TLast spring, Norway’s Huldalsjön Recovery Center, a private hospital that provided medication-free care for mentally ill patients in Norway, was forced to close due to the government’s decision to cut off public funding to private companies. . Currently, the drug-free ward at Asgard Hospital in Tromsø is at risk of closure.
This 6-bed ward is perhaps the most widely used in the Western world today for inpatient treatment of patients with psychosis and bipolar disorder, facilitating the reduction of psychiatric medications and, if the patient wishes, inpatient treatment without medication. It was the most visible example of this anywhere. of such drugs. The University Hospital of Northern Norway (UNN) has proposed replacing inpatient treatment with “consultants” who will support drug-free treatment in outpatient clinics across the region.
If the closure goes ahead, it would be the second major blow to the drug-free initiative dating back more than a decade, when five user groups in Norway jointly began lobbying for drug treatment in hospitals. right. In 2016, Norway’s Ministry of Health ordered all four of the country’s health districts to reserve beds for such treatment.
The Tromsø ward opened in 2017 and for six years has shown that offering patients the option of stopping or tapering their psychiatric medications can be a successful model of care. .
The user group is led by we must overcome (WSO) has protested this proposed closure in its latest letter dated October 29. They write:
“UNN’s current drug-free treatment program is the gold standard for drug-free treatment in Norway. It has attracted national and international attention and is of great interest to those who come to the district to learn. Several users have reported good results and are currently expressing support for the continuation of this division.
Many patients in mental health services feel that their medications do not improve their health or experience significant side effects. Therefore, it is important to maintain services that can support this group and to inform and provide non-drug treatments. Currently, non-drug treatment is not provided in acute psychiatry, and many patients receive medication, either voluntarily or under coercive measures, on their first visit to a psychiatric service, often in large doses. Medication is being administered. In that case, it may be difficult to stop or taper off the drug without a long-term, responsible tapering plan. Providing drug-free services, including acute psychiatry, makes it possible to prevent unnecessary drug use, unnecessary weight loss processes, and the unfortunate long-term consequences of drug use. ”
and:
“UNN’s drug prohibition program has been in place for almost seven years. During this period, the service has built a large capacity base in drug-free services and special expertise in the responsible reduction of psychotropic drugs. Inpatient wards are a unique area of research, and maintaining such inpatient wards is important for further knowledge development in this area. They need to be supported by a competent environment and should be based in a drug-free inpatient unit.
The proposal to transform drug-free inpatient services into consultation teams is not justified by service deficiencies or lack of demand, but because the aim is to free up resources for other drug management services. . This proposal appears to have not been adequately considered in the context of national guidelines for non-drug treatment services. WSO believes that this proposal would effectively lead to the closure of drug-free services at UNN, with significant negative consequences for users. At the same time, the professional community of drug-free inpatient units disappears and the knowledge gained is likely to be lost if converted to consultation teams. ”
The Norwegian Psychiatric Association opposed the initiative almost from its inception, and prominent psychiatrists argued that antipsychotics were an essential treatment for mentally ill patients. However, as the WSO wrote in its letter, the effort in Tromsø has received international attention as an example of a recovery-oriented approach that gives patients the right to choose whether to take antipsychotics and other psychiatric drugs. This approach may be helpful for patients.
WSO is calling on university hospitals to do both, rather than closing inpatient units and switching to providing “drug-free” treatment in the community. It writes:
“In summary, the WSO requests the following: In the future structure of PHRK at UNN, drug-free inpatient services will be maintained as a separate department as it currently is. At the same time, the entire region and all Our cross-departmental consultation team will strengthen our drug-free service.”
