WELCOME. Shuna Vanner and Anja Reilman. Project Support of FACT model in the Czech republic, n. CZ /0.0/0.0/15_023/

Transcription

1 WELCOME Shuna Vanner and Anja Reilman Clinical Nurse Specialists Project Support of FACT model in the Czech republic, n. CZ /0.0/0.0/15_023/

2 Recovery orientation, assertiveness and bounderies of the services.

3 FACT Principles built in 10 years 1. Being there presence in the places where the clients want to succeed 2. Support for community participation through IPS & ISN 3. Linking clients to the MHC network Continuity of care in community and hospital 4. ACT Flexibly available at any time 5. Treatment EBM & Guidelines 6. ICM to support recovery and rehabilitation

4 FACT and recovery Service values FACT team: Person-centered Strengths-based Collaborative, connectiveness Empowering Hope

5 Admission to FACT team Serious mental illness mental, behavioral, or emotional disorder serious functional impairment substantially interferes with or limits one or more major life activities.

6 Monitoring Client Outcomes Questionaire (OQ-45) Manchester Short Assessment of quality of life (MANSA) Personal rrecovery Professional Health of the Nations Outcome Scale (HoNOS) Functional remission

7 Research: clinical outcomes Improvement in unfulfilled care needs Improvement in quality of life Improved treatment compliance Improvement in remission Insignificant improvement in social functioning

8 Discharge from FACT team Mental health care General Practioner GP/MH care Basis MH care Specialist MH care

9 Resource group THAT way! Chosen group with people helping cliënt with recovery goals. Additionally to the treatment FACT-team Turn around!

10 Resource group Client decides Minimal: client, case manager en psychiatrist Professionals and non-professionals Flexible 10,

11 Example Resource team Client Case manager Psychiatrist DD-specialist Peer worker Mother Father Friends

12 Resource group meeting Recovery goals client are starting Every 3 months Cliënt decides place Maximaal 1 hour Treatment plan Division of tasks No discussions (take place at another moment) Chairman is important 12 Pleasant ambience is paramount!!!!! Low EE

13 Open Dialogue A Different Approach o Flexibility & Mobility: Using the therapeutic methods that best suit the case o Rapid response where physical safety threatened, otherwise, leaving models at the door (biological, CBT etc.) and using whatever works/arises in the moment through a dialogical process o Minimum 3 meetings, wherever possible, before new medication prescribed.

14 Open Dialogue A Different Approach o Being In The Present Moment: Therapists are no longer interventionists with some pre-planned map for the stories that clients are telling. Instead their main focus is on how to respond to clients utterances. o Team members are acutely aware of their own emotions resonating with experiences of emotion in the room. o Mindfulness is a major aspect of training (studies show how it improves therapeutic relationships)

15 Assertiveness and bounderies of the services Case-finding No drop out Attractive care Outreach Co-operation with family, police, housing companies, addiction services, etc..

16 Referal to Mental health service (case-finding) Front door: General practitioner or family-doctor with patient s consent (!) Backdoor: Only in crisis-situations: crisis-intervention team

17 No crisis/danger and help-rejecting: means no treatment. (Treatment-gap)

18 Public Mental Health Key tot success is co-operation: Community Health services Police Addiction-care service Mental Health service Centre for homeless people Community-council Social Housing company

19 Process In the Security-house of the city council: Public mental health meeting: Presenting cases Share responsibility and apoint caregiver Feedback on previous cases For complex cases: organizing meetings, including patients!

20 Terms for good practice Know your colleagues! Meetings Clear goals Know what to expect from each other Triage

21 Dilemmas! Why are we on earth?: Provide recovery oriented care or instrument of the security obsessed state?? What is enough danger for an admission? Do our patients also have a free will, like we do? Do we tolerate alternative lifestyles?

22 Think about that for a moment.

23 Nobody wants to become an inmate

24 Case 1 40 year old female; known with BPS and diagnosis of addiction and eating disorder

25 Case 1 To be continued. We gave her Clozapine and took care of cleaning housing We gave her mobile abonnement so she can call us when she wants/needs We have regular meetings with family