1
|
Bahl NKH, Nafstad HE, Blakar RM, Øversveen E, Brodahl M, Ness O, Prilleltensky I. How older adults recovering from substance use problems experience mattering. BMC Health Serv Res 2023; 23:1453. [PMID: 38129831 PMCID: PMC10740266 DOI: 10.1186/s12913-023-10413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
AIM Mattering (to feel valued and add value to self and others) is a fundamental human experience and mechanism in recovery. In this paper, we concern ourselves with the recovery of older adults with substance problems. This population is on the rise in many Western countries. To offer mattering enhancing programs for this group, more knowledge about later life mattering in service-assisted recovery processes is needed. This study aims to explore experiences of mattering in older adults receiving services to recover from substance use problems. METHODS A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services. Participants were recovering from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian social contexts: two urban and one medium size municipality. The age of the sample ranged from 65-80 years, with approximately equal numbers for those aged 60-69 (12 participants) and 70-80 (11 participants). Seven participants were women and 16 men. RESULTS Three main themes were identified in the analysis: "relational experiences of mattering and not mattering", "service-related experiences of mattering and not mattering" and "recovery and psychological sense of community as interrelated phenomena to experiences of mattering". The findings illustrate various nuanced experiences of mattering and not mattering in later life recovery processes. CONCLUSIONS Overall, the participants' mattering experiences rested on fair, healthy and positive community relationships and fair and attentive services, where participants could feel valued and also have a chance to add value to others. Experiences of not mattering were precipitated by lack of support, disrespect, devaluation and loss of relationships, and also by being ignored and not receiving fair treatment and help by professionals. Importantly, reciprocal and enhancing relations between mattering, recovery and relational PSOC seem to exist and to be significant for the older adults' access to substance use services. Several practical implications are suggested to promote the therapeutic and preventive potentials of later life mattering in recovery.
Collapse
Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs hospital, Trondheim University Hospital, Klostergata 48, 7030, Trondheim, Norway.
| | - Hilde Eileen Nafstad
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Rolv Mikkel Blakar
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Emil Øversveen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit On Concurrent Substance Abuse and Mental Health Disorders, Mental Health Division, Innlandet Hospital Trust, Divisjon Psykisk Helsevern, 2381, Brumunddal, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Isaac Prilleltensky
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
2
|
Bahl NKH, Øversveen E, Brodahl M, Nafstad HE, Blakar RM, Landheim AS, Tømmervik K. Multiple psychological senses of community and community influences on personal recovery processes from substance use problems in later life: a collaborative and deductive reflexive thematic analysis. Int J Qual Stud Health Well-being 2023; 18:2190200. [PMID: 36924073 PMCID: PMC10026775 DOI: 10.1080/17482631.2023.2190200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
PURPOSE There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes. METHOD A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems. RESULTS The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities). CONCLUSIONS The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery.
Collapse
Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Emil Øversveen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Mental Health Division, Innlandet Hospital Trust, Brumunddal, Norway
| | | | | | - Anne Signe Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Innlandet University of Applied Sciences, Faculty of Social and Health Sciences, Section for Mental Health and Rehabilitation, Campus Elverum, Norway
| | - Kristin Tømmervik
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
3
|
Kerr-Little A, Bramness JG, Newberry RC, Biong S. Exploring dog ownership in the lives of people with substance use disorder: a qualitative study. Addict Sci Clin Pract 2023; 18:57. [PMID: 37759274 PMCID: PMC10523709 DOI: 10.1186/s13722-023-00411-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Recovery from substance use is commonly seen as a process of integrating social relationships and creating a sense of meaning in one's life. Dog owners describe a close relationship with their dog that impacts many aspects of their everyday life. Yet for individuals with substance use disorder (SUD), little is known about how dog ownership could affect their lives. The aim of this study was to explore how people living with SUD experience and describe their everyday life when owning a dog. METHOD Eight semi-structured in-depth individual interviews were conducted with people having personal experience of living with SUD and owning a dog. Data were gathered and analysed using qualitative content analysis. RESULTS The analysis yielded four categories, reflecting different aspects of dog ownership. Living with SUD and owning a dog was primarily something positive in their life. People increased their social connections personally and within society. They felt a belonging which gave a sense of agency and purpose, and they developed structure in their day and boundaries to their environment. Dog ownership, however, could hinder access to services which was found to be challenging for some participants. CONCLUSIONS The owning of a dog can lead to changes that parallel those of a recovery process. This finding adds to the research on the connection that dogs can provide and shows how pertinent this can be particularly for vulnerable persons such as those with SUD.
Collapse
Affiliation(s)
- Andi Kerr-Little
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway.
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway.
| | - Jørgen G Bramness
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Dept of Alcohol Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Ruth C Newberry
- Department of Animal & Aquacultural Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Norway
| | - Stian Biong
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
| |
Collapse
|
4
|
De Salis HF, Martin R, Mansoor Z, Newton-Howes G, Bell E. A realist review of residential treatment for adults with substance use disorder. Drug Alcohol Rev 2023; 42:827-842. [PMID: 36747370 DOI: 10.1111/dar.13615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 02/08/2023]
Abstract
ISSUES Completion of residential treatment for substance use disorder (SUD) relates to improvements in substance use and mental health. Findings from systematic reviews have been equivocal about which interventions work best for clients. There has been limited attention to the theories that explain the effectiveness of residential treatment. APPROACH We conducted a realist review of the literature to identify program theories that would explain successful and unsuccessful outcomes from residential treatment for SUD. The unit of analysis was context-mechanism-outcome (CMO). Inclusion criteria were studies of residential treatment of more than 30 days for adults with SUD. Pharmacological studies were excluded. KEY FINDINGS We identified 24 studies from 5748 screened. The studies were from settings comprising Indigenous programs, faith-based programs, psycho-social interventions and therapeutic communities and were conducted in North America, Scandinavia, Continental Europe and Australasia. We chose six CMO configurations as the best explanations for outcomes from residential treatment. Theories that best explained the mechanisms of change were the need to belong, meaning in life, and self-determination theory. IMPLICATIONS Previous research has noted similar outcomes from different residential treatment interventions, but has not been able to explain these similarities. In contrast, our findings suggest that the outcomes can be explained by causal mechanisms that apply across all programs, regardless of the philosophy of treatment. CONCLUSION We identified six CMO configurations whose mechanisms of change could be explained by three overarching theories-the need to belong, meaning in life and self-determination theory. The findings apply across ethnicities and genders.
Collapse
Affiliation(s)
- Henry F De Salis
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Rachelle Martin
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.,Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - Zara Mansoor
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.,Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
| |
Collapse
|
5
|
Bahl NKH, Øversveen E, Brodahl M, Nafstad HE, Blakar RM, Ness O, Landheim AS, Tømmervik K. In what ways do emerging adults with substance use problems experience their communities as influencing their personal recovery processes? JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3070-3100. [PMID: 35187694 PMCID: PMC9545888 DOI: 10.1002/jcop.22816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Applying the multiple psychological sense of community concept (MPSOC), this study explored how emerging adults with substance use problems experience the influences of various senses of community and communities on their personal recovery processes. Semi-structured interviews with 21 emerging adults from different urban contexts in Norway were analysed using a collaborative, seven-step, deductive, and reflexive thematic approach. MPSOC is shown to be a key concept for achieving a broad, in-depth understanding of emerging adults' senses of community and personal experiences of community influences on recovery processes from substance use. Positive and negative senses of community in geographical, relational, substance use-related and ideal communities influence the potentials and challenges in emerging adults' recovery processes. Supportive and motivating community relationships, meaningful activities with peers, and distance from recovery-impeding communities were identified as important recovery components. To promote recovery and prevent substance use in emerging adults, community approaches and tools applied in substance use treatment have to take into account and utilise multidimensional and age group-specific aspects of belonging.
Collapse
Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction MedicineSt. Olavs University HospitalTrondheimNorway
| | - Emil Øversveen
- Department of Sociology and Political ScienceNorwegian University of Science and TechnologyTrondheimNorway
| | - Morten Brodahl
- Mental Health Division, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway
| | | | | | - Ottar Ness
- Department of Education and Lifelong LearningNorwegian University of Science and TechnologyTrondheimNorway
| | - Anne S. Landheim
- Mental Health Division, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway
- Campus ElverumInnlandet University of Applied SciencesElverumNorway
| | - Kristin Tømmervik
- Department of Research and Development, Clinic of Substance Use and Addiction MedicineSt. Olavs University HospitalTrondheimNorway
| |
Collapse
|
6
|
Zango-Martín I, Nafai S, El Ouazzani S, Derkaoui J, Stevens-Nafai E, Codern-Bové N. Understanding the role and importance of occupational therapy in mental health services in Morocco: Perspectives from mental health professionals. Work 2022; 72:775-784. [DOI: 10.3233/wor-213644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Across the global landscape, mental health care still exhibits challenges because of the lack of human and professional resources to face its consequences. In Morocco, mental health problems affect mainly adolescents and young adults, with a clear impact on functional engagement in their daily lives. Occupational therapy, as a holistic and person-centered practice, may be an ideal mental health strategy to promote health and well-being through occupation, thereby enabling individuals to participate in regular daily activities. OBJECTIVE: To understand, from an intercultural perspective, the point of view of mental health professionals regarding the role and importance of occupation-based practices in Errazi Mental Health Hospital in Salé(Rabat) Morocco. METHOD: A qualitative research design was used for this study. Data collection consisted of semi-structured interviews with 12 mental health care professionals (non-occupational therapists). These results were used to gain an understanding of their perspectives regarding the main role of human occupation in mental health services in Morocco, and to incorporate an intercultural outlook in terms of occupational therapy. Data analysis was conducted in three phases, by following the grounded theory methodology. RESULTS: Two categories, “dimensions of occupation in Moroccan mental health” and “the interplay between traditional and western perspectives involving mental health” emerged from this research. Both categories included five subcategories. CONCLUSION: This study identifies how occupation-based services in Moroccan mental health care require considering not only the cultural perspective of mental health, and the sociocultural meaning rooted in occupations, but also the relevance of incorporating a community-centered approach. Moreover, it discusses how occupational therapy education in Morocco must incorporate an intercultural perspective of the therapy’s theory and practice.
Collapse
Affiliation(s)
- Inmaculada Zango-Martín
- Occupational Therapy, Escola Universitária d’Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Autonoma Universiy of Barcelona, Terrassa, Spain
| | - Said Nafai
- Occupational Therapy, School of Health Sciences, American International College, Springfield, MA, USA
| | - Sophia El Ouazzani
- Division of Psychiatry and Global Health, University College London, London, UK
| | - Jamal Derkaoui
- Occupational Therapy, Higher Institute of Nursing Sciences and Health Technologies Rabat, Morocco
| | | | - Nuria Codern-Bové
- Occupational Therapy, Escola Universitária d’Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Autonoma Universiy of Barcelona, Terrassa, Spain
| |
Collapse
|
7
|
Ogundipe E, Sælør KT, Biong S. Social recovery and economy: a thematic analysis of staffs’ experiences with promoting social community participation for residents with co-occurring problems. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-11-2021-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore and describe staff working in a Norwegian supportive housing site’s experiences with promoting social community participation for residents with co-occurring problems. The research question addressed was: how does residential support staff experience promoting social community participation for residents with co-occurring problems?
Design/methodology/approach
Nine residential support staff participated in qualitative interviews. All interviews were recorded and transcribed verbatim. The transcripts were analysed using Braun and Clarke's approach to thematic analysis.
Findings
The analysis process resulted in two themes: “It is all about economics” and “Who will pay for it?”
Practical implications
Regarding the Nordic welfare system, the need for a redistribution of financial resources in health services is discussed. The authors recommend that further studies explore people outside the regular health-care system perspectives on how they can contribute to making community inclusion a reality for persons experiencing co-occurring problems.
Originality
This study provides a nuanced understanding of how financial resources can impede or support efforts and opportunities to promote community inclusion for residents experiencing co-occurring problems.
Collapse
|
8
|
Brekke E, Clausen HK, Brodahl M, Lexén A, Keet R, Mulder CL, Landheim AS. Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study. Front Psychol 2021; 12:727013. [PMID: 34566813 PMCID: PMC8457351 DOI: 10.3389/fpsyg.2021.727013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to explore and describe service user experiences of how receiving services from a Flexible Assertive Community Treatment (FACT) team may support or inhibit citizenship. Within a participatory design, individual interviews with 32 service users from five Norwegian FACT teams were analyzed using thematic, cross-sectional analysis. The findings showed that FACT may support citizenship by relating to service users as whole people, facilitating empowerment and involvement, and providing practical and accessible help. Experiences of coercion, limited involvement and authoritarian aspects of the system surrounding FACT had inhibited citizenship for participants in this study.
Collapse
Affiliation(s)
- Eva Brekke
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
| | - Hanne K. Clausen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
- Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
| | - Annika Lexén
- Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
| | - Rene Keet
- Flexible, Innovative Top-ambulatory Academy of Community Mental Health Service, Geestelijke Gezondheidszorg Noord-Holland-Noord, Heerhugowaard, Netherlands
| | - Cornelis L. Mulder
- Department of Psychiatry, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anne S. Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| |
Collapse
|
9
|
Doroud N, Fossey E, Fortune T, Brophy L, Mountford L. A journey of living well: a participatory photovoice study exploring recovery and everyday activities with people experiencing mental illness. J Ment Health 2021; 31:246-254. [PMID: 34269637 DOI: 10.1080/09638237.2021.1952950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIM Engagement in everyday activities has been identified as an important element in personal recovery from the experience of mental illness and a key priority for service-users. This study explored the role of everyday activities in recovery. METHOD This study used a photovoice participatory research. Twenty-one participants experiencing mental illness were recruited from a community-managed mental health service in Melbourne, Australia. Data collection included individual interviews and photovoice courses. The courses included group discussions and required participants to take photographs about their everyday activities that support recovery. A lived experience co-facilitator contributed to development and delivery of the course. The interviews and group discussions were transcribed verbatim and analysed using constant comparative methods. RESULTS Recovery as a "journey of living well" was identified as the central theme that encompasses three interlinked categories: (1) living a life on hold; (2) choosing to recover; and (3) learning and navigating strategies. CONCLUSIONS The findings suggest that recovery involves a range of experiences embedded in people's everyday lives. Recovery-oriented practice should provide opportunities for engagement in meaningful activities, to help consumers identify their potential and strategies to live well, and to adopt co-production at all levels.
Collapse
Affiliation(s)
- Nastaran Doroud
- Occupational Therapy Discipline, Rural Department of Allied Health, La Trobe University, Victoria, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Victoria, Australia.,Living with Disability Research Centre, La Trobe University, Victoria, Australia
| | - Tracy Fortune
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia
| | - Lisa Brophy
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.,Centre for Mental Health, Melbourne School of Population and Global health, The University of Melbourne, Victoria, Australia
| | - Louise Mountford
- Living with Disability Research Centre, La Trobe University, Victoria, Australia.,Possability, Victoria, Australia
| |
Collapse
|
10
|
Veseth M, Svendsen TS, Nesvaag S, Moltu C, Davidson L, Bjornestad J. "And then the rest happened"- A qualitative exploration of the role that meaningful activities play in recovery processes for people with a diagnosis of substance use disorder. Subst Abus 2021; 43:260-266. [PMID: 34214010 DOI: 10.1080/08897077.2021.1941506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: In this qualitative exploration, we report on a thematic analysis of the key role that engaging in meaningful activities may play in recovery processes for people with a diagnosis of substance use disorder (SUD). Methods: We conducted semi-structured, individual interviews with 30 participants and analyzed the parts of this material that were related to meaningful activities. Results: The findings are summarized through the development of three broad themes: (a) the central role of work-"The wages suck, but the job is gold"; (b) mastery and commitment-"I had to get up early, find my spot, I had to be present and fully functioning all day"; and (c) repairing the bridge to community life-"It's my job and working out that has made this possible, really, I see that now." Conclusion: We discuss these findings in relation to a recovery perspective and relevant empirical studies, highlight some important implications for research and practice, and consider the strengths and limitations of the present study.
Collapse
Affiliation(s)
- Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | | | - Sverre Nesvaag
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Larry Davidson
- Program for Recovery and Community Mental Health, Yale University, New Haven, Connecticut, USA
| | - Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
11
|
Nesse L, Aamodt G, Gonzalez MT, Rowe M, Raanaas RK. The role of occupational meaningfulness and citizenship as mediators between occupational status and recovery: a cross-sectional study among residents with co-occurring problems. ADVANCES IN DUAL DIAGNOSIS 2021. [DOI: 10.1108/add-08-2020-0018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Engagement in meaningful occupations and being included as full citizens of the community, is essential in everyday life, and may be of considerable relevance for recovery and quality of life. However, persons with co-occurring substance use and mental health problems experience extensive obstacles to engagement in occupations and citizenship. The relationship between objective measures of occupational status and subjective experiences of occupational meaningfulness, citizenship and recovery, is scarcely researched in the context of co-occurring problems. As such, the purpose of this study is to examine associations between occupational status, occupational meaningfulness, citizenship and recovery and quality of life and to examine the roles of occupational meaningfulness and citizenship as possible mediators between occupational status and recovery and quality of life.
Design/methodology/approach
The study used a cross-sectional design with a sample of 104 residents at supported housing sites across six Norwegian cities.
Findings
Linear regression analyzes indicated that occupational status was significantly associated with the citizenship domains caring for others and community participation and with the quality of life measure positive affect. Occupational meaningfulness and citizenship were significantly associated with different domains of recovery and quality of life. Furthermore, mediation analyzes showed that the relationship between occupational status and recovery and quality of life was mediated by caring for others and community participation.
Originality/value
The results suggest that emphasizing opportunities for occupational meaningfulness and citizenship in practice may have positive implications for recovery among persons with co-occurring problems.
Collapse
|
12
|
Whybird G, Nott Z, Savage E, Korman N, Suetani S, Hielscher E, Vilic G, Tillston S, Patterson S, Chapman J. Promoting quality of life and recovery in adults with mental health issues using exercise and nutrition intervention. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1854023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Zoie Nott
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Emma Savage
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Nicole Korman
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Shuichi Suetani
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Emily Hielscher
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Gabrielle Vilic
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
| | - Stephen Tillston
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
| | - Sue Patterson
- Metro North Mental Health Service, Metro North Health, Brisbane, Queensland
| | - Justin Chapman
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland
| |
Collapse
|
13
|
Tjörnstrand C, Eklund M, Bejerholm U, Argentzell E, Brunt D. A day in the life of people with severe mental illness living in supported housing. BMC Psychiatry 2020; 20:508. [PMID: 33059664 PMCID: PMC7559196 DOI: 10.1186/s12888-020-02896-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/24/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND People with severe mental illness (SMI) living in supported housing (SH) struggle in everyday life and we currently lack a comprehensive body of knowledge concerning how the residents experience their day. This paper aimed to gain knowledge about how people with SMI describe a day in SH in Sweden, in particular the activities they most frequently engage in and how they experience what they do in or outside their home. Furthermore, it is important to gain knowledge of which activities motivate residents to leave the housing facility and to participate in the community. This new knowledge can help staff to encourage a recovery process among the residents. METHODS One hundred thirty-three people living in SH completed a time-use diary and a mixed-methods approach was applied, including calculations of what activity that was most frequently performed and a manifest content analysis addressing experiences of activity. RESULTS The residents had a low activity level and were often alone. Approximately one-half of the reported activities were performed in their own apartments, and generally unaccompanied. A quarter of the activities were performed in the common areas and a further quarter outside the SH. The most frequently performed activities were quiet and tranquil ones, e.g. listening to music and resting. Doing errands and group activities with staff and residents were the main activities that motivated leaving the facility. The participant experience of a day is presented in three categories: "Experiences of chosen and enforced togetherness and overcoming loneliness", "Environmental change and emotional balance can generate activity", and "Met and unmet needs for support, friendship and security". CONCLUSIONS The residents were generally satisfied with their quiet and tranquil lifestyle and appeared to demand little of life, which may relate to previous experiences of institutional life and can constitute a challenge for staff. The findings highlight experiences that can help to improve SH. Services need to support individually adjusted contextual stimuli and individualize the support to help residents find a good balance and motivate them to be active in and outside SH, which can support a recovery process.
Collapse
Affiliation(s)
- Carina Tjörnstrand
- Department of Health Sciences, Occupational Therapy and Occupational Science, Lund University, Box 157, SE 221 00, Lund, Sweden.
| | - Mona Eklund
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Occupational Therapy and Occupational Science, Lund University, Box 157, SE 221 00 Lund, Sweden
| | - Ulrika Bejerholm
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Occupational Therapy and Occupational Science, Lund University, Box 157, SE 221 00 Lund, Sweden
| | - Elisabeth Argentzell
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Occupational Therapy and Occupational Science, Lund University, Box 157, SE 221 00 Lund, Sweden
| | - David Brunt
- grid.8148.50000 0001 2174 3522Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW Assertive Community Treatment is an established evidenced based practice that provides intensive community treatment for individuals with severe mental illness with recurrent hospitalizations and/or homelessness. Emerging evidence indicates limitations in its implementation in terms of to the original ACT model and its current relevance. RECENT FINDINGS Findings from recent studies (2018-2020) reveals challenges with implementation centered around basic implementation activities, such as changes in the psychosocial context of individuals with SMI, clinicians' abilities to demonstrate competencies with new practices, and ongoing evolution of mental health systems of care worldwide. Intermediary and purveyor organizations (IPO) can provide the infrastructure to support the spread of EBPs while addressing challenges and opportunities. Thus, implementation of ACT can be accomplished when employing a rigorous framework and infrastructure that can synthesize and translate science relevant for practice. SUMMARY The relevance of ACT depends on its implementation that is responsive to change. An implementation science-informed approach is key to providing ACT to individuals in the critical space between the hospital and community. With this approach, we can optimize ACT as a service delivery vehicle by careful analysis of how best to furnish and evaluate the latest, most effective and efficient treatments, rehabilitation and support services.
Collapse
|
15
|
Responsibilization and recovery: shifting responsibilities on the journey through mental health care to social engagement. SOCIAL THEORY & HEALTH 2019. [DOI: 10.1057/s41285-019-00097-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|