Ensio: the early access service in mental health and substance abuse problems

Case Study Submitted by: Yvonne Marjamaa, , Nurse manager, RN
Country: Finland

The Ensio early access service is a walk-in clinic which provides mental health and substance abuse services for people over the age of 18. The Ensio team will assess the clients’ current situation and if required, refers them for further care and support. The care model is based on a solution-focused, family- and network-centred approach. The staff are all psychiatric nurses and a psychiatrist and a social worker are available for consultation. The services are provided through individual appointments, family meetings, and group therapy, which all include also counselling and medical treatment. There is also a telephone counselling service available during office hours.

Historically, mental health and substance abuse services in the City of Tampere were delivered by separate organisations and the service system appeared unclear from the patients’ point of view. There were no walk­ in, early access services for people with mental health problems, which resulted previously, especially the patients with dual diagnosis, help­seeking primarily from the local Emergency Department.

The Ensio care model changed this paradigm. Ensio enables patients to seek immediate help without the need of a referral. The comprehensive model of both mental health and substance abuse disorders also allows for walk-ins. This ensures that the patients with co-existing mental health and substance abuse problems receive comprehensive professional care in which the mental health and substance abuse problems are addressed at the same time. The patient’s family situation is also taken into account and family/network meetings are arranged when necessary. The most suitable provider for further care is agreed immediately.

Today the Ensio service provides services for roughly 1,800 patients, with approximately 5,500 visits per year. In 2016, a Lean assessment was performed on the efficacy of the Ensio walk-in service to improve the process. According to the report, 66% of patients were first-time patients, with over 70 of 166 patients coming in without a referral. Patient feedback has praised the staff’s expertise and their respectful attitude towards patients

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