Work experiences among attendees of day centres for people with psychiatric disabilities

Work experiences, resources, and beliefs among vulnerable subgroups of mental health care users

BACKGROUND:

People with mental illness may have difficulties related to work and employment, especially if they experience additional difficult life situations.

OBJECTIVE:

To explore how subgroups with mental illness and additional adversities perceived their situation with respect to work and employment prospects.

METHODS:

Three subgroups were included, exposed to an additional difficult life situation: i) psychosis interrupting their career development at young age (n = 46), ii) having a history of substance use disorder (SUD) (= 57) or iii) having recently immigrated (n = 39). They responded to questionnaires addressing sociodemographics, work-related factors, everyday activity, and well-being. A professional assessed their level of functioning and symptom severity.

RESULTS:

The young people with psychosis had a low education level, little work experience, the poorest worker role resources, and a low level of functioning, but a high quality of life. The SUD group had the fewest work experiences, were the least satisfied with work experiences, and had the lowest activity level, but had the least severe psychiatric symptoms. The immigrant group had severe psychiatric symptoms, but high ratings on work experiences, work resources, and activity level.

CONCLUSIONS:

Each group presented unique assets and limitations pertaining to work and employment, suggesting that they also needed unique support measures.

Well-being and perceptions of everyday activities among those who attend community-based day centres for people with mental illness in Sweden - Does an immigrant background make a difference?

BACKGROUND

Community-based day centres (CBDCs) for people with mental illness are a common service for both people with an immigrant background and native Swedes.

AIM

The aim was to compare CBDC attendees with an immigrant background with attendees who were native Swedes in terms of well-being and perceptions of everyday activities and investigate whether ethnic background could predict these factors.

METHODS

Attendees at nine CBDCs were invited to participate. In all, 56 with an immigrant background and 69 native Swedes completed self-report questionnaires that addressed various aspects of well-being and everyday activities.

RESULTS

Attendees with an immigrant background had a worse situation regarding perceived self-esteem, empowerment and satisfaction with everyday activities. In multivariate logistic regression analyses, ethnic background only became a significant predictor in regard to empowerment. Quality of life and activity level were of importance for satisfaction with everyday activities. Empowerment and self-esteem mutually influenced each other.

CONCLUSION

Having a mental illness and an immigrant background may infer a particular risk for low empowerment. The mental health services and society at large should consider measures for adjusting the support to this group, including an analysis of how environments and contexts may act as barriers to activity enrichment and culturally congruent support.

Gendering of day center occupations as perceived by people with psychiatric disabilities in Sweden

BACKGROUND

The aim was to explore the experiences and views of people attending day centers for people with psychiatric disabilities concerning the occurrence and nature of gendering of the occupations performed there.

METHODS

Twenty-five day center attendees were interviewed regarding occupational choices at the day centers, whether they would describe day center occupations as gendered, and if so what the consequences were of the gendering of occupations. The transcribed texts were analyzed by thematic analysis.

RESULTS

Three main themes were identified: Thinking and doing gender; Understandings of gendering of day center occupations; and Consequences of gendered occupation. The participants were more open-minded in their reasoning than in what they were doing. They understood gendering to be a result of traditions, role models from childhood, ideas about typically male and female innate capacities, lack of knowledge and low self-confidence. Doing seemed to reproduce gender, but being in a group of the same sex could shape unity and a relaxed atmosphere.

CONCLUSIONS

The findings could be understood as a set of gender frames, which might prevent either of the sexes from developing their full potentials and transgress into e.g. the employment market. Gendering should be highlighted and debated in psychosocial rehabilitation.

How do Swedish day center attendees with psychiatric disabilities view their worker role? A structural equation modeling study

AIM

To investigate how day center attendees with psychiatric disabilities perceived their worker role and the importance of current work situation and personal factors in that respect.

METHODS

Two-hundred attendees completed the Worker Role Self-assessment and questionnaires addressing possible predictors of the worker role: current employment situation, satisfaction with that situation, and a personal factor (encompassing self-esteem, self-mastery and engagement). Structural equation modeling was used.

RESULTS

A model indicated two worker role factors; belief in a future worker role (WR1) and current capacities and routines (WR2). WR1 was positively influenced by having a job, younger age and the personal factor. Satisfaction with current work situation (usually unemployment) was negatively associated with WR1. The personal factor was single predictor of WR2. The attendees rated WR2 more positively than WR1.

CONCLUSIONS

The personal factor was crucial for both WR1 and WR2. Work-related factors were only important for WR1. The more negative rating of belief in a future worker role may be interpreted as mistrust in the services. The attendees' positive ratings of capacities indicate, however, that they had a rehabilitation potential to develop. Enhancing self-esteem, mastery and engagement may be an avenue for staff in efforts to support the attendee's worker role.

Staff ratings of occupational engagement among people with severe mental illness - psychometric properties of a screening tool in the day center context

Background

Staff who plan and organize day center activities may need to observe the attendees’ performance and progression. This led us to develop a tool for that purpose, termed General Occupational Engagement in people with Severe mental illness (GOES). The aim was to investigate its psychometric properties in terms of factor structure, internal consistency, corrected item-total correlations (CITC), convergent and discriminant validity, and test-retest stability.

Methods

Ninety-three day center attendees were assessed by the GOES and instruments addressing constructs hypothesized to be either similar to (activity level, motivation for day center attendance, perceptions of the worker role, hours spent in the day center) or divergent from the GOES (attendees’ ratings of engagement in specified occupations, self-rated health, psychosocial functioning, psychiatric symptoms). A second sample of 41 attendees were included for the test-retest analysis. Exploratory factor analysis, Cronbach’s alpha analysis, Pearson correlations and paired-samples t-tests were performed.

Results

Exploratory factor analysis indicated one factor, which was in line with the intentions of the scale. The alpha value was 0.85 and all CITC were above 0.30. The tests for convergent validity resulted in correlations ranging between 0.23 and 0.47, most of which were moderately strong and mainly confirmed the hypotheses. Discriminant validity was clearly indicated, since all correlations with the selected constructs were <0.20. GOES also showed preliminary test-retest stability (r = 0.32).

Conclusions

The GOES is ready for use in rehabilitation services and research where productive and other types of activities are of interest. It may serve as an important supplement to attendees’ self-reported occupational engagement.