Markussen Hilde V, Aasdahl Lene, Viksveen Petter, Rise Marit B
Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
St. Olavs Hospital, Trondheim University Hospital, Nidaros District Psychiatric Centre, Trondheim, Norway.
PLoS One. 2024 Dec 23;19(12):e0312513. doi: 10.1371/journal.pone.0312513. eCollection 2024.
Scarce treatment resources put pressure on mental health services prompting innovations in service provision. Various innovative strategies have been introduced to provide patients with improved and effective treatment due to increased demands for mental health services. In 2016 a district psychiatric centre (DPC) started a brief treatment program to provide early and effective help for moderate depression and anxiety. There is little evidence regarding the potential benefits that different mental health patients may experience after receiving brief therapy treatment. Moreover, few studies have explored the experiences of referring general practitioners (GPs) with different patient outcomes after brief therapy. The aim of this study was to investigate the long-term experiences of patients who received brief therapy at a DPC at least one year ago, as well as the experiences of general practitioners (GPs) who referred patients for such treatment since 2016. Specifically, the study sought to determine patterns in the patients' stories and GPs' experiences to see if it could provide new insight for further studies.
We conducted individual interviews with a total of seventeen participants, consisting of eleven patients and six GPs. Using an exploratory approach, we analyzed patients' narratives as they described them in the interviews, employing inductive and thematic analysis techniques. The GPs' experiences of referring several patients to brief therapy were also subjected to thematic analysis. In addition, we synthesized the patients' experiences into condensed stories for comparison. The experiences of GPs, who had referred patients to this brief treatment program over several years, were compared with the patients' experiences and reflections one year after receiving brief therapy. This comparison aimed to challenge and deepen the understanding of condensed patient stories.
The main results are presented as three condensed patient stories: A) Coping with mental problems; B) A path to another treatment; and C) Confusion and lost hope. The GPs' experiences are included in each condensed patient story to challenge and elaborate on relevant aspects.
Time-limited brief therapy was experienced as beneficial for patients with moderate affective and anxiety disorders but was experienced as unsuitable for those with more severe conditions. This raises important questions about the appropriateness of offering brief therapy to a diverse patient population and the efficient use of healthcare resources. We recommend further research to enhance understanding and develop tailored treatment services for different ailments. Identifying which patients benefit most from specific therapies can improve outcomes and resource allocation. An important improvement measure might be to enhance early communication between patients, General Practitioners (GPs), and District Psychiatric Centres (DPCs) before referrals. Ensuring brief therapy is targeted to those likely to benefit the most will enhance treatment effectiveness. Additionally, we suggest implementing joint assessment meetings to facilitate comprehensive information exchange and coordination among different care levels. This approach would improve assessments, treatment planning, and follow-up strategies, ultimately leading to better patient care and resource management.
稀缺的治疗资源给心理健康服务带来压力,促使服务提供方式进行创新。由于对心理健康服务的需求增加,已引入各种创新策略为患者提供更好、更有效的治疗。2016年,一个地区精神病中心(DPC)启动了一个简短治疗项目,为中度抑郁和焦虑提供早期有效帮助。关于不同心理健康患者接受简短治疗后可能获得的潜在益处,几乎没有证据。此外,很少有研究探讨转诊全科医生(GPs)对不同患者接受简短治疗后的体验。本研究的目的是调查至少一年前在DPC接受简短治疗的患者的长期体验,以及自2016年以来转诊患者接受此类治疗的全科医生的体验。具体而言,该研究旨在确定患者故事和全科医生体验中的模式,看是否能为进一步研究提供新见解。
我们对总共17名参与者进行了个人访谈,其中包括11名患者和6名全科医生。采用探索性方法,我们分析了患者在访谈中描述的故事,运用归纳和主题分析技术。全科医生转诊多名患者接受简短治疗的体验也进行了主题分析。此外,我们将患者的体验综合成浓缩故事进行比较。将多年来转诊患者至该简短治疗项目的全科医生的体验与患者接受简短治疗一年后的体验和反思进行比较。这种比较旨在挑战并深化对浓缩患者故事的理解。
主要结果呈现为三个浓缩的患者故事:A)应对心理问题;B)通往另一种治疗的途径;C)困惑与失去希望。每个浓缩患者故事中都包含了全科医生的体验,以挑战并阐述相关方面。
限时简短治疗对中度情感和焦虑障碍患者有益,但对病情较重的患者不合适。这就引发了关于为不同患者群体提供简短治疗的适宜性以及医疗资源有效利用的重要问题。我们建议进一步研究,以增进理解并为不同疾病开发量身定制的治疗服务。确定哪些患者从特定疗法中获益最大,可以改善治疗效果和资源分配。一项重要的改进措施可能是在转诊前加强患者、全科医生(GPs)和地区精神病中心(DPCs)之间的早期沟通。确保简短治疗针对最可能获益的患者将提高治疗效果。此外,我们建议召开联合评估会议,以促进不同护理层面之间的全面信息交流与协调。这种方法将改善评估、治疗计划和随访策略,最终实现更好的患者护理和资源管理。