The paper presents findings from an ongoing project concerning compulsory community care (CCC) in Sweden. CCC was introduced for both civil and forensic patients in 2008, following a series of incidents of assault involving people with mental illness that were widely reported in mass media. The stated purpose of CCC, however, is to facilitate the transfer of inpatients to community care.
Throughout the world, CCC has been controversial because it involves new ethical questions. For example, coercive measures may be invoked over longer time periods and they infringe into new and more private spheres of citizens. On an organizational level, it requires improved cooperation between health and social service providers.
The objective of this paper is to investigate the experiences of forensic patients subjected to CCC. Three aspects of experiences are focused: 1) what is the everyday life experience of being under CCC? 2) How is being under CCC different from other forms of voluntary and involuntary care? 3) How is CCC affecting the ways in which compliance is achieved? The objective is reached by analysis of 12 qualitative interviews with patients.
The paper notes that it is difficult for patients to separate the experience of CCC from the overall experience of psychiatric care and other forms of coercive interventions. Furthermore, it discusses the implications of some main findings: patients evaluate CCC as positive in comparison to inpatient care; patients have a poor understanding of regulations surrounding CCC; despite the label “community care”, some housing arrangements are very similar to confined institutions; patient compliance seems to be based on a culture of “sticks and carrots”.