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Case management for people with psychiatric disabilities in rural Sweden: experiences from the implementation of a national policy
- Authors:
- MARKSTRÖM Urban, LINDQVIST Rafael, SANDKLUND Mikael
- Journal article citation:
- European Journal of Social Work, 12(4), December 2009, pp.495-508.
- Publisher:
- Taylor and Francis
This study aimed to analyse the implementation of a case manager-model in rural Sweden. A sample of 15 case management teams was selected; written materials were collected and interviews on location were carried out. Findings were that rural case managers design their work methods themselves, which entail several deviations from the national policy guidelines in this field. The case management boards have a low capacity to direct and manage the activities of the case managers. Consequently, case managers develop into 'welfare entrepreneurs'. One salient risk is that teams become isolated from the welfare system. The Swedish version of case management in rural areas is a result of local processes of adaptation and negotiation that result in services that differ from those envisaged in national policy guidelines.
Staff experience and understanding of working with abused women suffering from mental illness
- Authors:
- BENGTSSON-TOPS A., SAVEMAN B.-I., TOPS D.
- Journal article citation:
- Health and Social Care in the Community, 17(5), September 2009, pp.459-465.
- Publisher:
- Wiley
Thematic interviews were conducted with 13 staff members from various welfare services in Sweden. Data were subject to content analysis. The findings showed that working with abused women was experienced as ambiguous and painful and made the staff act pragmatically. Feelings of ambiguity were mainly related to the lack of theoretical frameworks for interpreting why women with mental illness are exposed to abuse. Painful experiences involved intertwined feelings of distress, frustration, worthlessness, ambivalence and powerlessness. These were all feelings that emerged in the direct encounters with the abused women. In response to the abused women's comprehensive needs, staff members acted pragmatically, implying networking without any sanction from the leaders of the organisation, compliance with routines and taking action in here-and-now situations. By acting pragmatically, staff members could achieve concrete results through their interventions. It is concluded that staff members, working with abused women with mental illness, are in a vulnerable situation and in need of formally accepted and implemented support and legitimacy as well as theoretical knowledge regarding causes and consequences of abuse in this particular group of women.