Monika Knudsen Gullslett & Tor-Johan Ekeland

The significance and conditions of autonomy in relation to crisisresolutionhome treatment teams

The Norwegian Health Directorate targets the creation of ambulant home treatment teams in all 78 DPS units in Norway. This is seen not only as a new way of organizing services in the mental health field, but also as a new way of thinking which implicates an effort from the providers to involve users and next of kin in clinical decisions and the handling of crises. In this article we challenge the knowledge base for this kind of practice, and the necessary framework conditions. Research in this field shows that people who have received help at home for a mental health crisis, experiences increased feelings of coping and autonomy. It seems that a central premise for this is an experience of respected subjectivity and agency. We discuss how autonomy, as a relational phenomenon between user and provider, can be realized in practice. One problem can be framework conditions which foster standardization of practice and reduce the provider's clinical autonomy and, unintentionally, restrain the users’ autonomy.