My Voice Matters

Project Manager: Juni Raak Høiseth

Project Team Members: Christina Kildal, Johanne Bakken Moe, Liva Elvira Myrvold Nynes and Ellinor Elvrum Evensen

My Voice Matters is a three-year development project aiming to develop a method for actual user involvement for children and youth as service users. The goal is to enable children and youth to bring forward their experiences with the services with their own voice.

The project is based on User Interviews User (UIU) as a methodology, where former service users interview current users of a service. In this project we have young people/young adults in the ages of 18-23 as project team members, who themselves have experience with the use of mental healthcare services. The project team members are trained in the UIU-method, and participate in designing the interview guide, conducting interviews, analysis and writing the report. They present the results at a dialogue conference for employees of the service and service users. Here findings are discussed, and we decide how to work on improving the services according to findings. The service is given a final report which will serve as a tool for further development. One year after the project has ended we have a follow up meeting where we look into whether services are continuously developed after children and youth’s experiences and views.

In 2015 we evaluated the Children and Young People’s Psychiatric Out-Patient Clinic of St. Olavs Hospital in Trondheim, where we interviewed service users between the ages of 16 and 18. In the fall of 2017, we evaluated the out-patient services for children/youth between the ages of 12 and 18 at the Children’s and Young People’s Psychiatric Out-Patient Clinic of Levanger Hospital. In 2018-2019 we evaluated Team Children and Youth in Stange municipality.

We are currently interviewing service users and relatives in the evaluation of Children’s and Young People’s Psychiatric Out-Patient Clinic of St. Olavs Hospital in Trondheim. We are also awaiting interviews for the evaluation of the child welfare services in the Hemne and Snillfjord municipality.

The project is funded by Stiftelsen Dam through The Council for Mental Health.

The Canada-Norway Research Collaboration on Operationalizing Experience-Drive Innovation through Integration of Peer Support in Health Systems

Project Managers: Dr. Gillian Mulvale and Karl Johan Johansen

Research Team Members: Fiona Wilson, Dr. Ken Deal, Dr. Nick Kates, Shaleen Jones, Dr. Ian Arnold, Dr. Chuck Cunningham, Lee Purins, Anne B. Plathe, Ingvild Musdalslien Kvisle and Christina Kildal

Steering Committee Members: John Lee, Deborrah Sherman, Stella Ducklow, Frances Jewell, Patrick Mitchell, Eduardo Castro, Dagfinn Bjørgen, Torbjorn Mohn-haugen, Astrid Weber, Juni Høiseth and Ottar Ness

We have conducted an exploratory policy case study where the case is defined as the integration of formalized/intentional peer support services within clinical services located in hospital, primary care and community settings. Formalized/intentional peer support refers to peer support services (either group or one-to-one) focusing on issues such as education, employment, mental health systems navigation, systemic/individual advocacy, supported housing, food security, internet, transportation, recovery education, and antidiscrimination work. We have examined two sub-cases: peer support in Norway and in Ontario, Canada. These jurisdictions were selected because they are comparable in terms of socioeconomic development, embrace a recovery orientation, and are actively seeking to expand peer support in mental health service delivery, yet differ in important contextual factors, such as the policy climate and levers adopted to support implementation. Our data sources includes key informant interviews, surveys and published academic and grey literature. We have sampled the most common approaches to engagement of PSPs in adult mental health settings.

In Ontario, our recruitment strategy has focused on St. Joseph’s Healthcare Hamilton’s (SJHH) inpatient, Assertive Community Treatment Teams (ACTT) and outpatient clinic programs. In Norway, we have identified organizations that offer similar programs, including St. Olav’s Hospital Trondheim. Using a combination of focus groups and individual interviews, we have engaged PSPs, and individuals and families receiving peer support, 5-10 front line staff (psychiatrists, nursing, allied health professionals) and supervisors associated with each program. We have also conducted individual interviews with 2-3 policy makers in each jurisdiction (e.g. in Canada the Ministry of Health and Long-Term Care, the Hamilton Niagara Haldimand Brant Local Health Integration Network). We tailored the focus group and interview guides to capture the perspectives of each participant type, but have also explored common topics including: experience of providing/receiving peer support, barriers and facilitators to effective integration of PSPs (e.g. regulatory, funding, payment, organizational policies, team climate, information sharing, peer support and service delivery model) and change management approaches and implementation frameworks adopted. The survey (approx. 30 participants per sub-case) has focused on the influence of team climate on integration and functioning of PSPs.

The data collection and analysis is finished, and we are currently working on summarize the findings and writing articles based on the findings. One article has been published in Healthcare Management Forum.

The availability project

Project Manager: Heidi Westerlund

Project Team Member: Dagfinn Bjørgen

Since 1998 the User Interviews User-method has been used to collect the experiences from around 2000 users of different mental health care services. In 2013 the synthesis “Hva mener brukere av psykisk helsetjenester er en god tjeneste?” [What is a good mental health service according to service users?] was published in “Psykologtidsskriftet”.

Now we have started a comprehensive project to summarize data from 20 User Interviews User-evaluations of mental health services. Our goal is to formulate recommendations to services and to enable service user representatives to get documentation on the strengths and weaknesses of different approaches to meeting service users’ needs.

In 2017 our main subjects were “medication” and “meeting places”. Two workshops were held and we are currently working on summarizing these to create recommendations. This project will continue over several years.

Collaboration on user-driven innovation and service development in the municipality of Trondheim

Project Manager: Dagfinn Bjørgen

Project Team Members: Karl Johan Johansen and Ingvild M. Kvisle

The goal of the project is to develop and describe new ways of service innovation and user driven innovation. We want to develop services based on the recovery philosophy and what feels helpful and supportive from a user perspective. The mapping phase of the project was conducted in 2016-2017, with a User Interviews User-evaluation in the municipality. The project involves three of the municipality’s units; the unit for mental health and substance abuse, the unit for substance abuse services and the unit for meeting places and housing for people with mental health problems.

Steering committee meetings have been conducted throughout the project period. The steering committee consists of representatives from both KBT and Trondheim municipality.

We have established a peer panel in the project. The peer panel consists of people with service user experience from different mental health and substance abuse services. The panel has discussed the municipal services, hereunder subjects as the availability of the services. A dialogue conference was held the 20th of September 2017, where KBT presented the results from the User Interviews User-evaluation, and the peer panel presented their report for the municipality. The report is published on KBTs webpage.

At this time we are working on several continuations of the project. We are doing a User Interviews User-survey of the assisted housing in Jarleveien 10.

Peer Supporters in municipal mental health and substance abuse services, Trondheim municipality

Project Manager: Dagfinn Bjørgen

Project Team Members: Marthe Siira, Ingelin Anderssen and Ingvild M. Kvisle

This is a collaboration between KBT and Trondheim municipality. The goal is to strengthen the collaboration between employees in the services and service users through better understandings of communication and recovery. Two peer supporters have been employed in KBT, but their day to day work is within the municipality.

The peer supporters have different tasks and work areas. Marthe Siira works with following up people that receive support from the Recovery Team. She also partakes in talks and presentations about the team’s work. Ingelin Anderssen works in municipal housing through contact with residents. This means conversations, help with practical tasks or other things that the residents need support for. The peer supporters also partake in office meetings and strategy work in KBT.

Recovery HUBs

Project Manager: Karl Johan Johansen and Dagfinn Bjørgen

Project Team Members: Anne B. Plathe, Ingvild M. Kvisle and Christina Kildal

KBT, Sagatun Peer-driven Center, Vårres Regional Peer-driven Center, Bikuben Regional Peer-driven Center, ROM-Agder and Vestavind Peer-driven Center are working to become Recovery hubs. The Recovery hubs will serve as resource- and competence bases for recovery. We want to achieve:

  • Recognition of recovery being a personal and social process
  • Actual recovery for users. Sensible resource usage in the services and recovery processes based on equality between service users and services
  • Recognition and utilization of recovery-based user knowledge
  • Good quality of life and a worthy life for people with psychosocial challenges

We wish to strengthen individuals and groups, prevent stigma and exclusion. We want to promote human rights, a worthy life and increased participation for everyone, through activities such as teaching, guidance, courses, tools, and collection and dissemination of user knowledge. We assist and collaborate with user organizations, competence centers, municipalities, health thrusts, universities and colleges to make lived experience the basis for recovery-based services and practices.

A webpage has been made to spread information about the Recovery Hubs: In 2018 we held a workshop where we invited collaborators for discussion about the role and tasks for Recovery hubs. We plan to have a similar workshop in November 2019.

A final report marked the end of the project period, but we prolong our commitment to the Recovery hubs as a part of the regular work at the centers.

Medication-free treatment

Project Manager: Dagfinn Bjørgen

Project Team Members: Annika Alexandersen, Ingvild M. Kvisle, Anne B. Plathe, Juni Raak Høiseth and Christina Kildal

KBT has been commissioned by the regional health authorities to evaluate the newly established medication-free treatment services. The goal is to map the patients’ experiences and views. We will look into whether the service has met the patients’ needs, wishes and expectations. What are good approaches to drug-free mental health care, and how do the referral process, availability, treatment interventions and participation overall influence the servicer?

We have published the first report in this evaluation, which contains an overview and assessment of the implementation of the drug-free units. Click here to read the report in Norwegian.

We are making good process with the User Interviews User-evaluation (UIU) in the project, where we are interviewing users of medication-free treatment. This part of the project was delayed due to delays in implementation in the regional health thrusts, but we hope to complete the UIU-report in 2019.

Children, young people and service user involvement – a feasibility study of professionals’ understandings

Project Manager: Bente Hasle

Co-researchers: Betina Haug Olson, Juni Raak Høiseth, Aida Tesfai, Rigmor Dyrnes and Christina Kildal

This is a research project in collaboration with Associate Professor of Social Sciences Bente Hasle of the Institute of Social Sciences at Høgskulen i Volda and Mental Helse Ungdom [A Mental Health Organization for young people]. We wish to enlighten different understandings and practices regarding children’s and young people’s rights to service user involvement when receiving support from child protective services, mental health care services or health services from their schools. The main goal is to develop a practice where the right to service user involvement is realized to a larger degree. Several service user organizations have contributed to developing the project due to their interest in children and young people’s rights being strengthened.

The project is divided into three parts. In the first subproject “professionals’ understandings”, focus group interviews have been conducted with employees within mental health care for children and young people, child protective services and health services within schools. The interviews focused on the professionals’ understanding of user involvement for children and youth. KBT will continue to have a central position in the project, and will contribute to the analysis of the material and writing an article about the project. The findings will result in two articles, one of them to be published in Fontene Forskning [a Norwegian journal] in 2019. In the second subproject “Youth with ADHD advise helpers”, 19 youths have contributed with advice about prerequisites for realizing the right to user involvement. This is the base for an interview guide to be used in the main part of the project. The interview guide is further developed with four of the youths and young project team members with lived experience from KBT.

We are also planning the main project “Good conversations with children”, where we are going to investigate what happens when professionals think that they bring forward the child’s perspective and realize the right to user involvement, through analysis of recordings of conversations with children. After the recordings, Juni and Christina will conduct interviews with the children to bring forth their own perspective.

Cultural development by patient involvement

Project Team Managers: Dagfinn Bjørgen and Anne B. Plathe

In the spring of 2018 KBT established a partnership with the Departmental Attending Physician in the department of Østmarka, St. Olavs Hospital. We want to create a method for reflection groups consisting of the staff at Østmarka and people that have experienced involuntary commitment. The aim is to give patients the opportunity to create cultural changes at the hospital through dialogue. In between May and December 2018 Østmarka made an office available for KBT two days a week to get in contact with patients for the project. In 2019 we are setting up interviews with patients and taking part in evaluation conversations with patients and staff after use of involuntary commitment.

Patients and relatives’ alternatives to out-patient involuntary commitment – A qualitative study among patients and relatives at Nidaros DPS

Project Team Managers: Dagfinn Bjørgen and Anne B. Plathe

In the summer of 2018 KBT and Nidaros DPS started outlining a project to reduce the use of coercion in mental health care, and to explore challenges regarding out-patient involuntary commitment. The main goal of the project is to find what patients subjected to out-patient involuntary commitment think are areas for improvement, and how the use of involuntary commitment can be reduced with the use of alternative measures. The project is assisted by professor Marit By Rise of NTNU.

How the sense of belonging affects promotion of mental health in the workplace

Co-researcher: Juni Raak Høiseth

This is a collaborative project with PhD. candidate Olav Tangvald-Pedersen of the University of South-Eastern Norway, where Juni Raak Høiseth from KBT is contributing as a co-researcher. The project has been ongoing for several years. We are currently finalizing an article about how the sense of belonging in the workplace can affect the promotion of good mental health.

Guidance for Peer Supporters

Project Manager: Dagfinn Bjørgen

Project Team Members: Peer Supporters Marthe Siira and Ingelin Anderssen

The peer supporters employed by KBT are offered group-based guidance sessions once a month, in addition to guidance at their workplace in the municipality. The group-based guidance involves reflecting on common issues together. The intention is that the guidance is to pertain to both general subjects like recovery and self-care, but also specific issues that surface in their everyday work that they want to discuss.

Several other peer supporters in the area of Trøndelag have also participated in the sessions.

User Interviews User – Stavanger Municipality

Project Leader: Karl Johan Johansen

Project Team Members: Annika Alexandersen, Christina Kildal og Anne B. Plathe

In 2018 KBT was commissioned by Stavanger Municipality to contribute to a project about parent support called “Rask hjelp og riktig støtte i foreldrerollen” [Quick help and correct support in the parent role]. The goal of the project is to have a support and guidance service for parents that is coordinated, comprehensive and in accordance with parents’ needs.

KBT’s role is to convey the service users’ voices by doing a User Interviews User-survey amongst those who have used the service. We are gathering parents’ experiences with the service, mapping their needs and gathering their thoughts on what should be improved and what works well. This will be ground for further development of the services. A final report is due in fall.

Evaluation of assisted housing and “mestringsteam” – Trondheim municipality

Project Leader: Ingvild M. Kvisle

Project Coordinator: Anne B. Plathe

Project Team Member: Christina Kildal

Towards the end of 2018 KBT was commissioned to do a User Interviews User-survey in Trondheim Municipality. We were to interview people living in assisted housing, people being assisted by the mastery team, and people who previously lived in assisted housing, but have moved out and are now only using the “mestringsteam”. The “mestringsteam” is an ambulatory team that helps people who are moving from assisted living to independent living, and help prevent people having to move to assisted living in the first place.

In the project we are exploring the interviewees views regarding being in recovery and being in charge of their own lives. Ottar Ness of NTNU has interviewed employees of the assisted housing and mastery team, and we are to compare the experiences of both groups.

Interreg – Tidlig innsats (Early intervention)

Project Leader: Rolf Mollan

Project Team Member: Karl Johan Johansen

KBT and Braive have received grants from Interreg Sweden-Norway for the project “Tidlig innsats” [Early Intervention]. Braive offers a web based mental health service, where people can learn tools and coping strategies to overcome mental health challenges. The project is owned by Henrik H. Jahren of Braive, representing Sweden, and KBT by Karl Johan Johansen, representing Norway.

Unfortunately the public health services don’t have sufficient resources to help everyone that struggles. In other cases young people have to travel far to get help. Another aspect is that it is also important to help people mobilize their own resources. Therefore Braive will be tested as a self help resource for young people in Norway and Sweden.

The project will be documented by the Nord University and the Mid Sweden University.