Background People with psychiatric disability have been found to have a poorer quality of life ( QOL ) compared to the general population, and QOL is an important outcome from psychosocial rehabilitation. Aims This study aimed at comparing users of two approaches to psychosocial rehabilitation in Sweden, community‐based mental health day centres ( DC s) and clubhouses, regarding QOL . A further aim was to investigate predictors of QOL . Methods People regularly attending DC s (n = 128) or clubhouses (n = 57) completed questionnaires at baseline and a 9‐month follow‐up about socio‐demographics, QOL , self‐esteem, social network, satisfaction with daily occupations, satisfaction with services and the unit's organisation. Results Quality of life remained stable over time in both groups. QOL at follow‐up was associated with baseline self‐esteem, social network, satisfaction with daily occupations and QOL at baseline. The strongest indicator of a higher QOL at follow‐up was attending a clubhouse programme followed by having scored high on QOL at baseline. Conclusion Both approaches were suited for supporting their users in maintaining QOL . Visiting clubhouses seems, however, advantageous for QOL in a longer‐term perspective. Although this study contributed some new knowledge, research should further address which circumstances are associated with maintaining stability in QOL .
There is broad consensus among policymakers about the urgency of developing healthy, inclusive, and socially sustainable cities. In the Swedish context, social services are considered to have knowledge that needs to be integrated into the broader urban development processes in order to accomplish such ends. This article aims to better understand the ways in which social service officials collaborate in urban development processes for developing the social dimensions of healthy cities. We draw from neo-institutional theories, which set out actors (e.g., social service officials) as acting according to <em>a logic of appropriateness</em>, which<em> </em>means that actors do what they see as appropriate for themselves in a specific type of situation. Based on semi-structured interviews with social services officials in 10 Swedish municipalities on their experiences of collaboration in the development of housing and living environments for people with psychiatric disabilities, we identified that they act based on (a) a pragmatic rule of conduct through the role of the problem solver, (b) a bureaucratic rule of conduct through the role of the knowledge provider, and (c) activist rule of conduct through the role of the advocator. In these roles, they have little authority in the development processes, and are unable to set the agenda for the social dimensions of healthy cities but act as the moral consciousness by looking out for everyone’s right to equal living conditions in urban development.
Background/Objectives: The deinstitutionalisation of psychiatry in the Western world is a process characterised by ideological statements and initiatives at the policy level, where attempts to make it possible for people with psychiatric disabilities to fully participate in the society have been emphasised. In the last decades, the extent of outpatient services has increased significantly. Today, there is a focus on implementing evidence-based practice in community mental health. Governmental actors are producing research reviews and guidelines where specific methods are pointed out as successful and important to use, while others are rejected as ineffective. While there is knowledge of the effectiveness of each method, the evidence and guidance concerning the choice of strategies for implementing them, is limited. The focus of this presentation is a national initiative by the Swedish government aimed at implementing Assertive Community Treatment (ACT) in the mental health system. The strategy was to provide a specially designed education for a number of mental health and social service agencies in 12 different geographical areas. The aim of the presentation is to analyse how the choice of steering (policy?) instruments can influence the implementation process and the outcomes in terms of impact and program fidelity.
Abstract The deinstitutionalization of mental health care has changed the responsibilities of involved authorities and has led to a continuous need for new treatment forms and interventions. This article describes this development in Europe, and in particular how these new conditions have been handled in Sweden over the past 20 years at the level of governmental policy‐making. Three major policy documents from 1994, 2009 and 2012 were included in this study. To increase our understanding of the policies' contents, we have used theoretical concepts concerning governance, implementation and political risk management. Although our main interest was to find out how the government handles interventions for users of the mental health care system, we found that the policy work is progressing stepwise. The first document, from the deinstitutionalization era, did not discuss interventions clearly. Instead, it was mainly concerned with both practical and economical areas of responsibility. The second document, from the post‐deinstitutionalization era, was more focused on what services should be delivered to the users, while the most recently published document to a greater extent addressed the question of how the support is supposed to be designed. The trend in European community mental health policy has been to advocate services in open forms that are integrated into the society's other care systems. This is also the case in Sweden, and continuous work is being done by the government to find strategies to support the development, and to meet the needs at both political and local levels.
Purpose Rural communities face specific challenges when attempting to implement evidence-based interventions, due to their size, distance from knowledge centers, and broad responsibility for the local population. The aim of this study was to investigate the utilization of an RPC (Research Practice Collaboration) initiative as a strategy for translation and implementation of EBPs in rural municipalities seeking to develop their services for individuals with serious mental illness.
Syftet med kartlaggningen har varit att identifiera vilka strategier kommuner och landsting har nar personer med psykiska funktionshinder sviktar i sitt boende eller behover sarskilt stod vid aterg ...
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