Treatment teams see mental health successes in Norway – The Detroit News

Bergen, Norway Life seemed to crumble for Vibeke Hellesund in 2010.

Diagnosed with bipolar disorder, Hellesund was depressed after getting divorced and then breaking up with a subsequent boyfriend. TheNorwegianneededseveral hospitalizations of decreasing length and a year of intense outpatient treatment from an Assertive Community Treatment (ACT) team to getthe depression to lift.

Vibecka Hellesund, standing in the roof-top garden at Kronstad outpatient psychiatric clinic in Bergen, Norway, received at-home visits from a psychiatric nurse once or twice a week while recovering from bipolar disorder. She's now a peer support expert who helps others with severe mental illness.(Photo: Karen Bouffard, The Detroit News)

Six years sinceher last hospitalization, Hellesund now works as apeer support specialist on an ACTteam that provides at-home mental health and social supportto about 150 severely mentally ill people living in her city of Bergen. The team provides 24-hour access forclients in crisis.

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Though ACT is available in every U.S. stateincluding Michigan, it's more widely available in Norway. The Bergen community of about 280,000 people has two ACT teams that treat 300 people, or about 110 patients per 100,000 residents.

The Detroit/Wayne County Mental Health Authority, serving a population of 1.75 million county residents, has726 patientsenrolled in ACT, or 41 patients per 100,000 residents. Statewide, about 60 per 100,000 Michigan residents are enrolled in ACT, according to the state Department of Health and Human Services.

The mission of ACT is to treat patients at homeand move them toward independence while avoiding hospitalization.

The multidisciplinary teams typically include mental health professionals, social workers and peer mentors who stayin close face-to-face contact with patients, making sure they stay on their medications and that their needs for food, shelter, work and social interaction are met.

Like all other health services in Norway, the cost is covered by taxpayers through the country's socialized health service. Severely mentally ill people in Norway also receive housing and financial support from the government.

"I had a community psychiatric nurse that came to visitonce or twice a week," Hellesund said about her recovery that was aided by an ACT team. The nursevisits lasted for about a year, she said, but ACT treatment can continue as long as it is needed.

"Wed just go to the local shop, if thats what I needed to do, or wed go for a walk, or just have a chat," Hellesund said.

Hellesund now works on an ACT team that includes two psychiatrists, two psychotherapists, sixpsychiatric nurses, a social worker and a vocational specialist.

"We do work together to cover all aspects that really a person needs to function in the society.Theres not much that we dont do," Hellesund said, adding that she and other team members search the streets for patients if they disappear from their residences.

Wayne County has 12 ACT teams, each staffed by a psychiatrist, alicensed nurse orsocial worker, a case manager and a peer support specialist, saidDana Lasenby, chief clinical officer for the Detroit/Wayne Mental Health Authority.

Though ACTis costly, it's coveredby the Medicaid health program for patients who meet criteria that include a history of frequent hospitalizations,Lasenby said.

The availability of ACT in Wayne County isn't limited by funding somuch as by the difficulty of finding agencies willing and able to work with the challenging population in need of such services, she noted.

"Its very intense," Lasenby said of ACT treatment. "They review each of those individuals every day. On some level they're having some kind of contact24/7.

"Often the challenge is finding individuals who are trained and able to take care of that very complex person," she said.

Healing justice is a Detroit News project made possible through a fellowship with the Association of Health Care Journalists funded bythe Commonwealth Fund, a nonprofit foundation focused on health.

kbouffard@detroitnews.com

Twitter: @kbouffardDN

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Treatment teams see mental health successes in Norway - The Detroit News