Vocational Rehabilitation Center, AIR,

Sahlgrenska University Hospital

Birgitta Magnusson, OTAnette Jacobson, OT

www.sahlgrenska.se/su/kcs

For a long time assistive devices to compensate for impairments and to facilitate daily life have been available to people with disabilities in general. However, this has not been the case for people with mental disabilities.

In a report from 2003 the Swedish Institute of Assistive Technology (SIAT) concluded that almost no assistive devices were prescribed to people with mental disabilities and that very few assistive devices had been developed specifically for them. SIAT provided funding for developing, among others, the handheld computer Handi, presumably the first assistive device that has been developed particularly for people with mental disabilities.

Work developing the Handi-software has been ongoing since 2002, in cooperation with a engineering company named Handitek AB and users. The ambition was to produce a functional PDA, easy to use in daily living. Prescription of Handi started in 2005, and of Handi with phone and SMS function, in 2008.

In several studies investigating how people with mental disabilities used the handheld computer Handi, it has been shown that most respondents benefited from the handheld computer and carried it with them most of the time. They perceived greater independence, mainly because they felt safer, less anxious, were less dependent on others, could handle their symptoms better, could write their thoughts out, and saved time. It has been more difficult to observe changes in participation, as the respondents perceived this concept in significantly different ways. However, it is clear that all respondents were very satisfied with the handheld computer and appreciated the fact that it could be adapted to meet individual needs. It helped them in daily life, compensated for functional limitations, and facilitated living a normal life.

In 2006 it was stated by the Government that assistive devices was to be an unquestionable right also for people with psychiatric disabilities.

Users expectations:

What do you need from Handi?

• organizational help through a functional calendar• access to self-help tools• relapse prevention• safety

Results show…

Users…• perceived greater independence, • felt safer, • less anxious, • were less dependent on others, • could handle their symptoms better, • could write their thoughts out,• saved time,• felt great satisfaction with having a handheld

computer

Handi is useful in that it:

Compensates for difficulties -Sense of time-Planning and organizing-Take initiative

Provides Self-help tools-Access to strategies and actionplans that provides guidance in difficult situations, for example through:

- Forms for ”early warning signs” to prevent relapse- Notes to handle social situations e.g. lunchbreak or meetings at work

Compensation + self-help tools

MORE EMPOWERED USERS

Conclusion…

Said about Handi…

“ I often get lost and anxious while grocery shopping. Then I find that it’s easier to listen than to read – it demands less concentration. I use the Voice Synthesis for important notes, like my shopping list and instructions on how to get home.”

“I manage time so much better, thanks to Handi. I can even get a bit careless.”

“The notebook function is superior to all the ‘sticky-notes’ is used earlier. They always disappeared.”

“The Calendar function makes it easier to move activities. It doesn’t get messy and unreadable.”

“Handi is like a good friend, that organizes things for me, when I tell it to do so /…/ It never questions my decisions, it doesn’t argue with me, it doesn’t forget and never disappoints me.”

“ Handi doesn’t work as well and can’t help me with decision-making when circumstances demand of me to be flexible.”

Conditions for prescription

• In 2006 it was stated by the Swedish Government that assistive devices was to be an unquestionable right also for people with psychiatric disabilities

– The amount of assistive devices prescribed for people with psychiatric disabilities is still low

– Until this day around 50 patients have gotten the chance to try Handi

• The patient’s community is responsible for the rental cost

• A thorough assessment is needed in order to apply for an assistive device

• A continuous evaluation is made by the person who did the assessments and wrote the application

– A responsibility regulated by law

Finishing thoughts…

• Results confirm that people with mental/psychiatric disabilities are helped by having access to a technical assistive device. It:– works as a help in daily life, – compensates for functional limitations, – facilitates living a normal life

• Continued work and assistance from engineering companies in further developing existing software and in creating new software and products, is requested

• Increased knowledge about technical devices among people working in the Psychiatric field, is needed