Abstract
BackgroundIn 2016, the Western Norway Regional Health Authority started to integrate more evidence-based psychosocial interventions into the existing mental health care, emphasizing the right for persons with psychosis to choose medication-free treatment. This change emerged from the debate on the effectiveness and adverse effects of the use of antipsychotic medication. Aspects beyond symptom reduction, such as interpersonal relationships, increased understanding of one’s own pattern of suffering, hope and motivation, are all considered important for the personal recovery process.MethodsThis study explores whether these aspects were present in users’ descriptions of their recovery processes within the medication-free treatment programme in Bergen, Western Norway. We interviewed ten patients diagnosed with psychosis who were eligible for medication-free services about their treatment experiences. Data were analysed using Attride-Stirling’s thematic network approach.ResultsThe findings show a global theme relating to personal recovery processes facilitated by the provision of more psychosocial treatment options, with three organizing subthemes: interpersonal relationships between patients and therapists, the patient’s understanding of personal patterns of suffering, and personal motivation for self-agency in the recovery process. Participants described an improved relationship with therapists compared to previous experiences. Integrating more evidence-based psychosocial interventions into existing mental health services facilitated learning experiences regarding the choice of treatment, particularly the discontinuation of medication, and appeared to support participants’ increased self-agency and motivation in their personal recovery processes.ConclusionHealth care in Norway is perhaps one step closer to optimizing care for people with psychosis, allowing for more patient choice and improving the dialogue and hence the interpersonal relationship between the patient and the therapist. Personal patterns of suffering can be explored within a system aiming to support and have a higher level of acceptance for the discontinuation of medication. Such a system requires personal agency in the treatment regimen, with more focus on personal coping strategies and more personal responsibility for the recovery process.
Highlights
In 2016, the Western Norway Regional Health Authority started to integrate more evidence-based psychosocial interventions into the existing mental health care, emphasizing the right for persons with psychosis to choose medication-free treatment
This results section is structured according to the organizing themes: interpersonal relationships between patients and therapists, the patient’s understanding of personal pattern of suffering, and personal motivation for self-agency in the recovery process
Interpersonal relationships between therapists and patients When the participants in this project were asked about their reasoning for their choices, they expressed uncertainty both regarding the treatment options available to them and explanations for their choices
Summary
In 2016, the Western Norway Regional Health Authority started to integrate more evidence-based psychosocial interventions into the existing mental health care, emphasizing the right for persons with psychosis to choose medication-free treatment. This change emerged from the debate on the effectiveness and adverse effects of the use of antipsychotic medication. The provision of increased psychosocial intervention options within mental health care was intended to enable patients wishing to discontinue medication to do so in a supportive setting This change in mental health care emerged from the debate on the use of antipsychotic medication (referred to as AP medication) as a part of the treatment for severe psychiatric illness [2]. The discontinuation of AP medication is often described as nonadherence rather than as an integrated part of a treatment regimen in collaboration with psychiatrists
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