2025-06-112024/25:SoU16 · p.11SoUHealth & social services

Treatment methods

Evidence-based treatment methods and the right to medication-free psychiatric care

What's at stake: The decision affects how quickly older treatment methods for mental ill-health and depression are tested against newer evidence, and what rights patients have to opt out of psychiatric medication in favour of medication-free care.

Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.

What the vote decides

The question is whether the government should issue a special mandate to review evidence-based treatment methods for mental ill-health and enshrine the right to medication-free psychiatric care in law, or whether the Patient Act's current right to choose treatment alternatives and the existing knowledge-governance system are already sufficient.

Yes Yes — the committee proposal

The committee rejects the motions on treatment methods for mental ill-health. It refers to the fact that the Patient Act already gives patients the right to choose between treatment alternatives consistent with science and proven experience, that the national system for knowledge governance in healthcare aims to spread and use the best possible knowledge, and that the National Board of Health and Welfare and the Public Health Agency already have mandates to follow up and support work in the area of mental health. The committee therefore sees no reason for a formal statement.

No No — the reservations

Reservation 17 (SD)

The reservation (SD) wants the government to give the National Board of Health and Welfare a special mandate to thoroughly review evidence-based treatment methods for mental ill-health and depression, with the aim of replacing older methods with newer ones where there is evidence of better effect. It also wants to strengthen the right to medication-free psychiatric care and for the government to come back to the Riksdag with a proposal for a clear provision in the Patient Act on this right.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 17 by SD.

Abstain The party marks a position of its own that is not one of the two final alternatives.

What each plan points to — and how the party voted

For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.

PlanVoteConfidenceEvidence
VNoAbstain 0/0/20/4departs from the planconfidence: mediumnot addressed
SNoYes 90/0/0/16departs from the planconfidence: mediumderived
MPNoYes 14/0/0/4departs from the planconfidence: highderived
CNoYes 19/0/0/5departs from the planconfidence: mediumderived
LNoYes 13/0/0/3departs from the planconfidence: mediumderived
KDNoYes 15/0/0/4departs from the planconfidence: mediumderived
MNoYes 58/0/0/10departs from the planconfidence: lownot addressed
SDown reservationNoNo 0/61/0/11follows the planconfidence: mediumderived

Committee proposal

The Riksdag rejects the motions 2024/25:622 by Leila Ali Elmi (MP) claims 1-3, 2024/25:1362 by Carina Ståhl Herrstedt et al. (SD) claims 19, 22 and 23 as well as 2024/25:1923 by Nooshi Dadgostar et al. (V) claim 30.

Original (Swedish)

Riksdagen avslår motionerna 2024/25:622 av Leila Ali Elmi (MP) yrkandena 1-3, 2024/25:1362 av Carina Ståhl Herrstedt m.fl. (SD) yrkandena 19, 22 och 23 samt 2024/25:1923 av Nooshi Dadgostar m.fl. (V) yrkande 30.

Riksdag decision: The Riksdag rejected approximately 160 proposals on the organization of health and medical care that were submitted in motions during the general motion period of 2024. The Riksdag refers, among other things, to previous and ongoing work on the issues that the proposals address. The proposals concern, among other things, privatization and choice of care, accessible and equitable care and mental health.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoAbstaindeparts from the plannot addressed

The plan requires that healthcare is built on evidence and prioritized according to need, which supports the requirement that the National Board of Health and Welfare reviews treatment methods and replaces older methods with those with better evidence.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan requires that healthcare is built on evidence and prioritized according to need, which supports the requirement that the National Board of Health and Welfare reviews treatment methods and replaces older methods with those with better evidence. The election manifesto finds that mental ill-health is increasing without leading to expanded care and that help shall be given quickly also for burnout. The right to medicine-free care follows from the plan's protection of personal integrity and self-determination.

Original (Swedish)

Planen kräver att sjukvården bygger på evidens och prioriteras utifrån behov, vilket bär kravet på att Socialstyrelsen granskar behandlingsmetoder och ersätter äldre metoder med sådana som har bättre evidens. Valmanifestet konstaterar att den psykiska ohälsan ökar utan att det leder till utbyggd vård och att hjälp ska ges snabbt också vid utmattning. Rätten till medicinfri vård följer av planens skydd för den personliga integriteten och självbestämmandet.

  • evidence-based care according to needdecisive»evidens och prioriteras utifrån behov.« (party programme ↗)“evidence and prioritized according to need.”
  • expanded care for mental ill-health»Stressrelaterade sjukdomar blir allt vanligare och psykisk ohälsa ökar särskilt bland kvinnor och hos unga utan att det leder till utbyggd vård eller förändrad arbetsmiljö.« (2022 manifesto ↗)“Stress-related illness is becoming increasingly common and mental ill-health is increasing especially among women and young people without it leading to expanded care or changed work environment.”
  • quick help for mental ill-health»Du ska ha rätt till hjälp snabbt oavsett om du har brutit benet eller blivit utbränd.« (2022 manifesto ↗)“You shall have the right to help quickly whether you have broken your leg or become burned out.”
  • self-determination in care»har rätt till skydd av sin personliga integritet.« (party programme ↗)“have the right to protection of their personal integrity.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SSocialdemokraternaNoYesdeparts from the planderived

The plan requires ambitious measures against mental ill-health and healthcare at the technical and medical forefront, which speaks in favour of replacing older treatment methods with newer ones where evidence is better.

Plan documents: party programme

Reasoning and quotes

The plan requires ambitious measures against mental ill-health and healthcare at the technical and medical forefront, which speaks in favour of replacing older treatment methods with newer ones where evidence is better. Equal right to good care provided by society also supports the requirement to clarify the right to treatment alternatives. The plan says nothing specifically about medicine-free psychiatric care.

Original (Swedish)

Planen kräver ambitiösa insatser mot psykisk ohälsa och en sjukvård i teknisk och medicinsk framkant, vilket talar för att äldre behandlingsmetoder byts ut mot nyare där evidensen är bättre. Lika rätt till god vård genom samhällets försorg bär också kravet på att rätten till behandlingsalternativ förtydligas. Planen säger inget om medicinfri psykiatrisk vård särskilt.

  • measures against mental ill-healthdecisive»Ambitiösa insatser mot psykisk ohälsa, särskilt bland barn och unga.« (party programme ↗)“Ambitious measures against mental ill-health, especially among children and young people.”
  • care at the medical forefront»Sjukvård i teknisk och medicinsk framkant.« (party programme ↗)“Healthcare at the technical and medical forefront.”
  • equal right to good care»Lika rätt för alla till god hälso- och sjukvård genom samhällets försorg.« (party programme ↗)“Equal rights for all to good health and medical care provided by society.”
  • state responsibility for equality»Ökat statligt ansvar och kontroll över sjukvården för nationell likvärdighet.« (party programme ↗)“Increased state responsibility and control over health care for national equality.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MPMiljöpartietNoYesdeparts from the planderived

The plan wishes work with alternatives to medication, such as psychotherapy, to continue to be developed because medication consumption is a problem for patient safety, which bears the demand for strengthened right to medicine-free psychiatric care.

Plan documents: party programme

Reasoning and quotes

The plan wishes work with alternatives to medication, such as psychotherapy, to continue to be developed because medication consumption is a problem for patient safety, which bears the demand for strengthened right to medicine-free psychiatric care. Patient autonomy and rights shall be strengthened. The demand for a review of the evidence base responds to the plan's requirement that healthcare shall be based on scientific evidence.

Original (Swedish)

Planen vill att arbetet med alternativ till läkemedel, som psykoterapi, fortsätter att utvecklas eftersom läkemedelskonsumtionen är ett problem för patientsäkerheten, vilket bär kravet på stärkt rätt till medicinfri psykiatrisk vård. Patientens självbestämmande och rättigheter ska stärkas. Kravet på en granskning av evidensläget svarar mot planens krav på att vården ska bygga på vetenskapligt stöd.

  • alternatives to medicationdecisive»Miljöpartiet vill också att arbetet med att använda alternativ till läkemedel, exempelvis motion på recept och psykoterapi, fortsätter att utvecklas då läkemedelskonsumtionen i dag är ett problem både för patientsäkerheten och miljön.« (party programme ↗)“The Greens also wish work to continue with using alternatives to medication, for example exercise on prescription and psychotherapy, since medication consumption today is a problem both for patient safety and the environment.”
  • strengthened patient rights»Vi vill stärka patientens rättigheter och satsa mer på hälsofrämjande vård.« (party programme ↗)“We wish to strengthen patient rights and invest more in health-promotion care.”
  • patient autonomy»Patientens självbestämmande och delaktighet är en allt viktigare del av hälso- och sjukvården.« (party programme ↗)“Patient autonomy and participation is becoming an increasingly important part of healthcare.”
  • evidence requirements in healthcare»Den offentligt finansierade sjukvården ska dock inte uppmuntra eller stödja en patient att använda sig av metoder som saknar vetenskapligt stöd.« (party programme ↗)“Publicly funded healthcare shall, however, not encourage or support a patient to use methods that lack scientific evidence.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

CCenterpartietNoYesdeparts from the planderived

The election manifesto wants care to have better tools for treating mental illness, and the party programme requires that care be based on science and proven experience and encourages new methods.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The election manifesto wants care to have better tools for treating mental illness, and the party programme requires that care be based on science and proven experience and encourages new methods. A review that replaces older methods with better evidence-based ones follows from this. The plan's principle on having influence over one's own care also supports the requirement for a strengthened right to non-pharmaceutical psychiatric treatment.

Original (Swedish)

Valmanifestet vill att vården får bättre verktyg för behandling av psykisk ohälsa, och partiprogrammet kräver att vården vilar på vetenskap och beprövad erfarenhet samt uppmuntrar nya metoder. En granskning som byter ut äldre metoder mot bättre evidensbaserade följer av det. Planens princip om inflytande över den egna vården bär också kravet på en stärkt rätt till medicinfri psykiatrisk vård.

  • science and proven experiencedecisive»God vård och omsorg i hela landet, baserad på vetenskap och beprövad erfarenhet« (party programme ↗)“Good care in the entire country, based on science and proven experience”
  • better treatment tools»Vi vill att den som söker vård ska erbjudas en enkel väg in för stöd och hjälp, att vården ska få bättre verktyg för behandling och att sjukskrivningen ska bli mer flexibel.« (2022 manifesto ↗)“We want those seeking care to be offered a straightforward path to support and assistance, for care to have better tools for treatment and for sickness leave to become more flexible.”
  • patient autonomy»Alla ska ha inflytande över sina egna liv också när det gäller välfärdstjänster.« (party programme ↗)“Everyone shall have influence over their own lives also when it comes to welfare services.”
  • new care methods are encouraged»Utvecklingen av ny teknik och nya metoder för att bedriva vård och omsorg bör uppmuntras.« (party programme ↗)“The development of new technology and new methods for conducting care and support should be encouraged.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

LLiberalernaNoYesdeparts from the planderived

The plan requires that care and treatment of mental illness is provided on a scientific basis, which entails requiring that older methods be replaced with newer ones with better evidence.

Plan documents: party programme

Reasoning and quotes

The plan requires that care and treatment of mental illness is provided on a scientific basis, which entails requiring that older methods be replaced with newer ones with better evidence. It also wants to see a power shift to patients and has already taken a stance in favour of voluntary admission to psychiatric care with the aim of reducing coercive measures – the same patient autonomy that the requirement for drug-free care rests on. Both parts of the counter-proposal therefore align with the plan.

Original (Swedish)

Planen kräver att vård och behandling av psykiska sjukdomar ges på vetenskaplig grund, vilket bär kravet på att äldre metoder byts ut mot nyare med bättre evidens. Den vill dessutom se en maktförskjutning till patienterna och har redan tagit ställning för självvald inläggning i psykiatrin med målet att minska tvångsåtgärder – samma patientautonomi som kravet på medicinfri vård vilar på. Motförslagets båda delar ligger därför i linje med planen.

  • care on a scientific basisdecisive»Vård, behandling och rehabilitering av fysiska och psykiska sjukdomar ska ges på vetenskaplig« (party programme ↗)“Care, treatment and rehabilitation of physical and mental illness shall be provided on a scientific”
  • power shift to the patient»Det behövs en maktförskjutning inom hälso- och sjukvården till patienterna.« (party programme ↗)“There needs to be a power shift in healthcare toward patients.”
  • patient-directed psychiatry»Möjlighet till självvald inläggning inom psykiatrin, där patienten själv bestämmer över sina« (party programme ↗)“Possibility of voluntary admission to psychiatric care, where the patient decides over their own”
  • reduced coercion in psychiatry»Målet är att minska behovet av tvångsåtgärder.« (party programme ↗)“The goal is to reduce the need for coercive measures.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

KDKristdemokraternaNoYesdeparts from the planderived

The plan requires that solidarity-financed healthcare is evidence-based, which directly supports the requirement for a review that replaces older methods with newer where evidence is better.

Plan documents: party programme

Reasoning and quotes

The plan requires that solidarity-financed healthcare is evidence-based, which directly supports the requirement for a review that replaces older methods with newer where evidence is better. That investigation and treatment shall not occur against the patient's will except by means of a care certificate gives support for a strengthened right to drug-free psychiatric care. The plan also emphasizes accessibility and flexibility based on the patient's needs within psychiatry.

Original (Swedish)

Planen kräver att den solidariskt finansierade vården är evidensbaserad, vilket direkt bär kravet på en granskning som ersätter äldre metoder med nyare där evidensen är bättre. Att utredning och behandling inte får ske mot patientens vilja annat än vid vårdintyg ger stöd åt en stärkt rätt till medicinfri psykiatrisk vård. Planen betonar också tillgänglighet och flexibilitet utifrån patientens behov inom psykiatrin.

  • evidence-based healthcaredecisive»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna och baserad på kunskap och beprövad erfarenhet, det vill säga evidensbaserad.« (party programme ↗)“Solidarity-financed healthcare shall be appropriate and cost-effective, safe for patients and based on knowledge and proven experience, that is, evidence-based.”
  • treatment requires consent»patientens vilja annat än vid vårdintyg.« (party programme ↗)“patient's will except by means of a care certificate.”
  • care based on patient's needs»Psykiatrisk vård och omsorg ska präglas av tillgänglighet och flexibilitet utifrån patientens behov.« (party programme ↗)“Psychiatric care and support shall be characterized by accessibility and flexibility based on the patient's needs.”
  • choice in healthcare»av kvalitet, mångfald och valfrihet.« (party programme ↗)“of quality, diversity and choice.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MModeraternaNoYesdeparts from the plannot addressed

The counter-proposal wants the National Board of Health and Welfare to examine the evidence for treatment methods for mental health problems and strengthen the patient's right to medication-free care.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The counter-proposal wants the National Board of Health and Welfare to examine the evidence for treatment methods for mental health problems and strengthen the patient's right to medication-free care. The plan is built on the understanding that important decisions should be able to be made by the individual and that choice is a central part of the welfare model, as well as that care shall be developed with better knowledge base and earlier diagnosis. The plan says nothing explicit about medication-free psychiatry, which is why the conclusion is uncertain.

Original (Swedish)

Motförslaget vill låta Socialstyrelsen granska evidensen för behandlingsmetoder vid psykisk ohälsa och stärka patientens rätt till medicinfri vård. Planen bygger på att viktiga beslut ska kunna fattas av den enskilde och att valfrihet är en central del av välfärdsmodellen, samt på att vården ska utvecklas med bättre kunskapsunderlag och tidigare diagnostik. Planen säger inget uttryckligt om medicinfri psykiatri, varför slutsatsen är osäker.

  • choice in welfaredecisive»För Moderaterna är valfrihet en central del av den svenska« (party programme ↗)“For the Moderates, choice is a central part of the Swedish”
  • knowledge-based diagnostics»Förbättra möjligheterna att ställa tidigare diagnoser, bland annat med hjälp av digitala beslutsstöd och strukturerade arbetssätt med till exempel riskprofilering« (2022 manifesto ↗)“Improve the opportunities to make earlier diagnoses, among other things by means of digital decision support and structured working methods with for example risk profiling”
  • strengthened psychiatry»Stärka barn- och ungdomspsykiatrin så att barn och unga som mår dåligt får hjälp snabbt« (2022 manifesto ↗)“Strengthen child and adolescent psychiatry so that children and young people who are struggling receive help quickly”
  • quality and choice in care»Svensk sjukvård ska präglas av kvalitet, tillgänglighet och« (party programme ↗)“Swedish healthcare shall be characterized by quality, accessibility and”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SDSverigedemokraternaNoNofollows the planderived

The plan establishes that effective treatment measures such as talk therapy should be offered to a greater extent and that research is decisive for knowledge development about mental health.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan establishes that effective treatment measures such as talk therapy should be offered to a greater extent and that research is decisive for knowledge development about mental health. A task to review evidence-based methods and replace older methods follows from this, as does the party programme's requirement for evidence-based care. The demand for strengthened right to medication-free care is in line with the plan's emphasis on talk therapy.

Original (Swedish)

Planen slår fast att effektiva behandlingsåtgärder som samtalsterapi i högre grad bör erbjudas och att forskningen är avgörande för kunskapsutvecklingen kring psykisk hälsa. Ett uppdrag att granska evidensbaserade metoder och ersätta äldre metoder följer av det, liksom av partiprogrammets krav på evidensbaserad vård. Kravet på stärkt rätt till medicinfri vård ligger i linje med planens betoning av samtalsterapi.

  • talk therapy shall be offereddecisive»Effektiva behandlingsåtgärder, i form av exempelvis samtalsterapi, bör i högre grad erbjudas för att den psykiska hälsan hos patienten inte ska riskera att försämras.« (2022 manifesto ↗)“Effective treatment measures, in the form of, for example, talk therapy, should be offered to a greater extent so that the patient's mental health does not risk worsening.”
  • evidence-based care»Regionerna ska tillhandahålla evidensbaserad vård« (party programme ↗)“The regions shall provide evidence-based care”
  • research drives method choice»Forskningen är avgörande för den fortsatta kunskapsutvecklingen inom området psykisk hälsa samt för att hitta orsakerna till den växande psykiska ohälsan i samhället.« (2022 manifesto ↗)“Research is decisive for continued knowledge development in the field of mental health and for finding the causes of the growing mental ill-health in society.”
  • national research programme»Inrätta ett nationellt forskningsprogram inom området psykisk hälsa« (2022 manifesto ↗)“Establish a national research programme in the field of mental health”

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Sources and documents

Documents under consideration

Source: The Swedish Parliament