Where to get funding for reconstruction of the area? This issue was discussed by the management of psychiatric hospital in Červený Dvůr few years ago. The solution was found in Norway Grants. Programme focus inspired them to initiate a change which went much further than originally thought. The 3D clinic, where patients are approached individually was created. There are no scoring systems into which patient has to fit in. Moreover, the change enabled to treat people who otherwise wouldn’t be able to enter institutional care.

Newly reconstructed baroque chateau with a surrounding park covering the area over one hundred hectares, which is opened to patients and public - that is Červený Dvůr. Café is about to be open in one of the buildings. There are no bars in windows, the doors are unlocked. At the first glance almost no one would guess that this is psychiatric hospital focused on patients with addictions. Even after entering the building the feeling remains unchanged, patients are free to use wi-fi or admire historical tapestries. It doesn’t look like that the reconstruction changed the chateau into institutional environment rather that the hospital adapted to the chateau. As the director Jiří Dvořáček says, the environment here cultivates. He tries to manage the hospital in way that he wouldn’t have to be ashamed when treating his friends there.

The 3D clinic, which title refers to detox, diagnostics and differentiated care is really innovative. The hospital management looked for resources for reconstruction of a part of the area and found them in Norway Grants in 2014. The focus of the Norway grants on innovation in treatment methods and not only on infrastructure led Mr. Dvořáček to think about the essential change in attitude towards patients at a new established clinic. “We tried to find a new dimension in our services as a complement to common institutional care, which has its justification, but doesn’t fit everyone. We wanted to forget all the rules and focus on patient as a partner. We were the first ones in the Czech Republic who established individual approach towards patient in the institutional care which helped patients who didn’t feel comfortable in group sessions. It simultaneously opened a door to treat other patients with other mental health issues or mothers with children. We also have a special room where a handicapped person or mother with child can get a detox treatment. Situation of having a mother with a child in the institutional environment is far from ideal, but sometimes such situation happens,” Dvořáček explains.

The new approach emphasises the role of identifying the individual needs and abilities of each patient and also the importance of psychotherapeutic work, which is not just task for a specialized staff, but it involves all the personnel. Staff went through series of training sessions and the role of nurses grew up as they are also partly responsible for the overall management of the particular treatment. “The approach towards patients is non-directive. We are the partners to patients, not only their supervisors. The feeling when you don’t have to evaluate and score every little thing is liberating. We are also more involved in patients’ psychotherapy. It makes more sense to me,” describes case manager and nurse Markéta Šídlová.

The new way of treatment at 3D clinic hasn’t been only innovative regarding the role of the personnel, but also regarding the change of fixed rules, time scheme, structure of the day of the patient or community therapy. “I am here for the third time. I had no problems for two years, but it changed after breakup with my girlfriend. Now I have better individual therapy and coherent treatment which fits me better. I can handle the stress better, overcome bad thoughts easier and my mind becomes clearer,” says patient Petr.

Individual approach towards patients also reflects change of society and lifestyle and different needs that are based on it. “By certain level of simplification patients used to have similar problems during the communist regime. They got into psychiatric hospital after breakdown of all their life roles. Nowadays, people live completely different lives. They seek for help earlier and they still perform their life roles even when the addiction has developed. There can be a good father or company manager, who has problem with addiction. Commonly you should begin with detox at home. If it doesn’t work patient shall start with short-time institutional care enabling visiting home. And if even this doesn’t work then comes long-time institutional care and in certain cases with specific individual care,” says Dvořáček.

They would like to open addictological outpatient centre in Červený Dvůr to expand and supplement provided care. The concept would be similar to newly established centres for mental health care. “In an ideal case we would like to establish a core team of our employees and local NGOs employees. It would also include mobile services and providing services to local communities, which would enable us to work with people more individually. We would provide help to people, who don’t need the institutional care and on the other hand select those, who need to be treated in our hospital. Those in need of institutional care would then clearly understand the reason why they need it. Therefore, we would also help to build the common understanding of institutional care when necessary” concludes Dvořáček.

In 2016 the team of Červený Dvůr received a Kiron price for addictological project of the year for their 3D clinic. Psychiatric hospital Červený Dvůr is a facility specialized on mid-term institutional treatment of addictions on common substances and pathological gambling. It was established in 1966. Current capacity is 109 beds which provide service to 550-750 patients annually.

Activities described in the article were implemented within project “Creating the conditions for the implementation of enhanced and differentiated care in Psychiatric Hospital Červený Dvůr” supported by Norway grants 2009-2014. Information on the focus of the upcoming programme period of the EEA grants in the area of health are available here.