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Adults with mental health problems are not receiving adequate treatment - Document no. 3:5 (2008-2009)

How the right to necessary help from the specialist health service is understood varies greatly from one institution to another. The fulfilment of this right depends not only on how serious the complaint is, but also on the capacity of the institution to which the patient is referred. ‘This is a discouraging result after many years’ efforts in the field of mental health care.  In some areas, the capacity is so low that we believe special measures are necessary,’ says Auditor General Jørgen Kosmo.
Published 12/1/2008 4:09 PM

Document No 3:5 (2008–2009) The Office of the Auditor General’s investigation into the specialist health service’s facilities for adults with mental health problems was submitted to the Storting on 25 November.

The investigation shows that there are great differences between regional health authorities and between hospitals as regards their capacity to treat adults with mental health problems. This applies to all types of services: outpatient services, day clinics and inpatient services. There are also major differences in the percentage of specialists. In some areas, both capacity and the percentage of specialists are low. This results in long waiting times. Capacity, waiting times and competence in the specialist health service have an effect on the practice of primary physicians as regards referring patients.

The health trusts’ compliance with the Prioritisation Regulations varies greatly. Patients with self-evident rights are rejected, while patients who should have been rejected are admitted. There is no connection between diagnoses and the prioritisation of patients or between diagnoses and deadlines for treatment.

‘This is clearly contrary to the intention behind the Regulations, namely to give patients equal rights to treatment,’ says Mr Kosmo.

Many clinics give too little information both to patients and to GPs. This can result in patients not being in a position to assert their rights, including the right of appeal. This practice is not only a violation of the Regulations but also of the goal that the services shall be based on a user perspective.

Important management data are lacking, and the quality of the available data is poor. The Ministry of Health and Care Services stipulates many management requirements and indicators every year that are neither reported on to any great extent nor followed up. Thus, neither the regional health authorities nor the Ministry has good control in this area.

The Ministry of Health and Care Services agrees that there are still major challenges relating to the quality of referrals by physicians, compliance with the Prioritisation Regulations and competence and control in mental health care for adults.

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