Search results for ‘Subject term:"severe mental health problems"’ Sort:
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Outcomes of the Active in My Home (AiMH) intervention for people with psychiatric disabilities in supported housing: a longitudinal pilot and feasibility study
- Authors:
- EKLUND Mona, et al
- Journal article citation:
- British Journal of Occupational Therapy, 83(1), 2020, p.6–14.
- Publisher:
- Sage
Introduction: Facilitating occupational engagement in residents with psychiatric disabilities living in supported housing is important, because meaningful occupation is closely related to wellbeing. The aim was to explore whether residents taking part in the intervention Active in My Home (AiMH) made any changes in activity and recovery from baseline to completed AiMH; whether satisfaction with AiMH was related to any changes; and if changes between baseline and completed AiMH were stable at follow-up. Method: AiMH consists of eight sessions for residents and includes workshops for staff. This no-control study involved seven supported housing units and 29 residents who took part in data collection at the start and completion of AiMH and at follow-up after 6–9 months. Outcomes concerned occupational engagement, the unit’s provision of meaningful activity, personal recovery, psychosocial functioning and symptom severity. Findings: Improvements occurred in the AiMH participants’ occupational engagement (Z = −2.63, p = 0.008) and personal recovery (Z = −1.98, p = 0.048) from start to completion of AiMH. The improvement on occupational engagement was stable at follow-up (Z = −3.01, p = 0.005), when also psychosocial functioning (Z = −2.39, p = 0.017) and psychiatric symptoms (Z = −2.42, p = 0.016) had improved. Conclusion: This study could not show whether the improvements were due to AiMH or other factors. The findings are still promising, however, and encourage further development and testing of AiMH. (Publisher abstract)
Premorbid adjustment and personality in people with schizophrenia
- Authors:
- MALMBERG A., et al
- Journal article citation:
- British Journal of Psychiatry, 172, April 1998, pp.308-313.
- Publisher:
- Cambridge University Press
Discusses how schizoid personality and poor social adjustment have been thought of as common antecedents of schizophrenia but the existing literature is inconclusive. Describes a cohort study of the premorbid personality and adjustment of Swedish men who were assessed on entry into the army. Individuals who developed schizophrenia or another psychosis after 15-year follow up were identified. Concludes that some aspects of premorbid personality and adjustment may act as risk factors for schizophrenia. The results appear to be most consistent with a multi-factorial aetiology for schizophrenia and offer tentative support for psychological disturbance mediating genetic and environmental effects on the causal pathway to the illness.
Mental health professional experiences of the flexible assertive community treatment model: a grounded theory study
- Authors:
- LEXEN Annika, SVENSSON Bengt
- Journal article citation:
- Journal of Mental Health, 25(4), 2016, pp.379-384.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Despite the lack of evidence for effectiveness of the Flexible Assertive Community Treatment (Flexible ACT), the model is considered feasible and is well received by mental health professionals. No current studies have adequately examined mental health professional experiences of working with Flexible ACT. Aims: The aim of this study was to explore mental health professional experiences of working with the Flexible ACT model compared with standard care. Method: The study was guided by grounded theory and based on the interviews with 19 theoretically chosen mental health professionals in Swedish urban areas primarily working with consumers with psychosis, who had worked with the Flexible ACT model for at least 6 months. Results: The analysis resulted in the core category: “Flexible ACT and the shared caseload create a common action space” and three main categories: (1) “Flexible ACT fills the need for a systematic approach to crisis intervention”; (2) “Flexible ACT has advantages in the psychosocial working environment”; and (3) “Flexible ACT increases the quality of care”. Conclusions: Mental health professionals may benefit from working with the Flexible ACT model through decreased job-strain and stress, increased feeling of being in control over their work situation, and experiences of providing higher quality of care. (Publisher abstract)
Hazardous alcohol use in general psychiatric outpatients
- Authors:
- EBERHARD Sophia, NORDSTROM Goran, OJEHAGEN Agneta
- Journal article citation:
- Journal of Mental Health, 24(3), 2015, pp.162-167.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Hazardous alcohol use in psychiatric patients may increase the risk of the development of a substance use disorder and negatively affect the course of the psychiatric disorder. Aims: To investigate the prevalence of hazardous alcohol and drug use in a Swedish psychiatric outpatient population with particular focus on hazardous alcohol consumption and assess relationships of hazardous alcohol use to sex, age and psychiatric diagnosis. Methods: General psychiatric outpatients, n = 1,679, completed a self-rating Alcohol Use Disorders Identification Test (AUDIT). Results: Hazardous or harmful alcohol habits occurred among 22% of all women and 30% of all men with higher prevalence among younger patients. Nine percent of all women and 22 % of all men reported binge drinking. Binge drinking was more frequent in younger subjects. Women with a personality disorder diagnosis had a higher frequency of at risk drinking. Apart from that, psychiatric diagnosis was unrelated to rate of hazardous drinking. Conclusions: Hazardous alcohol use was common in this psychiatric outpatient population. With regard to possible risks related to drinking in psychiatric patients, alcohol habits should be assessed as a part of good clinical practice. (Publisher abstract)
How men and women in recovery give meaning to severe mental illness
- Author:
- SCHON Ulla-Karin
- Journal article citation:
- Journal of Mental Health, 18(5), October 2009, pp.433-440.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
An important factor in the recovery from mental health problems is not necessarily the cure or absence of symptoms, but involves a sense of mastery over the illness. It requires the creation of new meaning out of the illness experience. This paper investigated such recovery meaning with reference to severe mental illness, and how this new meaning facilitates recovery. Thirty men and women were interviewed regarding meaning-making with respect to mental illness. Findings indicated that, throughout the process of making-meaning, the perceived reason for the illness emerged as the core category. Four response patterns were found when analysing the material, and three of the four groups restructured the meaning of their illness more favourably. The author concluded that the results highlight the need for further research into recovery achievements connected to meaning-making, and changes in attitudes towards mental health problems. However, one further area that needs to be researched is meaning-making in which gender is considered in relation to the individual's situation.
Oral health problems and support as experienced by people with severe mental illness living in community-based subsidised housing - a qualitative study
- Authors:
- PERSSON Karin, OLIN Elisabeth, ÖSTMAN Margareta
- Journal article citation:
- Health and Social Care in the Community, 18(5), September 2010, pp.529-536.
- Publisher:
- Wiley
This study investigated how people with severe mental illness (SMI) experience oral health problems, especially dry mouth. Oral health problems were found to be associated with apathy and indifference, cognitive deficits, and long-term medication with psycho-pharmacological drugs. The study sought effective ways of mitigating dry mouth through increased support with oral health problems. Sixty seven informal interviews with ten participants in two community-based urban housing projects were conducted between November 2006 and June 2007, with a follow-up session in December 2007. Analysis yielded five categories: the shame of having poor dental health; history of dental care; experiences of self-care; handling of oral health problems; and experiences of staff support. Findings showed that poor oral health caused shame and limited participation in social activities. Participants avoided oral health issues such as denial of a tooth ache or dental infections. Support was frequently resisted because of previous unsatisfactory encounters with dental professionals. The authors suggest that self-care needs to be facilitated in an unobtrusive manner with minimal staff involvement, and clients should be referred to dental care providers experienced in treating people with SMI.
Content validity, clinical utility, sensitivity to change and discriminant ability of Swedish satisfaction with daily occupations (SDO) Instrument: a screening tool for people with mental disorders
- Authors:
- MONA Eklund, GUNNARSSON Birgitta A.
- Journal article citation:
- British Journal of Occupational Therapy, 71(11), November 2008, pp.487-495.
- Publisher:
- Sage
A screening tool for assessing satisfaction with daily occupations among people with mental illness has been devised - the Swedish version of the Satisfaction with Daily Occupations (SDO) instrument - comprising a satisfaction scale and an activity level scale. The aim was to investigate the SDO for content validity, clinical utility, sensitivity to change and discriminant ability. Nine occupational therapists evaluated the content validity of the SDO. Sensitivity to change was assessed on a sample of 36 clients in psychosocial occupational therapy. Discriminant ability was evaluated by comparing four samples: (1) 103 clients with a diagnosis of severe mental illness, (2) 55 clients attending an outpatient mental health clinic, (3) 36 women with a diagnosis of systemic sclerosis and (4) 40 healthy women. The SDO rendered positive ratings regarding content validity, but some rewording of items was indicated as well as clearer instructions. Both the satisfaction scale and the activity level scale were found to be responsive to change. Discriminant ability was shown in that, in particular, the activity level score distinguished the mentally ill participants from the other samples. The SDO was shown to reflect the targeted phenomenon satisfactorily and to be sensitive enough to detect change following an occupational therapy intervention. However, so far only the Swedish version of the SDO has been studied, but an English version is available whose cross-cultural validity should be examined.
Tenants suffering from severe mental illness: a Swedish empirical study
- Authors:
- BENGTSSON-TOPS A., HANSSON Lars
- Journal article citation:
- Community Mental Health Journal, 50(1), 2014, pp.111-119.
- Publisher:
- Springer
The aim of this Swedish study was to describe landlords’ experiences of having tenants suffering from severe mental illness. Sixteen landlords working in private and public housing agencies participated in open in-depth interviews. Data were subjected to a thematic latent content analysis. The results showed that having tenants with severe mental illness entails being confronted with various difficult circumstances, ranging from mismanagement of apartments to sensitivity among neighbours as well as issues regarding provocative behaviour. It involved providing assistance that was far beyond their professional obligations and to be neglected by the community-based psychiatric service system when in need of help. In order to support landlords and to prevent evictions of individuals with severe mental illness, community-based psychiatric services need to be more pro-active in their attempts to achieve collaboration with the parties at hand. (Publisher abstract)
Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders
- Authors:
- WAHLBECK Kristian, et al
- Journal article citation:
- British Journal of Psychiatry, 199(6), December 2011, pp.453-458.
- Publisher:
- Cambridge University Press
People with mental disorders show excess mortality due to natural and unnatural deaths. The gap in life expectancy between psychiatric patients and the population at large is seen as a proxy indicator of the effectiveness of social policy and health service provision. This study evaluated the achievements of Nordic mental health care reforms by looking at the life expectancy of people with serious mental disorders in Denmark, Finland and Sweden. Nationwide 5-year consecutive cohorts of people admitted to hospital for mental disorders between 1987–2006 were examined. The risk population was identified from hospital discharge registers and mortality data were retrieved from cause-of-death registers. The main outcome measure was life expectancy at age 15 years. People admitted to hospital for a mental disorder had a 2-3 fold higher mortality than the general population in all three countries; the gap in life expectancy was more pronounced for men than for women. Overall the gap decreased during the study period, especially for women, but a notable exception was Swedish men with mental disorders. In spite of the positive general trend, men with mental disorders still live 20 years less, and women 15 years less, than the general population. The authors believe that their results support further development of the Nordic welfare state model, i.e. tax-funded community-based public services and social protection.
A mismatch of paradigms disrupts the introduction of psycho-educative interventions for families of persons with SMI: an interview study with staff from community services
- Authors:
- PERSSON Karin, et al
- Journal article citation:
- Community Mental Health Journal, 55(4), 2019, pp.663-671.
- Publisher:
- Springer
Treatment and support of people diagnosed with severe mental illness in Sweden takes place in out-patient psychiatric services or municipality services. Most of the responsibility for support in daily life are provided by the close family. One crucial matter is how to support these families. This research project aimed to investigate the Swedish construction with shared responsibility between county psychiatric care and municipality social care for consumers with severe mental illness affects actions in municipalities in relation to family support. Ten representatives from five municipality settings were interviewed. Five semi-structured interviews were analysed using a thematic analysis. The following themes emerged; One overarching theme, “a mismatch of paradigms”, and sub-themes: (a) “accentuating differences”, (b) “doubts about including the entire family in the same session” and (c) “lack of a uniform family support policy”. The study concludes that a shared mandate needs a dialogue between psychiatric and municipality services concerning this mismatch. (Edited publisher abstract)