Marie B. Hagsgård explains how a simple but effective feedback project sought to improve the wellbeing of people coming before the Administrative Court in Karlstad, Sweden…

The Administrative Court in Karlstad undertakes assessment of whether forensic psychiatric care under the Forensic Psychiatric Care Act (1991:1129), LRV, should cease or continue.

This project involved a judge at the administrative court of Karlstad and myself as consultant, carrying out ten qualitative interviews with patients receiving forensic psychiatric care with special discharge trial at the Forensic Psychiatric Clinic in Kristinehamn, Sweden.  A group interview was then carried out with five support persons of the patients.

The purpose of the interviews was to work out what sort of information and what type of conduct by court staff the patients feel would allow them to express themselves and have the issue impartially assessed by the Administrative Court in cases under LRV.

In the interviews patients expressed:

  • a strong frustration because they feel they do not have an adequate opportunity to be heard on the issue of whether the forensic psychiatric care should cease or continue;
  • a feeling that the opinion they put forward was of no consequence when compared to that of the chief physician; and
  • that they wanted support in expressing their opinion in a better way.

The patients and their support persons highlighted several things that could be done in order for the patients to be better able to express their views regarding the issue of discharge. These included:

  • more information in advance of the hearing;
  • a clearer introduction to the hearing;
  • greater activity from the court’s side during the hearing; and
  • clearer and more concrete grounds for decisions.

“For me as a judge it was very interesting to interview the patients. It made a strong impression and has given me a deeper understanding of how the patients perceive the court process.” Marie-Jeanette Axelius Friberg Chief Judge at the Administrative Court in Karlstad

The result of the interviews was reported back to all judges and staff. They discussed the feedback and suggested a range of measures to improve information to the patients and to make judgments clearer.  The court leader also decided to improve information and conduct by judges in several ways in order to make it easier for patients to express their views during the court hearing.

The full report “An impartial trial Interview study at the Forensic Psychiatric Clinic in Kristinehamn” can be accessed online here

Marie B. Hagsgård worked as a judge for 15 years (assistant judge at the district court of Gothenburg and associate judge at the Court of appeal of Western Sweden).  In 2006 she was offered and accepted a permanent post as an organizational developer at the Court of Appeal of Western Sweden, a post she held until the end of 2012. During this time Marie developed the method Internal and External dialogue as a way to improve the functioning of these courts.     Since 2012 and currently Marie has been working as a consultant to support the quality of work in Swedish courts and in other professional organizations. 

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