Community-based Mental Health Services in Norway

Ruud, Torleif; Friis, Svein

doi:10.17816/cp43

Cited by 21 publications

(17 citation statements)

References 22 publications

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“…The municipalities have a large degree of autonomy, and the geographical context varies considerably, leading to variety in the organization and content of mental health and social services. There is an ongoing specialization of mental health services in Norway, which may improve the quality of services, but also increase fragmentation (Ruud and Friis, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

et al. 2021

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The aim of this study was to explore and describe service user experiences of how receiving services from a Flexible Assertive Community Treatment (FACT) team may support or inhibit citizenship. Within a participatory design, individual interviews with 32 service users from five Norwegian FACT teams were analyzed using thematic, cross-sectional analysis. The findings showed that FACT may support citizenship by relating to service users as whole people, facilitating empowerment and involvement, and providing practical and accessible help. Experiences of coercion, limited involvement and authoritarian aspects of the system surrounding FACT had inhibited citizenship for participants in this study.

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Section: Methodsmentioning

confidence: 99%

Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

et al. 2021

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“…They include 66 community mental health centres (CMHCs) and acute psychiatric hospital wards [19]. The CMHCs provide local inpatient services as well as outpatient services, including some mobile services by CRTs, teams for early intervention in psychosis, assertive community treatment (ACT) teams, or functional assertive community treatment (FACT) teams [20]. Due to variation in resources and geographics there are some variations in capacity and available services, but outpatient and mobile team services are available both in urban and rural areas.…”

Section: Introductionmentioning

confidence: 99%

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

et al. 2021

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Background Crisis resolution teams (CRTs) are specialized multidisciplinary teams intended to provide assessment and short-term outpatient or home treatment as an alternative to hospital admission for people experiencing a mental health crisis. In Norway, CRTs have been established within mental health services throughout the country, but their fidelity to an evidence-based model for CRTs has been unknown. Methods We assessed fidelity to the evidence-based CRT model for 28 CRTs, using the CORE Crisis Resolution Team Fidelity Scale Version 2, a tool developed and first applied in the UK to measure adherence to a model of optimal CRT practice. The assessments were completed by evaluation teams based on written information, interviews, and review of patient records during a one-day visit with each CRT. Results The fidelity scale was applicable for assessing fidelity of Norwegian CRTs to the CRT model. On a scale 1 to 5, the mean fidelity score was low (2.75) and with a moderate variation of fidelity across the teams. The CRTs had highest scores on the content and delivery of care subscale, and lowest on the location and timing of care subscale. Scores were high on items measuring comprehensive assessment, psychological interventions, visit length, service users’ choice of location, and of type of support. However, scores were low on opening hours, gatekeeping acute psychiatric beds, facilitating early hospital discharge, intensity of contact, providing medication, and providing practical support. Conclusions The CORE CRT Fidelity Scale was applicable and relevant to assessment of Norwegian CRTs and may be used to guide further development in clinical practice and research. Lower fidelity and differences in fidelity patterns compared to the UK teams may indicate that Norwegian teams are more focused on early interventions to a broader patient group and less on avoiding acute inpatient admissions for patients with severe mental illness.

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“…Each CMHC has outpatient clinics, mobile teams, and local inpatient wards. Most of the CMHCs has a CRT as one of their mobile teams [ 16 , 17 ]. The increase of staff in Norwegian CMHCs during the last decade has occurred mainly in CRTs and other types of mobile teams.…”

Section: Methodsmentioning

confidence: 99%

Accessibility and interventions of crisis resolution teams: a multicenter study of team practices and team differences in Norway

et al. 2022

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Background Components of crisis resolution teams’ (CRTs) practices have been defined in recommendations and a fidelity scale, and surveys have reported how team leaders describe CRT practices. However, studies on CRTs have not measured and reported details of the crisis intervention provided to individual service users. The present study aimed to measure how various components of CRT practice were provided to individual service users and differences in practice between CRTs. Methods The study was exploratory and part of a prospective multicenter pre-post project on outcome of CRT treatment in Norway. Accessibility and intervention components of 25 CRTs were measured for 959 service users at the first contact after referral and in 3,244 sessions with service users. The data on CRT practice components were analyzed with descriptive statistics and factor analyses, and differences between teams were analyzed using ANOVA and calculating the proportion (intraclass correlation coefficient) of total variance that was due to differences between teams. Results One-third of the service users had their first session with the CRT the day of referral and another third the following day. Treatment intensity was mean 1.8 sessions the first week, gradually decreasing over subsequent weeks. Three of ten sessions were conducted in the service user’s home and six of ten in the team’s location. Eight of ten sessions took place during office hours and two of ten in the evening. The CRT provided assessment and psychological interventions to all service users. Family involvement, practical support, and medication were provided to two of ten service users. Between CRTs, significant differences were identified for a substantial proportion of practice components and especially for several aspects of accessibility. Cluster analysis identified two clusters of CRTs with significant differences in accessibility but no significant differences in the use of intervention components. Conclusions Measurements of accessibility and interventions provided to individual service users gave a detailed description of CRT practices and differences between teams. Such measurements may be helpful as feedback on clinical practice, for studying and comparing crisis resolution team practices, and in future studies on the association between different outcomes and potential critical elements of crisis interventions.

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Community-based Mental Health Services in Norway

Cited by 21 publications

References 22 publications

Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

Accessibility and interventions of crisis resolution teams: a multicenter study of team practices and team differences in Norway

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