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Objectives: Compulsory mental health care includes compulsory hospitalisation and outpatient commitment with medication treatment without consent. Uncertain evidence of the effects of compulsory care contributes to large geographical variations and a controversy on its use. Some argue that compulsion can rarely be justified and should be reduced to an absolute minimum, while others claim compulsion can more frequently be justified. The limited evidence base has contributed to variations in care that raise issues about the quality/appropriateness of care as well as ethical concerns. To address the question whether compulsory mental health care results in superior, worse or equivalent outcomes for patients, this project will utilise registry‐ based longitudinal data to examine the effect of compulsory inpatient and outpatient care on multiple outcomes, including suicide and overall mortality; emergency care/injuries; crime and victimisation; and participation in the labour force and welfare dependency. Methods: By using the natural variation in health providers' preference for compulsory care as a source of quasi‐randomisation we will estimate causal effects of compulsory care on short‐ and long‐term trajectories. Conclusions: This project will provide valuable insights for service providers and policy makers in facilitating high quality clinical care pathways for a high risk population group.

Perspectives from psychiatric epidemiology and medical ethics are combined in a comprehensive analysis of geographical variation in compulsory hospitalisation in mental health care. The thesis contains important new knowledge that can help reduce unwarranted geographical varia­tion and compulsion. The magnitude of variation is quantified by analysing registry data spanning the whole population who were compulsorily hospitalised in Norway during 2014 - 2018. Different patterns of variation appear when counts are based on events, individuals and duration. Variations are large and stable over time. These variations suggest that some areas use more compulsion than necessary. They also question if some areas manage with less compulsion than expected due to efficient local services. We ex­plore how municipal mental health services re­late to compulsory hospitalisation by applying hierarchical models to panel data, specifically Random Effects Within-Between models. Fewer compulsory hospitalisations were seen when the number of general practitioners, mental health nurses and public housing was higher, compared to the area average. This indicates that situations where compulsory hospitalisation is considered necessary can hinge on supply of local services. The thesis includes an ethical inquiry of how geographical variation in compulsory hospitalisation can challenge principles of medical ethics. Supply-driven use of compulsion, due to lack of less restrictive alternatives, infringes on the principle of justice. Geographical variation in compulsory hospitalisation can also infringe on the principles of respect for autonomy and non-maleficence, since the principles are challenged differently, depending on area. Uncertainty surrounding beneficial outcomes makes it hard to identify overuse and underuse, but the right level of compulsory hospitalisation would never be higher than minimally necessary in a service system with good practices that promotes voluntariness.

Hvorfor utvikler folk forskjellige politiske verdier, til tross for at de lever og vokser opp under tilsvarende omstendigheter? Ved å analysere survey-data fra Tyskland og Nederland benytter jeg Big-Five rammeverket for å undersøke betydningen av personlighetstrekk for gamle og nye politiske verdier. Verdiorienteringene for ny politikk følger stort sett det samme mønsteret som de gamle dimensjonene, men trekket “åpenhet for nye erfaringer” er enda sterkere knyttet til venstresiden på de nye spørsmålene, mens vi finner den motsatte sammenhengen for trekket “planmessighet”. Ved å videreføre undersøkelsen til partivalg viser jeg at personlighetstrekk forbedrer våre prediksjoner for stemmegivning, og deler av effekten gjenstår til tross for omfattende kontrollvariabler. En høy skåre på trekket “nevrotisisme” øker sannsynligheten for å stemme på partier fra både nye venstre og nye høyre. Analysen avdekker et bilde av AFD-velgerne fra partiets første leveår som vesentlig mer åpne og utdannede enn forventet på bakgrunn av tidligere beskrivelser av nye høyre.

Supplemental material, sj-docx-2-inq-10.1177_0046958020972813 for What Makes Some Diseases More Typical than Others? A Survey on the Impact of Disease Characteristics and Professional Background on Disease Typicality by Tore Hofstad, James A. Hampton and Bjørn Hofmann in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Supplemental material, sj-docx-2-inq-10.1177_0046958020972813 for What Makes Some Diseases More Typical than Others? A Survey on the Impact of Disease Characteristics and Professional Background on Disease Typicality by Tore Hofstad, James A. Hampton and Bjørn Hofmann in INQUIRY: The Journal of Health Care Organization, Provision, and Financing