More information
Description
Financed from NO FM
Programme outcome the project contributes to “Improved prevention and reduced inequalities in health”
The project will establish a uniform, evidence-based and cross-sectoral system of out-patient services for long-term mentally ill patients subjected to coercive treatment, increase the quality of psychiatric evaluation to improve judiciary procedures and secure human rights in the use of coercion during treatment.
Project activities shall include:
- The development and implementation of out-patient services, combining state and local level services for long-term mentally ill patients subjected to coercive treatment;
- The development and piloting of a model for cross-sectoral cooperation between specialists in health care, social care and the judicial sector sectors at local and regional level;
- Training for multi-sectoral teams, social workers and family members of patients to deal with patients/clients with chronical mental illness;
- The development and implementing of a model for a multidisciplinary forensic psychiatric committee to improve the quality of psychiatric evaluation, to ensure proper judiciary procedures and to secure the human rights of patients in the use of coercion during treatment;
- The adaptation process of 6 of evidence-based evaluation instruments is prepared and the validation process of these instruments has been launched to accommodate them to the Estonian needs.
Summary of project results
The project goal was to establish a uniform, evidence-based and cross-sectoral system of out-patient services for long-term mentally ill patients subjected to coercive treatment, increase the quality of psychiatric evaluation to improve judiciary procedures and secure human rights in the use of coercion during treatment.
The main results and outputs of the project were:
- A model for cross-sectoral cooperation between specialists in health care, social care and the judicial sector sectors at local and regional level was developed and piloted in 6 regions - Tartu, Harju, Võru, Valga, Ida-Viru and Viljandi. A mobile team of specialist provided out-patient services, combining state and local level services for long-term mentally ill patients subjected to coercive treatment;
- A model for a multidisciplinary forensic psychiatric committee was developed to improve the quality of psychiatric evaluation, to ensure proper judiciary procedures and to secure the human rights of patients in the use of coercion during treatment;
- Viljandi Hospital staff received various trainings and study trips (Norway, Finland, Czech Republic) to deal with patients/clients with chronical mental illness;
- 2 evaluation instruments – STATIC 2002R and SANS/SAPS – have been validated and other instruments (OxRec, FoVox, OxMis, OxMiv, HCR) are ready to be validated.
A bus for mobile cross-sectoral teams has been renovated for specific needs and is in use for out-patient psychiatric coercive treatment model by cross-sectoral teams in different regions of Estonia. It enables to provide quality abulatory coercive treatment more closer to person''s home. In 2023, altogether 101 patients were treated (18 women and 83 men). The average number of treatment days for a patient is 758. Viljandi Haigla works on expanding the provision of the service.
THe principles laid down in the multi-forensic psychiatric committee model are being adhered to for impartial regular evaluation of the patients´psychological condition.
Viljandi Hospital is engaged in continuing with the scientific validation process of evaluation instruments (FoVox, OxRex, OxMiv, OxMis, HCR) in order to adapt them to the Estonian needs. In 2024, dr Liina Haring will train the specialists on SANS/SAPS after which the instrument will be taken into full use.
Additionally, Viljandi Hospital is organising to pilot FACT (flexible assertive community treatment) model in Estonia similarly to Norway.