Mental Health Care In Norway Research Articles

Letter Responding to Article ‘A Future for Pathways in Mental Health Care in Norway - a Discussion Paper Based on El-Ghorr et al. 2010’ by Biringer et al.

Letter Responding to Article ‘A Future for Pathways in Mental Health Care in Norway - a Discussion Paper Based on El-Ghorr et al. 2010’ by Biringer et al.

A Future for Pathways in Mental Health Care in Norway: A Discussion Paper Based on El-Ghorr et al. (2010)

We have read the paper by El-Ghorr et al. (Int J Care Pathways 2010;14:57-64) on Scotland's national approach to improving mental health services with great interest. The paper described the strategy developed by NHS Quality Improvement Scotland (NHS QIS) in which integrated care pathways were used as tools for redesign and continuous quality improvement. In our opinion, a similar national effort is also necessary in Norway. In particular, pathways would help bridge the ‘gap’ between primary and specialist services. We point to which elements of the Scottish programme it is that would be relevant to implement in Norway in future. Furthermore, we discuss factors that are already present in Norway upon which authorities, health leaders and professionals could build on in a future national-level implementation of pathways in mental health care.

Attitudes among stakeholders towards compulsory mental health care in Norway

Objectives The Norwegian Mental Health Care Act allows use of coercion under certain conditions. Even though the current practice has been criticized, little empirical data exist about the attitudes towards compulsory mental health care. Method This study used Q-methodology to identify prototypical attitudes and to test possible differences of attitudes between groups of stakeholders towards the use of coercion in mental health care. Sixty-two respondents who represented six groups with different roles in mental health care participated: former patients, relatives of psychiatric patients, members of supervisory commissions, psychiatrists, other physicians, and lawyers. The participants were asked to assess the degree to which they agreed on 30 statements concerning use of coercion for the mentally ill. Results Three factors that in a meaningful way express different attitudes towards the question were found. The most widely shared attitude stated that a trusting relationship between patient and therapist is more important than the right to have an attorney. This attitude gives partial support to the present Mental Health Care Act. However, the second most common attitude argues that involuntary hospitalization, if necessary, should be decided in a court and not by the hospital doctor. Conclusions Differences in attitude could partly be explained by the respondents' role in mental health care. Both psychiatrists and “somatic” physicians expressed more agreement with the present legislation than the other stakeholders. The findings may have implications for the legal protection of mental health care patients.

Perceptions of interprofessional collaboration within child mental health care in Norway

The present study investigates professionals' perceptions of interprofessional collaboration (IPC) in the field of mental health care for children and adolescents. In this study, a 48-item questionnaire was developed to measure perceptions of interprofessional collaboration. A theoretical model (PINCOM) is presented and suggests that interprofessional collaboration is perceived at the individual-, group- and organizational level. The questionnaire was distributed to a sample consisting of 157 professionals in Western Norway. The results of this exploratory study show that the most prominent constructs of collaboration perceived by the professionals were: motivation, group leadership, social support and organizational culture. Furthermore, results indicate that women are more oriented than men toward IPC aspects of communication, coping and organizational domain. It is suggested that the questionnaire may be used to help improve interprofessional collaboration in clinical practice by indicating new ways to enhance dialogue between professionals and to investigate changes in perception of interprofessional collaboration over time. Limitations of the present study were identified and suggestions for future studies within the field are provided.

Mental health care in Norway – structure and tasks in the future

The mental health care system in Norway will remain a public responsibility, run by the county authorities. We will see increased emphasis on quality, patient rights, consumer satisfaction, client involvement, accessibility, continuity of care, management and leadership, priority setting and psychiatric care as a specialized medical service. Acute patients and patients with long-term functional psychosis and major mood and anxiety disorders will have first priority. The county health care system will have a two-level structure: The local hospital level (catchment area 25 000 to 50 000 inhab., one to ten municipalities) and the central hospital level (catchment area 150000 to 300 000 inhab., one county). The care systems at these levels are described. In addition, there will be some services at regional and national level. The training programmes in psychiatry must qualify the doctors to work as “general psychiatrists” at the local hospital level. All psychiatrists must have a basic training in psychotherapy. The training must put more emphasis on psychotherapy to patients with severe mental disorders, and consultation to primary health care and other community mental health work.Catchment Area, Mental Health Care, Number of Beds, Priority, Training Programme.

Recent Developments in the Care, Treatment, and Rehabilitation of the Chronic Mentally Ill in Norway

As in most other Western nations, the ideology shaping mental health care in Norway has shifted since World War II from a traditional institutional approach to a community-based concept of treatment for the chronic patient. And as in many other countries, communities have been poorly equipped to deal with the influx of deinstitutionalized patients. Few appropriate community alternatives have been developed to care for hospitalized patients, many of whom must remain institutionalized. The author reports on a 1979 census of Norway's mental patients which showed that about half of the mental hospital patients could be expected to remain in the hospital because adequate community facilities did not exist. However, the author says, there is a new interest in Norway in reducing the number of hospital beds and transferring more patients to community programs; one large mental hospital has recently been closed. Legislation focusing on patients' rights and new research on "quality of life" of patients are also pushing mental health care into the community, he says.