Annika Alexandersen (left), and Astrid Weber (right), authors of the report “I fear I will never make it out of this”.
KBT’s report “I fear I will never make it out of this” is used as part of the basis in the draft of a new circular for competency-based practice in psychiatric care.
The User Interviews User-evaluation of compulsory care in outpatient treatment in Tromsø, was conducted in collaboration with the municipality and UNN HF in 2016.
The circular from The Norwegian Directorate of Health points to several findings in the report. The patients reported feeling a high a degree of coercion. The participants were also concerned with losing necessary support when transitioning from compulsory to voluntary care.
The circular is still being processed after the hearing, and is aimed at securing higher autonomy and better rule of law for the patients.
An important new criteria for use of involuntary treatment, is that the patient must lack competency to consent. Our report revealed that several of the patients had a different understanding of psychosis than the institution. This can lead to a higher degree of coercion, in that the patient runs the risk of being labelled “irrational”. There is need of more research on how the services deal with such situations.
What constitutes “good help” can also be interpreted differently. [ … When they force me to take medication me, they make me “well” too fast, and I don’t become “whole”. You have to fight that battle yourself – the psychosis is an inner conflict. When you get the time to fight that battle, and are not under threat of compulsory medication, you become whole. The medicine made me stagnate.]
The patients emphasized that the care that felt the most positive and supporting, was “Practical help in everyday life, the option to submit oneself in accordance with one’s own needs and wishes, having a therapist/staff one can trust, having mutual dialogues, having people around, and having meaningful activities to fill the day”.
The patient has a right to necessary healthcare. It became clear that the participants in the evaluation wanted support to handle their everyday lives themselves, to maintain independence, but have effective aid available during a crisis.
The circular concludes with stating that the services being offered must be based on knowledge and quality. Regardless of the method of treatment it is imperative to maintain a trustful relationship, and a process marked by continuity and predictability,
KBT is happy to see our work used to emphasize the patients’ perspective in government procedures.
TEXT: Astrid Weber, Dagfinn Bjørgen, Lasse Barr.
TRANSLATION: Lasse Barr