and alcohol use to intoxication, reported more compulsory care episodes for substance use, had ever been charged with crime, had ever been in inpatient mental health treatment, and had a higher ASI mental health symptom composite score, were significantly more likely to report more voluntary addiction treatment episodes. The strongest significant association with the number of treatment episodes was the number of compulsory treatment episodes for alcohol and drugs. Individuals who experienced prior compulsory care including mandatory treatment through LVU (law (1990:52)), been in prison, and had children mandated to out-of-home care, were more likely to have two or more entries in the compulsory care system for substance use disorder. In addition, this analysis showed that 59% of clients mandated to compulsory care dropped-out during their compulsory care episode, and that younger clients were significantly more likely to drop-out. Those who drop-out were significantly more likely to experience negative outcomes, i.e. additional sentence to compulsory care and higher risk of mortality.  A hierarchal logistic regression model also identified that individuals with riskier childhood conditions were more likely to have had repeated entries to compulsory care for substance use disorder. The indirect effects showed that a family history of substance use disorder and psychiatric problems are both associated with higher probability of institutional care as a child i.e. LVU, and that in turn, mandated childhood institutional care is related to repeated compulsory care intakes as an adult. Individuals who use treatment for substance use disorder repeatedly have a higher degree of problems i.e. an exposed and problematic group of individuals characterized by problem in several different areas of life. Growing up in a home environment with unfavorable conditions, mandated care before the age of 18 (LVU), compulsory care for substance use disorder as an adult, children taken into out-of-home care, and crime are the factors that are primarily associated with repeated treatment for substance use. A change in the view of treatment for clients in need of repeated use of treatment seems important, and access to adapted continuous care efforts are crucial to counteract the risk of relapse after a treatment episode of voluntary or compulsory care. Further, it seems important to motivate the client to complete the compulsory care without any deviation, since this seems to have positive effects on their substance use disorder.

This research will explore how social workers in the Swedish childcare system argue about semi coercive measures, tensions between voluntariness and coercion, and their discretion for those actions. Semi coercive measures are regulated by The Care of Young Persons Act (LVU), section 22. To investigate this a qualitative method was adopted. Eight semi- structured interviews were conducted with social workers that have experience when it comes to work within social services regarding children and young people. The research utilises a thematic analysis as a means of processing the data. To analyse the results, Lipsky’s theoretical concept; Street-level bureaucracy and Foucault’s theoretical concept of power; discipline and disciplining based on panopticism and pastoral power, are used. The analysis of the results indicates that the respondent’s views of the tension between coercive and voluntary measures differ, and that there is no clear distinction. Most of the respondents considered the regulations on semi coercive measures as unnecessary while others thought they are a useful tool when implemented correctly. Moreover, social workers use similar forms of semi coercive measures but not according to section 22 LVU. Respondents use their discretion in different ways, which influences their views on whether the section is necessary or not.

Bakgrund: Att vårdas mot sin vilja medför en komplicerad vårdsituation, trots detta måste patienten kunna erbjudas en god humanistisk psykiatrisk hälso- och sjukvård på lika villkor. Att bli utsatt för tvångsåtgärder under vårdtiden kan medföra trauma och skadar behandlingsalliansen med patienten. Således blir en av de viktigaste faktorerna för att kunna uppnå en god psykiatrisk vård att i största möjliga mån försöka undvika tvångsåtgärder under vårdtiden. Syfte: Syftet med studien var att belysa patienters uppfattning av faktorer som bidrog till tvångsåtgärder. Metod: Studien utfördes som en kvalitativ litteraturstudie och utgick från sökningar i de vetenskapliga databaserna, PubMed, Cinahl och PsycINFO. Åtta kvalitativa artiklar inkluderades i resultatet, vilka alla var utförda i nordiska länder. Studierna analyserades genom en metasyntes som utgick ifrån Thomas &amp; Hardens metod för tematisk syntes. Resultat: Det framkom att patienterna tyckte att det var personalen som i stor omfattning bidrog till att tvångsåtgärder blev nödvändiga. Sexton första nivåns teman identifierades i artiklarna. Fyra andra nivåns teman framkom där bland annat maktfaktorer, brister hos personalen och bristande delaktighet framkom, vilket slutligen mynnade ut i två resultatteman: Tvångsvård kunde skapa en maktobalans som missbrukades och ledde till onödiga tvångsåtgärder och starkare mellanmänskliga relationer mellan vårdare och vårdtagare bidrog till en mer personcentrerad vård som minskade antalet tvångsåtgärder. Efter bedömningen av GRADE CERQual framkom att det är möjligt att fyndet är en rimlig representation av fenomenet. Konklusion: För att kunna minska antalet tvångsåtgärder måste patienternas perspektiv stå i fokus, vilket innebär en personcentrerad vård där personalen utgår ifrån patientens synvinkel och behandlar dem som likvärdiga människor så att de kan vara mer delaktiga i sin vårdprocess. / Background: Being cared for against one's will entails a complicated care situation, despite this, the patient must be able to be offered good humanistic psychiatric health care. Being subjected to coercive measures during the care can lead to trauma and damage the treatment alliance with the patient. One of the most important factors to be able to achieve good psychiatric care is to try as much as possible to avoid coercive measures during the care. Aim: The aim of the study was to shed light on patients' perceptions of factors that contribute to coercive measures.Method: The study was conducted as a qualitative literature study and was based on searches in the scientific databases, PubMed, Cinahl and PsycINFO. Eight qualitative articles were included, all were made in the Nordic countries. The studies were analyzed through a meta-synthesis based on Thomas &amp; Harden's method for thematic synthesis. Results: It emerged that the patients thought that it was the staff who to a large extent contributed to the necessity of coercive measures. Sixteen first-level themes were identified in the articles. Four second-level themes emerged where, among other things, power factors, staff shortcomings and lack of participation emerged. Which ultimately resulted in two result themes: Compulsory care could create a balance of power that was abused and led to unnecessary coercive measures, and stronger interpersonal relationships between caregivers and care recipients contributed to a more person-centered care that reduced the number of coercive measures. After the assessment of GRADE CERQual, it emerged that it is possible that the finding is a reasonable representation of the phenomenon.      Conclusion: To reduce the number of coercive measures, the patients' perspective must be in focus, which means a person-centered care where the staff starts from the patient's point of view and treats them as equal people so that they can be more involved in their care.

The legislation should be gender neutral, and should not have a gender bias, but it does happen that the court takes decisions based on gender stereotypes and norms. The purpose of this thesis is to investigate if there are any gender constructions in the Care of Young Persons Ac, to highlight these possible differences between how boys and girls get judged according to article 3 in the law and also on what grounds the girls and boys are taken into custody. The thesis is based on 28 judgements from the Administrative court of appeal in Sweden. The first question that is answered in the thesis is how girls and boys are represented or written about in the judgements regarding article 3 in the Care of Young Persons Act. The second question that is answered is on what grounds these children are taken into compulsory care and if these grounds differ on the basis of gender. Gender theory is the theoretical framework in this thesis and is applied on the judgements. The results in this thesis show that there are certain differences between how boys and girls are judged according to article 3 in the Care of Young Persons Act. The analysis of the 28 judgements show that the differences can be that girls are taken into compulsory care based on descriptions of their sexuality. Their mental illnesses and emotions are more highlighted in the judgements. The results found that there are more boys taken into compulsory care and they are more involved in criminality and have violent behaviour and a heavier drug addiction compared to the girls. The gender differences could mostly be seen in statements made by the social welfare board in the judgements and in some statements made by the Administrative court of appeal when they described the “vagabonding” lifestyle of the girls.

Sedan år 1982 har utgångspunkten varit att socialtjänstens verksamhet ska grunda sig i den enskildes integritet och självbestämmanderätt. Den enskilde ska därigenom själv få bestämma huruvida en viss insats från socialtjänsten ska tas emot eller inte. Insatserna ska således grunda sig i frivillighet och utformas tillsammans med den enskilde. Detta gäller även när ett barn har behov av vård. I vissa fall föreligger dock ett behov av tvångsvård, där principen om frivillighet och självbestämmande inte kan upprätthållas på samma sätt som vid socialtjänstens frivilliga insatser. Ett barn ska enligt 1 § andra stycket LVU beredas vård i det fall 2 eller 3 §§ LVU är uppfyllda samt att det kan antas att barnet inte kan ges behövlig vård med samtycke av vårdnadshavarna och barnet självt om det har fyllt 15 år. Av bestämmelsen kan därmed utläsas att ett samtycke dels är en förutsättning för att socialnämnden ska kunna fatta beslut om frivilliga insatser, dels att ett samtycke till frivilliga insatser i regel utgör ett hinder för att det ska kunna fattas beslut om tvångsvård enligt LVU.  I uppsatsen uppmärksammas att det kan finnas viss problematik med ett samtycke till frivilliga insatser. Det kan tänkas förekomma situationer där ett samtycke till frivilliga insatser inte kan anses vara tillräckligt för att ett barn ska kunna ges nödvändiga insatser. Det kan vidare tänkas förekomma situationer där det saknas samtycke till frivilliga insatser, men tvångsvård heller inte kan aktualiseras på grund av att barnets situation inte är tillräckligt allvarlig för att uppfylla kraven i 2 eller 3 §§ LVU. Eftersom problematikerna handlar om just samtycke uppmärksammas även vad ett samtycke till frivilliga insatser har för rättslig innebörd och vad som krävs för det ska kunna betraktas som giltigt. För att utreda vad som gäller i dessa situationer och vilka möjligheter som finns att besluta om tvångsvård eller andra insatser för barnets räkning används den rättsdogmatiska metoden i uppsatsen. Metoden används inledningsvis för att identifiera och beskriva gällande rätt på området. Vidare används den för att analysera och kritisera gällande rätt samt diskutera förslag de lege ferenda. Uppsatsen avslutas därefter genom att den deskriptiva och analytiska delen binds ihop till sammanfattande slutsatser. / Since 1982, the starting point has been that the activities of the social services should be based on the individual's integrity and right to self-determination. The individual must thereby be able to decide for himself whether a certain contribution from the social services is to be received or not. The contributions must thus be based on voluntariness and be designed together with the individual. This also applies when a child needs care. In some cases, however, there is a need for compulsory care, where the principle of voluntariness and self-determination cannot be maintained in the same way as in the social services' voluntary contributions. According to 1 § second part LVU, a child must be provided with care if 2 or 3 §§ LVU are fulfilled, and it can be assumed that the child cannot be given the necessary care with the consent of the guardians and the child himself if he has reached 15 years. It can thus be read from the regulation that a consent is partly a prerequisite for the social welfare board to be able to decide on voluntary contributions, and partly that a consent to voluntary contributions generally constitutes an obstacle to a decision on compulsory care according to LVU.  The essay draws attention to the fact that there may be some problems with a consent to voluntary contributions. There may be situations where a consent to voluntary contributions cannot be considered sufficient for a child to be given the necessary contributions. Furthermore, there may be situations where there is no consent to voluntary contributions, but compulsory care can also not be actualized because the child's situation is not serious enough to meet the requirements of 2 or 3 §§ LVU. Since the problems are specifically about consent, attention is also paid to what a consent to voluntary contributions has for legal meaning and what is required for it to be considered valid. To investigate what applies in these situations and what opportunities there are to decide on compulsory care or other contributions on behalf of the child, the legal dogmatic method is used in the essay. The method is initially used to identify and describe current law in the field. Furthermore, it is used to analyze and criticize current law and discuss proposals de lege ferenda. The essay is then concluded by binding the descriptive and analytical part together into summarized conclusions.