The most common misconception about people with bipolar disorder is that they are able to cope with its effects much better than they actually do, says Monica Gilbert from St Vincent's Hospital, Melbourne.
"People think they're well once medicated because they don't see their deterioration, which is why they are often quickly discharged from hospital and treated by a GP," Gilbert says.
Accessing treatment
Bipolar disorder, characterised by a spectrum of mood episodes from mania to depression, occurs in at least 1% of the general population, with some estimates closer to 5%.
Until two years ago, Medicare offered very few mental healthcare items, meaning the majority of patients were unable to access adequate treatment.
"Many with bipolar disorder are unemployed and face financial difficulties," says Gilbert. "They can't afford to go to a private psychologist or service to get treatment."
Psychosocial intervention
With the support of the Bupa Health Foundation in Australia, therapists at St Vincent's have developed a psychosocial intervention involving 12 weekly group therapy sessions that emphasise the importance of maintaining support networks.
"It's a self-management program that teaches people to understand what they may be vulnerable to and the impact this has on the illness," says Gilbert. "We help them see early warning signs of relapse and develop an action plan.
"If they lose sleep, leading to mania or depression, they can ask someone to help them reduce their workload and hopefully that extra communication will assist them in staying well," she adds by way of example.
Under control
Twelve months following the treatment program, 120 trial patients were revisited to see if their conditions had been improved.
"We found we were able to reduce relapses and prevent all manic episodes, which are often the most destructive in terms of financial burden and loss of relationships," says Gilbert.
In order to replicate the study in a natural environment, the hospital has trained 17 private and public health service providers to implement the intervention program by referral in South Australia and Victoria.
"If you have it under control you can get back to your life and hopefully avoid secondary effects like divorce, which is huge among people with bipolar disorder, and suicide," says Gilbert.
What next?
Researchers are working to make the program more affordable and accessible to all Australians with bipolar disorder through a wide range of Medicare health services. "It will improve their quality of life and give them the ability to maintain relationships, resist admission to hospital and reduce the overall impact of the disorder on their lives," Gilbert says.
Website: http://www.svhm.org.au/research
