Coercive treatment to be proposed for pregnant substance abusers
Calls for greater availability of voluntary treatment as well
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A working group pondering the treatment of pregnant women with substance abuse problems plans to propose that the option of coercive treatment - treatment that is independent of the will of the person in question - should be made available for such cases.
The working group is considering services for expectant mothers who use intoxicants, and is scheduled to publish its proposal in February. Helsingin Sanomat has learned that the task force has already decided on proposing coercive treatment. The final formulation of the proposal, with all of its legal details, is still being worked on.
The report, and its various proposals, is to be submitted to Minister of Social Services Paula Risikko (Nat. Coalition Party).
Coercive treatment is a thorny issue and has both supporters and opponents.
Debate on the issue has continued since 2001, when Osmo Soininvaara (Green), the Minister of Social Services at the time, proposed more efficient care for expectant mothers using intoxicants.
Soininvaara felt that coercive treatment would also be justified, but said that the ministry was only planning for greater efficiency in the providing of voluntary treatment at that time.
The arguments are largely the same as before, with supporters of coercive treatment worried about the effects of the constant increase in the use of alcohol on the health of unborn children.
Opponents warn that the prospect of mandatory treatment could discourage women with substance abuse problems from going to maternity clinics, making it more difficult to prevent the spread of a mother's possible hepatitis C or HIV infection to the child.
The working group plans to propose that the possibility for coercive treatment should be used only as a last resort.
More than 3,000 foetuses are exposed to alcohol each year. The proposal for coercive treatment would apply only to the most difficult cases - a fraction of all mothers who use intoxicants.
Voluntary treatment has shown good results in Finland, and the working group is unanimous in its view that voluntary treatment must be made more easily available. This could impose significant new obligations on local authorities.
Under the present system, there have been difficulties in getting municipalities to agree to meeting the costs of treating pregnant substance abusers. There is also great variation in the services provided by different local authorities.
Ritva Karinsalo, director of the Federation of Mother and Child Homes and Shelters points out that if a decision is made on coercive treatment, more places to treat the mothers will also be needed.
“Will pregnant women be sent to a mental hospital, or put in jail?” Karinsalo asks. rhetorically.
Legislation on both substance abuse treatment and mental health contain paragraphs authorising coercive treatment, but they have generally not been applied to substance abusers who are pregnant.
Sweden has coercive treatment for pregnant substance abusers. In Norway there is a system of “voluntary coercive treatment”, in which entry into the programme is voluntary, but once started, the patient does not have the option of discontinuing it.
Helsingin Sanomat
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| 5.1.2009 - TODAY |
 Coercive treatment to be proposed for pregnant substance abusers |
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