Commitment to psychiatric care: what justifies broader criteria for minors?

Background

Commitment to psychiatric care is in Finland allowed for minors in broader terms than for adults. Minors can be committed to and detained in involuntary psychiatric treatment if they suffer from severe mental disorder and fullfil the additional commitment criteria defined in the Mental Health Act. Adults can be committed to involuntary psychiatric care only if they are mentally ill (= psychotic), and fullfil the additional criteria. Involuntary treatment of minors has been increasing steadily since the Mental Health Act was passed in 1991.

Methods

This study was set up to find out whether the Finnish child and adolescent psychiatrists agree with the need for defining broader commitment criteria for minors, and why. Semi-structured, reflexive dyadic interviews were carried out with 44 psychiatrists working with children and adolescents. The data was analyzed using qualitative and quantitative content analysis.

Results

The analysis showed that broader commitment criteria for minors were favored referring to developmental needs related to childhood and adolescence, prevention of mental illnesses and inadequacy of descriptive diagnosis in childhood and adolescence. The commitment criteria were rather seen as too narrow for adults than as too broad for minors, and the medical rights of minors were preferred over self-determination.