In 2022, a record number of patients, users and relatives contacted the Patient and User Ombudsman. New figures from the ombudsman show that it is dissatisfaction with mental health care that has seen the greatest increase. And an increasing number of these relate to complaints about refusals at the child and youth psychiatry (BUP). – We see that the municipality refers a young person or a child to the specialist health service, but then they are refused on the grounds that they can receive treatment in the municipality, says Jannicke Bruvik, national patient and user representative. She is contacted by parents with despairing children and young people whose hope is extinguished when the referral is rejected. – The children are left in a limbo, where they do not receive adapted treatment in the municipality or anything from the specialist health service. It is a terribly despairing situation, says Bruvik. Jannicke Bruvik, patient and user representative, believes that mental health for young people must be prioritized. – The younger you are, the greater the consequences for the rest of your life, she says. Photo: Synne Lykkebø Hafsaas / news Fears for young people in smaller municipalities BUP provides mental health care for moderate to severe mental health problems. Bruvik is particularly concerned about the children who live in the smaller municipalities that are rejected by BUP. The patient and user ombudsman An independent actor who can help you if you do not get your rights as a patient or next of kin fulfilled. Can help with advice and compensation. Anyone can contact the patient and user representative, orally or in writing. It is possible to apply anonymously. Getting help is free, and they are bound by confidentiality. There is a patient and user representative in each county, and they are administered by the Directorate of Health. Source: Norsk Helseinformatikk – If there are small municipalities or municipalities with capacity problems in mental health, then you risk receiving worse treatment than in the neighboring municipality because it is larger, she says. Coincidences also come into play based on the kind of expertise found in the municipality. – You must have some luck with your mental illness. You should have a diagnosis that fits what the municipality has expertise in. It is left to chance, says Bruvik. Hello! Have you or your child been rejected by the Child and Youth Psychiatric Outpatient Clinic (BUP)? Then we would like to hear from you. Helge Eide is area director for society, welfare and democracy in the Municipal Sector’s interest and employer organization (KS). She says that there has been a clear increase in man-years for municipal services in mental health for children and young people. – Despite this, we know that it is a significant challenge for those with serious, complex and long-term disorders, says Eide. He believes that the municipalities and the specialist health service together must find better solutions. Not decreased after the pandemic Figures from Health Bergen confirm an increase in admissions to child and youth psychiatry in the specialist health service. An increased trend that is left over from the corona pandemic. – This is a demanding situation. Despite the fact that we have received more resources and the number of consultations has increased, we see that our waiting times are also increasing, says Liv Kleve, clinic director for mental health care for children and young people (PBU) at Helse Bergen. During the pandemic, healthcare organizations noticed a drastic increase in the number of inquiries. Among other things, several young people had eating disorders. BUP still notices a large influx from children and young people who struggle psychologically. Photo: Line Hødnebø / news The large increase leveled off in 2022, and the employees in the health care system hoped that the situation would return to pre-pandemic times. But in January 2023, the number of referrals was as high as in January 2022. – The trend with an increased level of the number of referrals therefore seems to continue, says Kleve. The most common inquiries to BUP in Helse Bergen concern suspicions of ADHD, anxiety, depression and eating disorders. – People are in very difficult situations, for which people need help. We are here to help, but we have to make better use of the offers at different levels, says Kleve. May have greater capacity problems The government’s aim is that everyone who is referred to mental health care in Norway should receive an assessment interview. But that can lead to bigger capacity problems, according to the clinic director at Helse Bergen. – This is a dilemma we are in. If the pressure increases, then we will be expected to spend more time on investigation and assessment, and less on those who need more long-term treatment due to a more serious condition, she says. She says there is a need for more resources for the specialist health service. Liv Kleve, clinic director for mental health care for children and young people (PBU) in Helse Bergen, believes that the division of tasks between the municipality and the specialist health service should be improved. Photo: Gerd Johanne Braadland – But here we also need more and better agreements on task sharing with our partners. There are many referrals that come to us who could very well benefit from the services offered by the municipal health service. The aim is to ensure that unnecessary time is not spent visiting the specialist health service and then being offered help in the municipality, she says. – Can’t do the municipalities’ work Helse Førde, which is responsible for BUP in Sogn og Fjordane, also continues to experience high pressure. There, they refuse few patients, but experience a large influx after the pandemic. There, the specialist health services must take away patients who are actually the municipality’s responsibility, according to Toril Taklo, head of department at Helse Førde. – It is a problem because we are equipped to meet 5 percent of the child population who have moderate to severe problems. Those with milder and moderate conditions will receive help in the municipalities. But in Sogn og Fjordane, it varies how well the provision for children and young people is there, she says. In the company, the employees see that healthcare services in the first line, i.e. in the municipality, are expanding. – We know there is a big difference from municipality to municipality. We would like to help the first line build up its services, but we cannot do the work that the first line should actually be responsible for, says Taklo. Toril Taklo, head of department for mental healthcare for children and young people in Helse Førde. Photo: Benedikte Grov / news
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– You must be lucky with your diagnosis – news Vestland
