In Stockholm, Sweden, people who suffer from mental illness are given therapy on wheels
Over 1,500 suicides and 15,000 suicide attempts are reported annually in Sweden. In order to tackle this, Stockholm’s care services have introduced the Psychiatric Emergency Response Team (PAM) – an ambulance dedicated only to mental health care. It’s the first of its kind in the world, essentially an emergency response therapy room that can travel at 70 miles per hour.
As it speeds across the city, PAM looks like the conventional ambulance. On the inside, however, comfortable seats have replaced stretchers, and the bright lights have been altered for a warmer glow.
The response team includes two mental health nurses and one paramedic. In Sweden, the police traditionally handle these emergency cases. By making trained professionals available for emergency response, the quality of care provided is improved. It has also minimised the stigmatization of patients with psychiatric problems.
In Stockholm, PAM responds to over 130 calls per month on average. The vast majority of these calls relate to suicidal risk.
Anki Björnsdotter works as a mental health nurse, and gave a small insight into working with PAM:
We help people who are suicidal and people who suffer from severe mental illness. It can be someone who is manic and not aware of their own mental state, such as a person who needs to go to a hospital without realising they need to. Also, people who are psychotic and people suffering from schizophrenia who haven’t taken their medicine and are in distress.
It used to be the police who handled these kinds of calls. But just the presence of the police can easily cause a patient to feel like they’ve done something wrong. Mental illness is nothing criminal so it doesn’t make sense to be picked up by the police.
When we first arrive at the scene, we evaluate the situation. If it’s a suicide case, it can take some time before you reach a contact person or someone who’s able to calm the patient down. We talk to the person in order to make a call about whether we should bring the patient to the hospital, or give them a ride home.
For example, if we get a call about a person on a bridge about to commit suicide and things have cooled down by the time we arrive, we might consider the situation and decide that, in this particular case, the patient won’t try to commit suicide after all and won’t need to be hospitalised.
During its first year of operation, PAM was requested 1,580 times, and had 1,254 cases attended to. That’s an average of 4.3 requests and 3.4 cases per day. 1,036 individuals of all ages were attended to, and 96 of them had contact more than once. One third of all attended cases resulted in no further action after a psychiatric assessment and sometimes crisis intervention had been made on site.
It is a scheme that is widely believed in, offering the right response to such delicate emergencies. PAM plans to continue operating in Stockholm after a successful trial, according to Fredrik Bengtsson, Head of Mental Health Emergency at Sabbatsberg Hospital. “I can’t see any reason as to why the project shouldn’t continue,” Bengtsson told VICE Sweden. “It has been considered a huge success by police, nurses, healthcare officials, as well as by the patients.”
Currently, Stockholm is the only Swedish city to have taken such measures to reduce suicide rates. However, Because of its success, other regions – like Skåne, Örebro, Blekinge and Jönköping are all looking into the possibility of using PAM. In Gothenburg, they have already set up a scheme that takes mental health nurses to emergencies by car, again delivering the right type of care for patients suffering from poor mental health.
This article by John-David Ritz was originally published on Vice and the Social Innovation Exchange.
By Rachael Holster
People dealing with mental illness and bipolar disorder in particular talk a lot about mood swings: how they feel, what they’re like, how your life can be affected. What is discussed less is what things can trigger a mood swing — good or bad — and how to deal with them. Here I will cover just three of my big triggers and some tips on dealing with them.
Missing a parent or friend, an argument with a spouse or child, your boyfriend breaking up with you, sister moving home… all of these instances have a profound impact on us mentally and so they also affect our mental health.
No one is perfect — not our friends, family or ourselves, and one of the quickest ways for me to slide into depression or rise into mania is on the words and actions of others.
I’ll be honest: I’ve lost good friends and even family over not being able to go out and socialize when I plan to, or attend regular church meetings or talk therapy because I literally cannot get out of bed. People say, “why don’t you ever show up?” Or, “just get over it.”
But the opposite can also be true. Just a small encouraging word can brighten my day significantly, or a good conversation can help me out of the dark hole I’ve started to slide into.
If there’s one thing I could say to others about this trigger, it is that your interaction with me go a long long way toward keeping me stable or swinging me into a phase of depression or mania. Be careful. Your words hold tremendous power. Use them to help heal wounds and build up friends, not to tear down. Whatever you say to me, my mind will take it and amplify it 10 times to shape me for a while. By being your friend and family, that is a big responsibility I give to you.
I cannot emphasize enough the mental benefits of a clean and organized home, though I know well it can be hard to do. When my house is messy and disorganized, my brain is in a constant state of anxiety and irritability, like trying to see through a kaleidoscope. This affects my moods, which affects my relationships. When my house is clean, I feel like I can finally breathe and remain calm. Though this cleanliness may not come around as often as I’d like and I have to work hard for it, the hard work is worth the benefit of thinking clearly and being less irritable.
Tip: take it slow. Don’t try to do everything in one day or you will fail and feel bad about yourself. Instead, make a list of the specific small things to do each day and tailor it to fit your needs. There is no right or wrong way to do this. An example would be clean the kitchen Monday and the bathrooms on Tuesday.
Time spent alone is another big thing that affects my mood. If I get too much time alone, I get depressed, but if I don’t get any time alone my mixed moods (depression and extreme anxiety) will get the better of me.
So make sure you get regular time alone just doing something that makes you happy. You may, for example, take your dog for a walk, paint, read, watch a movie alone with popcorn, or my personal favorite: take a drive in the country, listening to your favorite music.
Sometimes, these little breaks are all we need to keep a dive into depression or a rise into mania at bay. Sometimes, they are all we need to stay in the “normal” zone.
In a nutshell, the words others say to us, the amount of time we spend alone, and our personal environment all help to shape who we are, and where we are in this bipolar adventure. Some small, easy to make decisions can go a long way.
Walk on, my friends, and hold your head high, for you are an amazing person just because of who you are.
I’m Jason, I am 26 and I have bipolar type 2.
I am NOT Bipolar, but I live with bipolar.
It is a strange thing that seems to occur in our society ‘do you know that this person is bipolar?’ What?? They are the embodiment of a whole illness? Great news, at least we have now isolated it to one person, wait what? There’s another person that is also bipolar? NO! Just flat out no, we do not suddenly lose our identity at the diagnosis of a mental health problem.
It seems to be difficult to convince some, as it’s a battle internally which can naturally mean that some of our behaviour is affected by our health condition, and I know that certain behaviours of mine have put strains on personal relationships and I can often isolate myself when I am going through a depressive episode. I can be extremely flaky, plans with me can often change at the last minute. I have quite an enduring physical health condition that I will use as my excuse when I do flake out. But these are just parts of my personality, not the whole.
I have always been a supporter of talking about mental health conditions, but I have always struggled to talk openly about mine, and the fear of stigma underpins this. It was why I wanted to write about my experience, because only by being open about our struggles can we pave the way for a new society, where difference is championed and we can see the skills that every individual has, not just the label they have been given. I don’t want to have to just use my physical health condition as an excuse, I want to be able to frankly say, ‘hey, look I was really looking forward to seeing you, but unfortunately, the black cloud that sometimes personally rains on me, has decided to pay me a visit, do you mind if we reschedule until it lifts a little?’
It has been a long journey to get to the point of diagnosis, mainly because of a fear of what that would mean for my future, but it took a close relative to challenge my behaviour and encourage me to seek help. I have now found a combination of medication that helps my mood swings stabilise, I do have to keep a close eye on it all, I have also been able to monitor early warning signs and I managed to notice that my dysfunctional thinking was returning regarding suicidal thoughts, and could seek treatment before attempting any harm to myself. I find humour helps me when I am in a depressive episode. I might not be able to laugh my way out of it, but it helps me separate the blackness from my sense of self. Similarly, when the lovely haze of euphoria comes my way and I have 1 trillion amazing new ideas that I urgently must write about or draw, or speak about at 4am, I recognise that I really should take a step back and try and laugh at the situation.
I do work, but it does have an impact, I also have many physical health conditions, so combined they make working life quite a challenge. The hardest part is the self-doubt, indecisiveness and being on the verge of tears at work and at the other end of the spectrum I take on the everything, and then end up crushed by the weight of it all. I am learning to become better at discussing my mental health with my manager, and this will hopefully come with accepting and challenging perceptions of mental health.
So, here begins my new chapter of talking openly and treating myself with the same compassion, that I give others with mental health conditions, and encouraging others in our society to talk about mental health with the openness that physical conditions are treated with.
Many thanks to Lions Moorabbin for their generous
donation of $500 to greatly assist us in our work.