Transition to independent accommodation for adults with schizophrenia

Les visions du rétablissement dans des services résidentiels en santé mentale d’une région québécoise

Objectif À la suite d’une réorganisation dans le secteur de l’hébergement en santé mentale dans une région québécoise, cette étude descriptive a évalué l’intégration des principes de rétablissement selon des utilisateurs de services (n = 25), des responsables de milieux d’hébergement (n=19) et des professionnels de la santé et de services sociaux (n = 30).

Méthode La version française du Recovery Self-Assessment a été remplie par tous. Les utilisateurs de services ont également rempli l’Échelle de satisfaction envers les domaines de la vie. Des questions qualitatives supplémentaires écrites ont été posées.

Résultats La plupart des utilisateurs de services étaient globalement satisfaits de leur résidence actuelle, mais ont noté que les options d’intervention et aborder les besoins sexuels pourraient être améliorés. Les intervenants considèrent qu’il y a une intégration significativement plus faible des différentes dimensions du rétablissement que les deux autres groupes (p < 0,001). Les trois groupes ont indiqué que les utilisateurs de services devraient être davantage impliqués dans la planification des services en résidence.

Conclusion L’intégration des points de vue a mis en lumière le besoin de travailler de façon collaborative pour soutenir le processus de rétablissement dans les milieux d’hébergement et impliquer davantage les personnes utilisatrices de services.

Resident and proprietor perspectives on a recovery orientation in community-based housing

OBJECTIVE

Stable housing is a fundamental human right, and an important element for both mental health recovery and social inclusion among people with serious mental illness. This article reports findings from a study on the recovery orientation of structured congregate community housing services using the Recovery Self-Assessment Questionnaire (RSA) adapted for housing (O'Connell, Tondora, Croog, Evans, & Davidson, 2005).

METHODS

The RSA questionnaires were administered to 118 residents and housing providers from 112 congregate housing units located in Montreal, Canada.

RESULTS

Residents rated their homes as significantly less recovery-oriented than did proprietors, which is contrary to previous studies of clinical services or Assertive Community Treatment where RSA scores for service users were significantly higher than service provider scores. Findings for both groups suggest the need for improvement on 5 of 6 RSA factors. While proprietors favored recovery training and education, and valued resident opinion and experience, vestiges of a traditional medical model governing this housing emerged in other findings, as in agreement between the 2 groups that residents have little choice in case management, or in the belief among proprietors that residents are unable to manage their symptoms.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

This study demonstrates that the RSA adapted for housing is a useful tool for creating recovery profiles of housing services. The findings provide practical guidance on how to promote a recovery orientation in structured community housing, as well as a novel approach for reaching a common understanding of what this entails among stakeholders. (PsycINFO Database Record

Narratives reflecting the lived experiences of people with brain disorders: common psychosocial difficulties and determinants

BACKGROUND

People with brain disorders - defined as both, mental disorders and neurological disorders experience a wide range of psychosocial difficulties (PSDs) (e.g., concentrating, maintaining energy levels, and maintaining relationships). Research evidence is required to show that these PSDs are common across brain disorders.

OBJECTIVES

To explore and gain deeper understanding of the experiences of people with seven brain disorders (alcohol dependency, depression, epilepsy, multiple sclerosis, Parkinson's disease, schizophrenia, stroke). It examines the common PSDs and their influencing factors.

METHODS

Seventy seven qualitative studies identified in a systematic literature review and qualitative data derived from six focus groups are used to generate first-person narratives representing seven brain disorders. A theory-driven thematic analysis of these narratives identifies the PSDs and their influencing factors for comparison between the seven disorders.

RESULTS

First-person narratives illustrate realities for people with brain disorders facilitating a deeper understanding of their every-day life experiences. Thematic analysis serves to highlight the commonalities, both of PSDs, such as loneliness, anger, uncertainty about the future and problems with work activities, and their determinants, such as work opportunities, trusting relationships and access to self-help groups.

CONCLUSIONS

The strength of the methodology and the narratives is that they provide the opportunity for the reader to empathise with people with brain disorders and facilitate deeper levels of understanding of the complexity of the relationship of PSDs, determinants and facilitators. The latter reflect positive aspects of the lives of people with brain disorders. The result that many PSDs and their influencing factors are common to people with different brain disorders opens up the door to the possibility of using cross-cutting interventions involving different sectors. This strengthens the message that 'a great deal can be done' to improve the lived experience of persons with brain disorders when medical interventions are exhausted.