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Tijdschrift voor Psychiatrie 50 (2008) 9, 567 - 577

New research

The judge follows the advice of the psychiatrist; an investigation into the jurisprudence concerning compulsory admission requests and decisions under the Dutch Act on Special Admissions to Psychiatric Hospitals (Bopz)

T.E. Stikker, R.A. Schoevers, J.A. Swinkels, C.L. Mulder, W. van Tilburg

People are under the impression that there are differences between regions and between psychiatrists and judges in the criteria that are applied with regard to compulsory admission under the Dutch Act on Special Admissions to Psychiatric Hospitals (Bopz).
aim To find out how the legal criteria are currently put into operation, what topics come up for discussion and what evidence the judge generally requires in order to have recourse to compulsory admission.
method All judgments pronounced between 2002 and June 11 2005 and published in the journal Bopz Jurisprudence (bj) were analysed juridically.
results In two-thirds of the cases the judge followed the advice of the psychiatrist and decided on compulsory admission. The required admission was refused for formal judicial reasons or because circumstances during the court hearing differed from those prevailing at the time when the medical report was drawn up. There was very little discussion about psychiatric disturbances or about the seriousness of the danger involved, but no objective criteria on this subject exist.
conclusions The jurisprudence suggests that within the boundaries of the legally defined criteria there is still room for manoeuvre and negotiation with regard to compulsory admission applications under the Bopz Act. It is very important that the psychiatrist fully underpins his findings and draws up his application in accordance with the requirements of the Bopz Act and satisfies the judge's need for detailed information. The development and utilisation of instruments for assessing the degree of danger and the severity of the psychiatric disturbance within the framework of the Bopz could be a useful supplement to the law in its current form.

keywords Act on Special Admissions to Psychiatric Hospitals (Bopz Act), compulsory admission, criteria, judge, jurisprudence, psychiatrist