Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing (original) (raw)
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Interprofessional Collaboration in the Mental Health Services in Norway
Nursing Research and Practice, 2014
The aim of this study was to describe and interpret interprofessional collaboration between healthcare professionals (HCPs) working at the district psychiatric centre (DPC) and employed in community mental health care (CMHC) using a dialogueoriented co-operative approach. Data were collected by means of multistage focus groups and qualitative content analysis was performed. The main theme "development of interprofessional collaboration by means of organisational strategies and interactional styles" encompassed the following categories: "improved communication skills, " "developing structures for coordination and responsibility" and " increased professional insight into the values and conditions necessary for decision-making. " In conclusion, more attention should be paid to leadership in terms of coordination and feedback. The HCPs must be acknowledged, understood and strengthened in their work to improve the quality of CMHC. Finally, we recommend that a range of organisational and administrative models of care be used in order to support improvement work.
International journal of mental health nursing, 2017
There is a need for various types of interventions when meeting needs of clients with psychiatric disabilities and complementary interventions may also influence their well-being. The Culture and Health project, based on complementary interventions with 270 clients, was created in a county in Sweden for clients with psychiatric disabilities and for professionals to carry out the interventions. The aim of this study was to investigate the professionals' expectations regarding the project and their clients' possibilities for participating, and to investigate the professionals' experiences of the project after its completion. Focus group data with a total of 30 professionals participating were collected. A qualitative content analysis revealed four categories of the professionals' expectations before entering the project: "Clients' own possibilities and limitations for their development and independence", "Professionals' possibilities for supporti...
Scandinavian Journal of Caring Sciences, 2010
Left alone-Swedish nurses' and mental health workers' experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study The professional role of nurses and mental health workers in social psychiatry is being redefined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general.
Improvement work in mental healthcare: an example from Region Jönköping County, Sweden
BJPsych International, 2020
Region Jönköping County (RJC) in Sweden is a healthcare system that is characterised by sustainable work with quality in healthcare and long-term system-wide improvement. This article describes important factors behind the improvement work in RJC, and how the improvement methods and initiatives have been adopted also in mental healthcare. For example, patients otherwise eligible for admission to a psychiatric department were treated at home after introduction of home treatment teams. Patient satisfaction was high and the number of visits to the emergency department, hospital admissions and hospital stay decreased.
Journal of Hospital Administration, 2014
The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pres...
Residents’ Perceptions of Quality in Supported Housing for People with Psychiatric Disabilities
Issues in Mental Health Nursing, 2019
The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. Onehundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.
Journal of Multidisciplinary Healthcare
Background: The work of staff in supported housing facilities for people with psychiatric disabilities has most often been studied from the perspective of one of the two groups but not from both. The staff in these facilities generally come from differing professions, reflecting either the beliefs of the medical or social models of psychiatric care. Aim: The aim of the present study was thus to investigate the perceptions of residents and staff of the frequency and the importance of verbal and social interactions in supported housing facilities for people with psychiatric disabilities and to compare these perceptions. A further aim was to investigate whether differences in education background and other sociodemographic factors are reflected in the staff perceptions of these interactions. Methods: One hundred and eleven residents living in supported housing facilities in Sweden and 223 staff completed the Verbal and Social Interaction Supported Housing questionnaire. Results: The results revealed significant differences between the perceptions of the residents and staff on all six categories of interactions, where the staff rated the frequency and importance higher than the residents, but also some similarities in terms of the relative order of the frequency of the categories of interactions. Both the residents and staff perceived that "To build a relationship with a supportive quality" as the most frequently occurring and most important category. The mean levels of importance for all the categories were higher than for the frequency according to both groups. No differences were found between the staff with a medical or social educational background. Similarly, no differences were found in staff perceptions between those with short experience and those with long experience. Conclusion: This study is the first survey of its kind and the results indicate the need for reducing the gap between the staff intentions and the residents' preferences, which could form the basis for in-house training activities.
Health Professionals' Experiences of Person-Centered Collaboration In Mental Health Care
Patient preference and adherence, 2008
ObjectiveThe basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.MethodThe study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semi-structured in-depth interview to judge validity.ResultsOur results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.ConclusionTaking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.
Perceptions of health professionals on social inclusion in a Psychosocial Care Center
Revista da Rede de Enfermagem do Nordeste, 2019
Objective: to understand the perceptions of the technical team about social inclusion in the Psychosocial Care Center. Methods: qualitative research, developed with 20 health professionals. A semi-structured interview technique and non-participant observation were used. Data analyzed through the descending hierarchical classification and content thematic analysis, processed in the Analyse Lexicale par Contexte d'un Ensemble de Segments de Texte software. Results: three categories emerged: Social inclusion, family participation in inclusion/ exclusion and income generation; Therapeutic activities: inclusion inside and outside the Psychosocial Care Center; and Challenges of inclusion: service management and professional training. Conclusion: prejudice or discrimination in this field, coupled with the difficulties of support of the management with service and stiffening of the work process with centrality in the psychiatric consultation, jeopardize attempts at rehabilitation and social inclusion of users and families. Descriptors: Social Support; Mental Health Services; Psychiatric Nursing; Mental Health. Objetivo: compreender as percepções de equipe técnica sobre inclusão social em um Centro de Atenção Psicossocial. Métodos: pesquisa qualitativa, desenvolvida com 20 profissionais de saúde. Utilizaram-se a técnica de entrevista semiestruturada e a observação não participante. Dados analisados por meio da classificação hierárquica descendente e análise temática de conteúdo, processados no software Analyse Lexicale par Contexte d'un Ensemble de Segments de Texte. Resultados: emergiram-se três categorias: Inclusão social: participação familiar na inclusão/exclusão e a geração de renda; Atividades terapêuticas: inclusão "dentro e fora" do Centro de Atenção Psicossocial; e Desafios da inclusão: gestão do serviço e capacitação profissional. Conclusão: o preconceito ou a discriminação neste campo, aliado às dificuldades de apoio da gestão com serviço e "engessamento" do processo de trabalho com centralidade na consulta psiquiátrica, prejudica as tentativas de reabilitação e inclusão social de usuários e famílias.
Cross-sector problems of collaboration in psychiatry
Danish medical journal, 2013
INTRODUCTION Some mental health service users need support from both hospital-based and community-based services. Treatment requires well-functioning collaboration practices between different mental health organizations and professions. However, serious cross-sector problems of collaboration have existed in Danish psychiatry since the 1980s when mental health service provisions were split into two psychiatric systems. MATERIAL AND METHODS We report from two qualitative studies: STUDY#1 (n = 24) consisted of twenty-four individual, qualitative interviews with the staff and management of a psychiatric emergency unit, a closed psychiatric ward, and a community-based residential facility, respectively. STUDY#2 (n = 22) consisted of four individual interviews with service users and mental health staff, and three focus group interviews each including six staff members from both hospital- and community-based services. RESULTS Staff and management experiencing cross-sector problems of colla...