Seattle University Collaborative Projects - International Academy of ...

can be interpreted in a vast number of ways. Such is the case for Community Treatment Orders(CTOs). The purpose of this presentation is to present the findings of a study using InstitutionalEthnography (IE) that explored CTOs in Newfoundland and Labrador, Canada. Participants inthis study included clients, family members, and health professionals, administrators, and otherswho had experience with CTOs in mental health settings. Data collected through interviews andreview of institutional documents were examined for evidence of the social web of influence thatgoverns everyday actions. IE elucidated the everyday work/life experiences with CTOs andshowed how they were influenced by institutional social structures and discourses known asruling relations (Smith, 2005). It also uncovered disjunctures, points where what was actuallyoccurring did not match what was supposed to be occurring. In bringing these patterns anddisjunctures to light, hopefully the resulting awareness will foster a greater understanding ofCTOs, how issues may arise, and how best to deal with such concerns.88. Involuntary Treatment and HospitalizationFreedom Restrictions in Child and Adolescent Psychiatry: Future DutchLegislationVivianne Dorenberg, VU University – Medical Centre (v.dorenberg@vumc.nl)The legal position of young people with mental illness in the Netherlands is governed by a widerange of laws and regulations. None of these laws or regulations present a clear legal frameworkfor freedom restrictions when admitted to a psychiatric hospital, and mental health care providersstruggle with this issue. The term "freedom restrictions" refers to all kinds of measures, fromhouse rules to restraint and seclusion. Current law focuses strongly on keeping patients (or othersin their environment) from harm or danger, without realizing that the treatment of children andadolescents with mental illness entails so much more. Mental health care providers especiallystruggle with pedagogical measures, like sending a child to his or her room. Current law does notrecognize these measures, which means there are no clear legal guidelines for executing them.The Compulsory Mental Health Care Bill (sent to Parliament in 2010) will bring some clarity,but we have to realize that most children and adolescents with mental illness are treated on avoluntary basis. This presentation will discuss current and future Dutch legislation concerningfreedom restrictions in child and adolescent psychiatry (focusing on future legislation) and theneed for practical guidelines.Freedom Restrictions in Care for Youth and Young Adults with a MildIntellectual Disability: Future Dutch LegislationBrenda Frederiks, VU University – Medical Centre (b.frederiks@vumc.nl)214