Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

Eva Brekke; Hanne K Clausen; Morten Brodahl; Annika Lexén; Rene Keet; Cornelis L Mulder; Anne S Landheim

doi:10.3389/fpsyg.2021.727013

Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study

Front Psychol. 2021 Sep 8:12:727013. doi: 10.3389/fpsyg.2021.727013. eCollection 2021.

Authors

Eva Brekke¹, Hanne K Clausen^{1

2}, Morten Brodahl¹, Annika Lexén³, Rene Keet⁴, Cornelis L Mulder⁵, Anne S Landheim^{1

6}

Affiliations

¹ Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway.
² Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
³ Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden.
⁴ Flexible, Innovative Top-ambulatory Academy of Community Mental Health Service, Geestelijke Gezondheidszorg Noord-Holland-Noord, Heerhugowaard, Netherlands.
⁵ Department of Psychiatry, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands.
⁶ Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.

Abstract

The aim of this study was to explore and describe service user experiences of how receiving services from a Flexible Assertive Community Treatment (FACT) team may support or inhibit citizenship. Within a participatory design, individual interviews with 32 service users from five Norwegian FACT teams were analyzed using thematic, cross-sectional analysis. The findings showed that FACT may support citizenship by relating to service users as whole people, facilitating empowerment and involvement, and providing practical and accessible help. Experiences of coercion, limited involvement and authoritarian aspects of the system surrounding FACT had inhibited citizenship for participants in this study.

Keywords: citizenship; flexible assertive community treatment; integrated care; recovery; severe mental illness; substance use disorder.