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Group-apartments for recovery of people with psychosis in Italy: democratic therapeutic communities in post-modern social communities
- Authors:
- BRUSCHETTA Simone, BARONE Raffaele
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 37(4), 2016, pp.213-226.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present a model of democratic therapeutic community (DTC) for people with a diagnosis of schizophrenia and psychotic disorder, namely the Group-Apartment (GA). The authors will describe it in more detail, discussing the ideas which lie behind it, considering the relative cost of treating people in larger residential DTCs and in GAs, outlining findings from the first data gathered on a GA and looking at the usefulness of this model in post-modern societies, with particular reference to Sicily. Design/methodology/approach: In brief a GA is a flat, located in an urban apartment building, inhabited by a small group of people. In this paper the authors consider an apartment inhabited by a group of three or four patients with the presence of clinical social workers who work in shifts for several hours a day on all or most days of the week (Barone et al., 2009, 2010). GA is also inspired by the pioneering work of Pullen (1999, 2003), in the UK tradition of the apartment post TC for psychosis. Findings: GAs in Italy have become one of the main methods of support housing in recovery-oriented treatment, because it allows the empowerment of the users and fights against the stigma of mental illness (Barone et al., 2014; Bruschetta et al., 2014). The main therapeutic activities provided in the GA depend on the type of recovery route being supported, on the level of autonomy being developed and on the level of participation in the democratic life of the local community. Originality/value: GAs appear better, cheaper and a more appropriate treatment for mental problems in the current financial and social climate than larger institutions. Where they have been tried out, they have been found to be effective, by users and by stakeholders. They exemplify the advantages of the DTC for encouraging recovery, but cost less to run. In accordance with DTC principles, the social democratic process is used not only to evaluate the clinical effectiveness of GAs, but also to build a network to support the development of innovative mental health services and new enabling environments (Haigh et al., 2012). (Publisher abstract)
The Recovery House in Trieste: rational, participants, intervention as the “work”
- Authors:
- CASADIO Roberta, et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 39(4), 2018, pp.149-161.
- Publisher:
- Emerald
Purpose: Too often people with complex mental health needs do not find their way out of the mental health system or find satisfactory solutions that enable them to live a full life. In 2015 the Mental Health Department (MHD) of Trieste established the Recovery House pilot project to address this concern. The paper aims to Investigate the project. Design/methodology/approach: The Recovery House was co-created with and for people between 18 and 35 years old with diagnoses of psychosis and other complex mental health conditions. An integral part of the pilot was the organization of the “Recovery Community,” inspired by the Assembly model embraced by Franco Basaglia. The Recovery Community met regularly to both support and learn from the Recovery House and aimed to create a democratic and reflective space where power relationships, self-determination, responsibility and ownership by all the stakeholders, including family members, could be explored together. Findings: Over a period of 31 months, four groups of people have successfully completed their residency at the Recovery House. In total, 89 percent of people who stayed at the Recovery House did so up to six months. After the period of staying at the Recovery House most of them moved to independent living or shared supported accommodation. Originality/value: This initiative sheds light on the fact that democratic values, approaches and structures can improve both service functioning and the recovery outcomes for people with complex health needs. Further, the Recovery House has had a significant effect on the culture and practice of the MHD in adopting a comprehensive approach to emotional distress. (Edited publisher abstract)