Community treatment orders in an Assertive Community Treatment setting: a qualitative study of experiences of patients, care providers and responsible clinicians
Hanne Kilen Stuen
Bok Engelsk 2019
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| Utgitt | Tromsø : UiT The Arctic University of Norway, Faculty of Health Sciences , 2019
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| Omfang | 1 b.
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| Opplysninger | Doktoravhandling. Norges arktiske universitetet (UiT).. - Hvilke erfaringer har pasienter, de ansatte i ACT-teamet og vedtaksansvarlige med bruk av tvang uten døgnopphold (TUD)? This study is part of the national research-based evaluation of the 12 first assertive community treatment (ACT) teams in Norway that took place between 2009 and 2014. The purpose of this study was to investigate patients’, care providers’ and responsible clinicians’ experiences with community treatment orders (CTOs) and CTO decision making in relatively newly established ACT teams. ACT is a model of multidisciplinary community-based treatment teams that aims to provide a full range of medical, psychosocial and rehabilitation services to people with severe mental illness. In this study, 15 in-depth interviews with patients subject to CTOs were conducted. We also interviewed 8 responsible clinicians and conducted four focus group interviews with 20 providers. The data were analysed using a modified grounded theory approach. CTOs, which is a legal tool to compel patients with severe mental illness in the community, have been widely used since the implementation of the Mental Health Care Act in 1961. The results show that patients have mixed views of CTOs. However, the ACT team’s availability and the flexible combination of interventions, continued care and possibility to make choices were considered as important improvements to traditional office-based mental health services. Several of the patients described a gradual transition of regarding the CTO as an acceptable solution, provided that they received other services they found beneficial. CTO decisions involve dilemmas and difficult professional judgments, and the clinicians highlighted the importance of frequent patient contact, multidisciplinary team discussions and sharing ideas about clinical problems allowed for more flexibility and more voluntary treatment.
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