Medicationfree treatment

Transcription

1 Medicationfree treatment Developing a structure for care in a ward circumstances that provides treatment and being with without medication Experiences Views

2 Short history 1,5 years ago we established our medicationfree ward in Tromsø Whos idea was it to establish a medication free ward? The User-organisations had been working towards the politicans for many years. They wanted a possibility to receive treatment without medication. The helth ministery decided that every healtregion in Norway(4) should establish 1 drugfree ward each, 2 in the largest region This should be done in close cooperation with the usersorg. This has been very differently solved in Norway

3 Protocol for Medication free treatment Open ward. No coercion. Both staff and users must want and believe a drugfree treatment Patients with psychosis and bipolar disorder Six beds Patients from Northern Norway (Finnmark, Troms and Nordland.) Located at UNN Åsgård Referrals from local/outpatient hospital units. Not addiction as main problem

4 Making the choice available Our understanding is that our unit/ward is part of a prosess to manage without medication. It may start at home together with your family and therapist and when you run into foreseen or unforeseen troubles, you can come to our unit for support. We discuss how it would be wise to use us?

5 Medication-free treatment Meaning: Not using neuroleptics Patient with at goal to not use neuroleptic Supporting withdrawal over time (means that we also have patient using neuroleptics while tapering down) Explore how to cope with hearing voices or seeing things without neuroleptics

6 Staff 23 employees Different education - Nurse (6) - Social educator (2) - Social worker (3) - Psychologist (1) - Physical therapist (2) - Experience consultant (2) - Other (4) - Occupational therapist (2) - Doctor (1) - Psychiatrist (1) - Art therapist (2) Three treatment teams Interdisciplinary compound

7 Focusing recovery and goals for recovery Writing their own referral Wanting a drugfree treatment, and not only not wanting the drugs. Wanting something else than treatment as usual. Previous experiences with withdrawal Previous experiences of what is effective/useful treatment and support Individual treatment and support What is different compared to an ordinary hospital ward? The combination of treatment possibilities in this unit is perhaps different. The goal to not offer neuroleptics for these problems, but help at struggle together with the patients to find other options.

8 The main program Structure of the day Building relationships Group therapy Social networking Individual therapy Individual plans - Recovery plan - Crisis and a plan to handle it - Plan for tapering down Different and individual patient care - Frequency - Length - Planned elective stays in the ward

9 Weekly program Drug-free treatment unit Tromsø

10 Recovery workshop Dialog and discussion in group about recovery and daily life Sharing own experiences both patient and staff Teaching Movies / youtube Whiteboard-reflection, brainmap. Themes (A meaningful life, Goal and dreams, Sleeping, Understanding of mental illness, Coping with stress, My herd - Relations and network, Medication and withdrawal, Crises - a natural part of life.)

11 Physical exercise Different exercises strength exercise, interval training. Inside and outside. In group, individual. Staff participate. The training is tailored to the physical conditions and needs of the Individual participants. Can also receive individual physical therapy.

12 Art therapy Finding a expression through painting. Both group and individual. Staff participate

13 Statistics Who are the patients? - They are 38 persons - 14 men and 24 women - They are between 19 and 61 years old, average 36 years. - The group between years and years are the biggest. Who is referring patients to our unit? Local units of hospital Other wards in the hospital Acute wards

14 Our patiens Troms: 20 patients Finnmark: 10 patients Nordland: 8 patients

15 Referrals and patients 80 referred - some patients are rejected and some patients have changed their mind (addiction, not psychosis/bipolar disorder/neuroleptics) 38 patients so far: Written own referral: 63,2% Present use of neuroleptics: No use of neuroleptics when inpatient: 19 Use of neuroleptics when inpatient: 19 Psychosis: 22 Bipolar disorder: 11 Others: 5 Average days in ward: 26

16 Making friendships

17 Some of the challenges ahead How to involve family, friends and other parts of the supporting system? Use open dialogue and reflecting processes as part of daily practice. How to help patients to engage in daily life and society from a hospital ward? How to work together with the local health services and supporting system when the region is very big? Coping with different perspectives of treatment and ideolgies when working together with the local collaborators When people are referred to us, we use much time to explore how we can be of help. Can this be solved outside the institution? Should we create a ambulant team?