– Results from clinical studies indicate that patients who are placed on a waiting list have less improvement than those who are not offered any treatment, says Joar Halvorsen. He is a specialist in psychology and associate professor at NTNU. There is no research directly on those waiting for psychiatric help in the public sector, but Halvorsen believes that the research that has been done in scientific studies can perhaps be transferred to being on the waiting list in Norway. The researchers do not know exactly why someone gets worse from waiting. But Halvorsen has a theory. The nocebo effect – I think it may have something to do with the fact that they simply have an expectation that if you wait for treatment, they will not get any better. They become passive. He talks about the opposite of the placebo effect. Namely the nocebo effect. While placebo is that a positive expectation can lead to an experience of improvement, nocebo is that a negative starting point worsens the symptoms. – But why waiting lists contribute to a nocebo effect, we don’t know for sure, says Halvorsen. At the same time, he believes that those who are told that they will not receive treatment, may do more themselves to get better. For example, there are self-help programs that work well. Psychologist Joar Øveraas Halvorsen is concerned with which treatment actually helps with mental disorders. Photo: Sverre Lilleeng / news No health regions meet the requirement In Norway, the authorities have set an upper limit for how long people with mental illness must wait to receive help from the specialist health service. For children and young people, it is 35 days. For adults, the goal is to stay within 40 days. None of the four health regions is able to fulfill this so far in 2022. All have, on average, longer waiting lists from last year to this year: The health authorities that come out worst are the University Hospital of Northern Norway (UNN) and Helse Møre og Romsdal. For adults at UNN, the waiting time this year has been an average of 74 days. For children and young people at Helse Møre og Romsdal, the waiting time this year has been an average of 81 days. – We are very sorry and apologize that the waiting time has increased. That’s what Manuela Strauss, head of mental health care for children and young people in Møre og Romsdal, says. The waiting time at the department she works at is around 30 days longer than a year ago. More patients – too few professionals Ho explains that many more are being referred now than before. Some also have more serious ailments. – For the most seriously ill, we make an offer quite quickly. It also means that someone has to wait even longer. The last reason for long waiting times is difficulty in getting hold of professionals. Even if they have received extra money to hire more people. – We have recruitment difficulties. It can’t be stuck under a chair. She hopes they will have shortened the waiting lists by Christmas. Manuela Strauss believes that several problems at the same time contribute to children and young people having to wait a long time for mental health care. Photo: Jonas Otneim / news They have also tried to appoint more people at UNN. In addition, they have tried to have a clinic open in the evening. – So far, it has not produced the effect we want. So we are still working on finding new ways to operate which will hopefully mean that we can reduce the waiting time, says Eirik Stellander, head of mental health and the drug addiction clinic in Tromsø. I mean long waiting time = longer course of treatment Professor Jan Ivar Røssberg at the University of Oslo is researching which treatment works for mental illnesses. He is clear about the consequences of waiting: – We know from studies, and this applies to all mental disorders, that the later we arrive at optimal treatment, the worse the prognosis. Jan Ivar Røssberg believes that mental illnesses are taken less seriously than physical illnesses. Photo: Silje Bergum / OUS – Psychosis is more deadly than cancer and cardiovascular disease combined. And many who spend their lives struggling with depression. But since it’s psychiatry and mental health, we don’t care. He says that reducing the waiting time, especially for young people, will save society a lot of money. The general secretary of Mental Health, Linda Berg-Heggelund, says the same. She calls it completely unsustainable that any company has between 70 and 80 days waiting time. – Waiting time causes more damage. Those waiting in line can go from moderate mental health challenges to more serious mental health challenges. This may mean a longer course of treatment. Linda Berg-Heggelund says waiting time comes as an additional burden to the suffering the sick already have. Photo: Magnus Kristiansen Are more rejections a solution? Mental health is a membership organization for people affected by mental illness. They constantly come into contact with people who are queuing. – They put their lives on hold. For adults, it can be difficult to get into work and maintain social relationships. Children and young people may drop out of school and have difficulties with social activities. Waiting for help takes up a lot of space in life, says Berg-Heggelund. If waiting can be worse than not getting help, is it better that more people get a clear no? Will several blank rejections prevent the negative development of the disease? – If we get more rejections, we will in any case have more accurate statistics on how many people seek help without receiving an offer, says Berg-Heggelund, and continues: – But we know that rejections are also very demanding, because some people feel that they really need help. Mental health believes that all the country’s municipalities must put in place low-threshold services for children and young people with moderate mental health problems. An overview from the Directorate of Health from last year shows that one in ten municipalities do not have such offers. – The right help at the right time should not depend on which country you live in, states Berg-Heggelund. Time as medicine It is not easy to find a definitive answer to what best makes mentally ill people healthier. Is it medication or therapy? Or something completely different? Like time? Some of those who have participated in scientific studies, and have been told that they will not receive treatment, have gotten better on their own. Especially those with less serious ailments. – Within three months, we know that a quarter of those who have a diagnosis of depression have improved so much that they are almost healthy. Within six months, a third have experienced the same thing. When a year has passed, over 50 percent have recovered on their own, says psychologist specialist Halvorsen. But that in no way means that time is a guarantee of recovery. Because treatment makes people well faster – and can reduce the risk of you getting sick again later, he says. – If you have symptoms that go beyond your ability to function at school, work or socially, then you should definitely seek help. This episode of Folkeopplysningen is about mental health. Why do so many young people say they have anxiety and depression?
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I think waiting can make mentally ill patients – news Trøndelag
