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"Nobody Can Help Me" 

Users of health and care services who frequently call the emergency services pose a challenge to the support system. Their condition can be complex and difficult to understand for those attempting to provide assistance. 

The reference case for this investigation is the story of a young woman we have named Malin. She had a complex psychiatric condition with symptoms that could be interpreted in various ways. She felt that no one was able to help her. It was hard for the healthpersonell to understand what she needed, and there was disagreement on how to interpret her symptoms and care needs. Many of her helpers went to great lengths to assist, but differing understandings and approaches led to fragmented assistance that Malin found difficult to benefit from. When her symptoms intensified during the evening and night, Malin often became the responsibility of the emergency services. They responded and took her to the emergency room, and sometimes to psychiatric care for a brief stay before she was discharged again. The cross-sectoral collaboration lacked a unified plan – a joint interaction plan. Extensive care measures were implemented from various parts of the health and care service, but the overall assistance was not evaluated. 

After years of complex symptoms, persistent suicidality, and a period of significant deterioration and functional decline, Malin took her own life. 

In this investigation, we looked for possible contributing factors and causal relationships from which the health and care service can learn in managing patients with complex conditions who frequently call emergency services.  

We found that:  

  • Complex conditions challenge the support system. 
  • Disagreement on diagnosis and treatment affects the healthcare provided. 
  • Malin's condition worsened even though she received extensive help. 
  • Emergency services acted as the safety valve for the support system and seek closer cooperation with municipalities. 
  • Emergency services lack a cross-sectoral interaction plan. 
  • Malin's treatment process was resource-intensive without her feeling that anyone could help her. 

Based on these findings, we offer recommendations, learning, and improvement points at the end of the report. 

The translation from Norwegian to English is based in AI. Ukom has reviewed, edited and quality assured the translation.