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“没有一项服务是一座孤岛”:在挪威与危机解决团队合作的经验

'No service is an island': experiences of collaboration with crisis resolution teams in Norway.

作者信息

Klevan Trude, Karlsson Bengt, Hasselberg Nina, Ruud Torleif

机构信息

Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway.

Mental Health Services, Akershus University Hospital, Lillestrøm, Lørenskog, Norway.

出版信息

J Interprof Care. 2022 Mar-Apr;36(2):195-201. doi: 10.1080/13561820.2021.1888900. Epub 2021 Apr 14.

Abstract

Crisis resolution teams (CRTs) are a community-based service targeting adults experiencing acute mental health crises. The rationale for the development of CRTs is both value and efficacy based, suggesting that CRTs should contribute to the humanizing of mental health services and replace some acute hospital-based services with services in the community. Despite the collaborative nature of CRT work, how professionals from health and social services experience collaboration with CRTs is scantly explored. In the current study, semi-structured focus group interviews with eight different groups of 44 clinicians collaborating with CRTs in Norway were conducted. Data were analyzed using thematic analysis and categorized into four themes: (1) 'The accessible experts', (2) 'A broad and deep expertise', (3) 'Doing it together' and (4) 'Toward a new culture?'. The themes elaborate on issues related to the content and organization of CRT services, emphasizing the need for CRTs to be able to contribute their professional expertise in accessible, flexible and collaborative ways. A diversity in the knowledge base and in how services are organized may pose a challenge in interprofessional mental health crisis collaboration and mutual expectations. The study suggests that a shift toward a value-based and coherent mental health and social system could be a purposeful direction.

摘要

危机解决团队(CRTs)是一项针对经历急性心理健康危机的成年人的社区服务。CRTs发展的基本原理基于价值和功效,这表明CRTs应有助于心理健康服务的人性化,并以社区服务取代一些急性医院服务。尽管CRT工作具有协作性质,但很少有人探讨卫生和社会服务专业人员如何体验与CRTs的协作。在本研究中,对挪威与CRTs合作的44名临床医生组成的八个不同小组进行了半结构化焦点小组访谈。使用主题分析对数据进行分析,并分为四个主题:(1)“可接触的专家”,(2)“广泛而深入的专业知识”,(3)“共同开展工作”和(4)“迈向新文化?”。这些主题阐述了与CRT服务的内容和组织相关的问题,强调CRTs需要能够以可接触、灵活和协作的方式贡献其专业知识。知识库以及服务组织方式的多样性可能会给跨专业心理健康危机协作和相互期望带来挑战。该研究表明,朝着基于价值且连贯的心理健康和社会系统转变可能是一个有意义的方向。

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