A Norwegian Developmental Narrative: From Traditional Institutional Psychiatry to Modern Mental Health Care

Hege Saltnes is a chief physician and specialist in psychiatry, and she holds a master’s degree in health management. She is head of  the Norwegian National Unit for Sensory Loss and Mental Health. In addition to her professional expertise, she also has personal experience because she is married to a deafened man. This combination gives her a unique background to understand how sensory loss affects functioning in all areas of life and how it can also impact the development of mental illness.

Over the course of 45 years, Norwegian National Unit for Sensory Loss and Mental Health has transformed from a small center for deaf individuals with psychiatric disorders in the capital, Oslo, into a robust national service. This service now caters to individuals with various types of sensory loss, engages in extensive competence building, and offers education in mental health care both within the field and in society at large.

Fifteen years ago, the service had 11 employees, and it has now expanded to a workforce of 36 full-time specialized health care professionals. The most recent expansion included the provision of services for the visually impaired, as it became evident that visually impaired individuals encounter many of the same barriers as those with hearing impairments when accessing healthcare services.

Norway, with its vast geographical expanse and varying population density, necessitates collaboration with smaller units spread across the country. The overarching goal is to ensure that individuals with sensory loss have access to mental health care services that are as effective as those available to the general population.

Even in a wealthy country like Norway in 2023, there remains a shortage of expertise regarding the specific challenges and burdens faced by individuals with hearing and visual impairments, whether in the healthcare system, the workplace, or daily life.

This presentation will focus on the efforts to secure and advance equitable mental health care for individuals with sensory loss, addressing the obstacles faced, lessons learned, and how to challenge the hurdles on the track in the future.

Some key points from the presentation include:

1. Understanding the need for a specialized service.
2. Recognizing the importance of ongoing sign language education.
3. The organizational positioning of a specialized service and the continuous struggle for its existence.

4. The importance of cooperation with user organizations
5. Financial considerations and constraints.
6. Maintaining connections with the broader professional community and staying updated.
7. Creating a communication environment for employees with hearing and visual impairments, including the integration of interpreters.
8. Disseminating knowledge about the existence of the service in a world of competing messages.

Hege has extensive experience in collaboration with user organizations. The combination of professional expertise, research that documents needs, and political influence through the channels of user organizations has proven to be invaluable in the development of the service in recent years.