The strategic network position: a feasible model for implementing a decentralized psychiatry

• Published in: Health Promotion International
• Main Authors: SØRENSEN, TOM, SANDANGER, INGER
• Format: Text
• Language: English
• Published: Oxford University Press 1989
• Subjects: Original articles; Lofoten; Norway; Northern Norway
• Online Access: http://heapro.oxfordjournals.org/cgi/content/short/4/4/297; https://doi.org/10.1093/heapro/4.4.297

The Norwegian psychiatric health system is sectorized, decentralized and mainly in the public domain. This paper examines the theoretical and empirical foundation for community psychiatry with the responsibility for dealing with all mental disorders within the confines of a community, both current and potential cases. Some results from a comprehensive epidemiological research project in a catchment area—Lofoten in Northern Norway—are presented. The paper describes a model— the strategic network position—and its application in the same area. A main requirement for the model is a small catchment area (25—35 000 inhabitants) with geographical and personal proximity of psychiatric specialists, primary health services and other resources for mental health in a community. The model aims at reaching in an optimal way the people and the networks which influence the present and future mental health of the given communities. The model also focuses on various preventive and mental health promoting approaches which are feasible in the Norwegian social system. The recognized strategic networks consist of the most demanding patients, people with explicit responsibility for treatment and care of defined psychiatric patients, persons often in contact with people in a position to influence attitudes or with possibilities for observing a great number of people, persons setting the framework and priorities for health and social services and people with special influence on the social function of the local communities. The attention and collaboration take place in the normal day to day working situation, in offering support in crisis situations and in establishing priorities when there is a need of psychiatric help. The model, so far, contributes in a promising way, both to psychiatric treatment and implementation of mental health promotion in the community.