People with mental disabilities negotiating life in the risk society: a theoretical approach

A qualitative study of occupational well-being for people with severe mental illness

BACKGROUND/AIM

People with severe mental illness (SMI) do not receive adequate attention in research or clinical practice. They are considered hard to reach and difficult to engage. Information is needed to help provide support for this vulnerable population. This paper aims to investigate the well-being of adults diagnosed with SMI and receiving Assertive Community Treatment (ACT) by applying the occupational well-being framework to the everyday activities of this vulnerable group of people.

MATERIALS AND METHODS

Eleven adults diagnosed with an SMI, living in the community, participated in semi-structured interviews over a 12-month period. A longitudinal design was used to collect data through using field notes and audio recordings. For this paper, secondary analysis was conducted by coding the data deductively thereby investigating the participants' experiences in relation to the seven Occupational Well-being framework descriptors (accomplishment, affirmation, agency, coherence, companionship, pleasure and renewal).

RESULTS

Participants' everyday activities and occupational well-being appeared severely restricted and largely determined by the type of care they received. There was minimal evidence of the well-being descriptors, though all the participants reported experiencing some form of pleasure, even though some of the pleasurable experiences negatively impacted their health.

CONCLUSION/SIGNIFICANCE

The episodic nature of SMI means that people living with an SMI require continuity in key relationships and support to achieve Occupational Well-being. Occupational therapists working with mental health consumers need to facilitate the types of activities that foster well-being through accomplishment, affirmation, agency and companionship, and that derive pleasure in healthy and positive ways.

To live as mentally disabled in the risk society

The contemporary society is to some extent characterized by longitudinal changes, towards individualization, uncertainty, and risk. Numerous risks and dangers in modern society have been mastered, while others have emerged, often created by human actions. The individual's freedom of choice has increased, but also the responsibility for the choices made. In this society, the risk society, there is a greater need for formative and situation-related knowledge to manage risks. The aims of this paper are to discuss the concept of risk society in the light of everyday experiences made by people with mental disabilities, how challenges can be mastered and positive possibilities can be utilized. Data collection was made through a multistage focus group, and the data were analysed by qualitative content analysis. The results show that characteristics of the risk society are identified by people with mental disabilities. Change and uncertainty, obstacles created by societal institutions, lack of trust, and the need of adapted working conditions are frequently experienced, impersonal relations and feelings of loneliness as well. However, these conditions can be partly counteracted by belonging to an alternative fellowship, which might lead to quality of life-related personal improvements.