RESUMEN
The object of this paper was to investigate the experiences of patients with severe mental illness (SMI) living in a community, including their utilization of care and treatment services. Psychiatric care and social services staff members were asked to make an inventory of those they served in two districts of Malmö, Sweden. Participants had to be over 18 years of age and unable to manage their daily lives without help from others. Almost all of the 80 participants (95 %) were under psychiatric care. A majority (86 %) was receiving dental treatment, and 61 % were supported by social services. Fifty-four percent of the participants received somatic care on an ongoing basis. Although the majority reported the care given as sufficient, one-third of this SMI population considered the care and support they received to be insufficient. Satisfying those who are dissatisfied with the care they are being given would be a significant challenge for service providers, since the unsatisfied are shown to have more difficult lives.
Asunto(s)
Actitud Frente a la Salud , Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Atención Odontológica/estadística & datos numéricos , Femenino , Humanos , Masculino , Trastornos Mentales/tratamiento farmacológico , Persona de Mediana Edad , Psiquiatría , Calidad de Vida , Apoyo Social , Encuestas y Cuestionarios , Suecia , Adulto JovenRESUMEN
BACKGROUND: Across several research studies comparing the individual placement and support (IPS) approach to traditional vocational services, the approach has achieved employment outcomes superior to comparison conditions. However, to understand the efficacy of IPS, it is equally important to consider what is more or less effective as viewed by the IPS participants. AIM: To investigate participants' experiences of IPS participation and their experiences of receiving support from an employment specialist (ES). METHOD: Interviews were conducted with 17 persons with severe mental illness. The interviews were subjected to qualitative content analysis. The principles of informed consent and the voluntary nature of participation were included as ethical considerations. RESULTS: Participation in IPS was associated with hope, meaning and an individualized support provided by the ES. The skills of the ES facilitated the relationship with the participant and the contact with the labour market. However, to make a change happen, everybody involved in IPS had to contribute. CONCLUSION: These findings have endorsed the guiding principles of IPS and emphasized the ES's role and skills during IPS as well as the participant's motivation.
Asunto(s)
Trastornos Mentales/terapia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Suecia , Adulto JovenRESUMEN
BACKGROUND: Research has identified stigmatization as a major threat to successful treatment of individuals with mental illness. As a consequence several anti-stigma campaigns have been carried out. The results have been discouraging and the field suffers from lack of evidence about interventions that work. There are few reports on psychometric data for instruments used to assess stigma, which thus complicates research efforts. The aim of the present study was to investigate test-retest reliability of the Swedish versions of the questionnaires: FABI and "Changing Minds" and to examine the internal consistency of the two instruments. METHOD: Two instruments, fear and behavioural intentions (FABI) and "Changing Minds", used in earlier studies on public attitudes towards persons with mental illness were translated into Swedish and completed by 51 nursing students on two occasions, with an interval of three weeks. Test-retest reliability was calculated by using weighted kappa coefficient and internal consistency using the Cronbach's alpha coefficient. RESULTS: Both instruments attain at best moderate test-retest reliability. For the Changing Minds questionnaire almost one fifth (17.9%) of the items present poor test-retest reliability and the alpha coefficient for the subscales ranges between 0.19 - 0.46. All of the items in the FABI reach a fair or a moderate agreement between the test and retest, and the questionnaire displays a high internal consistency, alpha 0.80. CONCLUSIONS: There is a need for development of psychometrically tested instruments within this field of research.
Asunto(s)
Actitud Frente a la Salud , Trastornos Mentales/epidemiología , Inventario de Personalidad/estadística & datos numéricos , Opinión Pública , Encuestas y Cuestionarios , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Enfermos Mentales/psicología , Prejuicio , Psicometría , Reproducibilidad de los Resultados , Autoinforme , Índice de Severidad de la Enfermedad , Estereotipo , Estudiantes de Enfermería/psicología , Suecia/epidemiología , TraducciónRESUMEN
Lifestyle changes that affect physical and psychological health are described in research literature; however, the meaning of participating in a lifestyle intervention programme together with the staff has not been described. This study illuminates meanings of participating in a lifestyle programme as experienced by persons with psychiatric disabilities. The first author interviewed five women and six men with schizophrenia and depressive syndrome, aged 26-53, participating in a lifestyle programme. The transcribed interviews were analysed using a phenomenological hermeneutic approach inspired by the philosophy of Ricoeur. Meanings of participating in a lifestyle programme include my health can be improved as both the physical effects and the obstacles are considered and the daily life is partially given a changed content in new experiences and by participating in something to take pride in. The meanings of participating together with the staff mean an increased sense of closeness and equality with the staff expressed in changes in relationships and the difference between the two groups being revealed and also in becoming aware of the life situation, an insight into the loss of a healthy life but also hope for the future is expressed. The conclusions that could be drawn from this study are that a lifestyle intervention affects health and other important life areas such as the content of daily life and the relationship with the carers, which appears to affect the sense of hope and the ability to see new possibilities. Carers should find situations and activities where the residents and carers participate under equal conditions giving the residents the opportunity to leave the sick roll, experience equality and develop good relationships.
Asunto(s)
Estilo de Vida , Trastornos Mentales/fisiopatología , Adulto , Concienciación , Femenino , Humanos , Masculino , Trastornos Mentales/psicología , Persona de Mediana EdadRESUMEN
BACKGROUND: This cross-sectional study is aimed at describing and investigating empowerment and its relationships with level of engagement in daily activities and community life, experienced stigma, psychopathology, and quality of life among people with mental illness entering supported employment. METHOD: The following scales were administered to 120 persons: Empowerment Scale, Profiles of Occupational Engagement Scale, Manchester Short Assessment of Quality of Life Scale, Rejection Experience Scale and Brief Psychiatric and Rating Scale. RESULTS: Higher scores of empowerment were associated with fewer symptoms and experienced stigma, a higher level of engagement in daily activities and community life, better quality of life and having work rehabilitation. Self-efficacy and self-esteem were in particular significantly correlated to depressive symptoms. Descriptive statistics enveloped the group of participants that said 'Yes I want to work' with a somewhat high mean score for empowerment, level of engagement and quality of life, but a low mean score with regard to both symptoms and experienced stigma. CONCLUSIONS: This study advocates the importance of evaluating empowerment in supported employment research and practice. The findings suggest the importance of taking into account not only monetary aspects of having a job but also social and psychological aspects such as empowerment, reduction in experienced stigma and community integration.
Asunto(s)
Empleos Subvencionados/psicología , Investigación , Autoeficacia , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estereotipo , Suecia , Adulto JovenRESUMEN
AIMS AND OBJECTIVES: The aim of this study was to investigate how a lifestyle intervention programme influences psychiatric and psychosocial factors among persons with psychiatric disabilities. BACKGROUND: Persons with psychiatric disabilities often suffer from a simultaneous physical health problem, where circulatory disorder, hyperlipideamia, digestive disease, diabetes mellitus and obesity are prevalent. Studies have also shown a relationship between physical activity and mental health. But few randomised controlled trails have been aimed specifically at lifestyle interventions and their effect on psychiatric health and quality of life among persons with psychiatric disabilities. DESIGN: A cluster randomised controlled trail. METHODS: Forty-one persons with a DSM-IV diagnosis in eight supported housing facilities and two housing support programmes and their carers were on cluster level randomly assigned to a 12-month health intervention programme in the form of study circles with diet sessions and physical activities or a control programme. The changes in the mean of quality of life, level of functioning, psychiatric symptoms and sense of coherence was investigated and its relationship to physical health and attendance. RESULTS: A significant increase in the sense of coherence was seen in both programmes but also significant improvements in the intervention group compared to controls at the follow-up. CONCLUSIONS: Structured activities in the form of lifestyle intervention programmes with a sufficient level of challenge that encourage persons with psychiatric disabilities to participate in activities in a social context may contribute to a significant increase in the sense of coherence. RELEVANCE TO CLINICAL PRACTICE: Improving physical health with lifestyle programmes in the form of study circles and when involving their cares will in addition to increased physical health end in improved sense of coherence.
Asunto(s)
Estilo de Vida , Trastornos Mentales/psicología , Calidad de Vida , Adulto , Análisis por Conglomerados , Femenino , Humanos , Masculino , Trastornos Mentales/fisiopatología , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
The aim of the study was to examine the changes in attitudes towards mental illness after theoretical education and clinical placement among students from university programmes preparing for different kinds of health professions. Three different questionnaires were used, measuring the level of familiarity with mental illness and attitudes towards mental illness in general and towards specific mental illnesses. The data were collected on two occasions, before the theoretical course and after the completed clinical placement. The result showed that the attitudes toward mental illness in general had changed in a less stigmatising direction after the clinical placement. On the other hand, attitudes toward specific mental illnesses did not show any major changes. A conclusion is that the clinical placement included in the university programmes to some extent could affect attitudes in a de-stigmatizing direction, possibly because of the interaction with persons suffering from mental illness and experienced supervisors.
Asunto(s)
Actitud del Personal de Salud , Trastornos Mentales/terapia , Preceptoría/estadística & datos numéricos , Estudiantes del Área de la Salud/estadística & datos numéricos , Adulto , Distribución por Edad , Escolaridad , Femenino , Estudios de Seguimiento , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Prejuicio , Distribución por Sexo , Factores Socioeconómicos , Suecia , Adulto JovenRESUMEN
BACKGROUND: Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. METHODS: Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. RESULTS: At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. CONCLUSIONS: Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions.
Asunto(s)
Servicios Comunitarios de Salud Mental/normas , Eficiencia Organizacional , Necesidades y Demandas de Servicios de Salud , Adulto , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
The objective was to explore the impact on physical health of a lifestyle programme among persons with psychiatric disabilities, and their caregivers. Their satisfaction with the intervention was also assessed. Somatic comorbidity and an increased mortality related to the lifestyle among persons with psychiatric disabilities are well known. Few randomized controlled trials have been aimed specifically at lifestyle issues among persons with a psychiatric disability. This trial includes clients with psychiatric disabilities living in supported housing and their staff. Forty-one persons with a DSM-?V diagnosis of severe mental illness from psychiatric disability from 10 supported housing facilities and 41 of their caregivers participated in this 12-month study during 2005-2006 in Sweden. The supported housing facilities with residents and staff were randomly assigned to either a health intervention programme or a control programme with an aesthetic content. The presence of metabolic syndrome and changes in the mean of physiological parameters such as Hba1c, P-glucose, P-insulin, lipids, blood pressure, physical working capacity, body mass index, Heart Score were investigated and participants' satisfaction assessed. There was a significant reduction in the mean of metabolic syndrome criteria in the intervention group compared with the control group at the follow-up. The participants expressed satisfaction with the programme. The results indicate that health interventions on lifestyle issues when involving carers are appreciated, feasible and could be successful in reducing some health-related risk factors among persons with psychiatric disabilities.
Asunto(s)
Estado de Salud , Estilo de Vida , Trastornos Mentales/rehabilitación , Síndrome Metabólico/rehabilitación , Grupo de Atención al Paciente , Trastorno Autístico/sangre , Trastorno Autístico/rehabilitación , Trastorno Bipolar/sangre , Trastorno Bipolar/rehabilitación , Glucemia/metabolismo , Presión Sanguínea , Índice de Masa Corporal , HDL-Colesterol/sangre , Prueba de Esfuerzo , Hemoglobina Glucada/metabolismo , Hogares para Grupos , Educación en Salud , Humanos , Trastornos Mentales/sangre , Trastornos Mentales/psicología , Síndrome Metabólico/sangre , Satisfacción del Paciente , Trastornos de la Personalidad/sangre , Trastornos de la Personalidad/rehabilitación , Trastornos Psicóticos/sangre , Trastornos Psicóticos/rehabilitación , Factores de Riesgo , Esquizofrenia/sangre , Esquizofrenia/rehabilitación , Suecia , Triglicéridos/sangre , Relación Cintura-CaderaRESUMEN
Stigma and discrimination have been identified as important obstacles to the integration of people with mental illness in society. In efforts to reduce stigma and discrimination, health professionals play an important role as they have frequent contact with and responsibility for treatment and rehabilitation of consumers. The aim of the present study was to investigate attitudes towards mental illness and people with mental illness among nursing staff working in psychiatric or somatic care. The sample consisted of 120 registered or assistant nurses who were interviewed about intimacy with mental illness and attitudes about seven different mental illnesses. The results showed that nursing staff in somatic care, to a higher degree than nursing staff in mental health, reported more negative attitudes with regard to people with schizophrenia as being more dangerous and unpredictable. In contrast, professional experience, intimacy with mental illness and type of care organization were found to be more associated with attitudes to specific mental illnesses concerning the prospect of improvement with treatment and the prospect of recovery. In conclusion, attitudes among nursing staff are in several respects comparable with public opinions about mental illness and mentally ill persons. In order to elucidate if negative attitudes about dangerousness and unpredictability of persons with specific mental illnesses are associated with realistic experiences or with prejudices further studies with a qualitative design are suggested.
Asunto(s)
Actitud del Personal de Salud , Hospitales Psiquiátricos , Trastornos Mentales , Relaciones Enfermero-Paciente , Personal de Enfermería en Hospital/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Enfermería Psiquiátrica , Trastornos Psicofisiológicos/enfermería , SueciaRESUMEN
BACKGROUND: Studies investigating the importance of social network, empowerment and experiences of stigma on subjective quality of life among persons with mental illness are rare. AIM: This study aimed to investigate beliefs of devaluation/discrimination, actual rejection experiences, empowerment, social network and the relationship of these factors to subjective quality of life among subjects with mental illness. METHODS: A cross-sectional study assessing beliefs of devaluation/discrimination, actual rejection experiences, empowerment, social network and subjective quality of life was performed on 150 subjects with mental illness. RESULTS: The factors most prominently related to subjective quality of life were overall empowerment and overall social network. For a subgroup of subjects suffering from psychotic disorders there was a significant negative relationship between subjective quality of life and rejection experiences. This group also reported more frequent rejection experiences. CONCLUSION: The findings indicate that persons with mental illness are a heterogeneous group with regard to the influence of social network, stigma and empowerment on subjective quality of life. The negative impact of actual rejection experiences might express that, in order to increase subjective quality of life, stigma must be addressed as a separate and important factor in its own right.
Asunto(s)
Poder Psicológico , Prejuicio , Calidad de Vida , Apoyo Social , Estereotipo , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , SueciaRESUMEN
Stigma has been identified as one of the most important obstacles for a successful integration of people with mental illness into the society. Research about stigma has shown negative attitudes among the public towards people with mental illness. Studies so far have, however, put little emphasis on how these negative attitudes are perceived by the mentally ill persons. The aim of the present study was to investigate acceptability and internal consistency of the Swedish versions of two stigma scales, the Devaluation and Discrimination scale and the Rejection experiences scale. Forty individuals were subject to an interview, which also comprised assessments of needs for care, quality of life, therapeutic relationship and empowerment. The results showed that both the Devaluation and Discrimination scale and the Rejection experiences scale had a good internal consistency and acceptability. Stigma in terms of perceived devaluation and discrimination was found to be most markedly associated with empowerment and rejection experiences was found to be most associated with the number of previous psychiatric admissions. It is concluded that the Swedish versions of the Devaluation and Discrimination scale and the Rejection experiences scale may well be used in further studies of stigma among people with mental illness.
Asunto(s)
Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Estereotipo , Actitud Frente a la Salud , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Evaluación de Necesidades , Inventario de Personalidad/estadística & datos numéricos , Prejuicio , Psicometría , Opinión Pública , Rechazo en Psicología , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Suecia/epidemiologíaRESUMEN
BACKGROUND: As a part of a set of reforms launched in 1995, 10 pilot case management services were established in Sweden, which have been subject to an evaluation with regard to outcome and changes in use of services. The present study was designed to provide information about client outcomes over a 6-year follow-up period. AIMS: The aim of the study was to investigate changes during the follow-up period with regard to symptoms, needs for care, psychosocial functioning, quality of life and social network. METHODS: The study used a time series design with 6-year follow-up of client outcomes. RESULTS: Of the original 176 clients, 92 clients participated in the 6-year follow-up. Improvements were found in a number of clinical aspects, quality of life and social network, and a decrease in use of psychiatric services during the follow-up period. CONCLUSIONS: The findings support results from earlier studies showing a decrease in use of psychiatric services and sustained improvements in social functioning. The study also supports the findings that client outcomes change over time and that certain outcomes do not appear in a short-term perspective.
Asunto(s)
Manejo de Caso , Trastornos Psicóticos/rehabilitación , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Adulto , Anciano , Servicios Comunitarios de Salud Mental , Femenino , Estudios de Seguimiento , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Satisfacción del Paciente , Proyectos Piloto , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Calidad de Vida/psicología , Esquizofrenia/diagnóstico , Ajuste Social , Apoyo Social , SueciaRESUMEN
BACKGROUND: A major goal in mental health research and policy is to identify ways to reduce stigma among persons with mental illness. AIMS: The aims of the present study were to (1) investigate the prevalence of rejection and devaluation/discrimination in a cross-sectional sample of 200 individuals with experiences of mental illness and (2) investigate the relationship between sociodemographic and clinical, client characteristics and perceived devaluation/discrimination and experiences of rejection. METHODS: A total of 200 subjects in current contact with mental health services or with earlier experiences of this were interviewed regarding beliefs about devaluation/discrimination and rejection experiences. RESULTS: The results showed that subjects with a higher degree of global functioning perceived less devaluation/discrimination. With regard to rejections experiences associations were found between rejection experiences and global functioning, number of admissions to inpatient psychiatric care and current contact with social services. CONCLUSION: Further research should investigate the causal relationship between stigma experiences and psychosocial functioning. To understand what consequences perceived devaluation/discrimination has for the afflicted, a psychological and social approach in the research must be taken into consideration.
Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Prejuicio , Rechazo en Psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Estudios Transversales , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To investigate the cross-sectional relationship between subjective quality of life and sociodemographic clinical and social factors over three points of assessment during a 6-year follow-up, and to investigate longitudinal predictors of subjective quality of life. METHOD: We investigated a sample of people with severe mental illness (n = 92), mainly with a psychosis diagnosis, at baseline and at an 18-month and 6-year follow-up. Measures included the Lancashire quality of life profile, Manchester short assessment of quality of life, Symptom Check List 90, Camberwell Assessment of Needs and the Interview Schedule for Social Interaction. RESULTS: Cross-sectionally subjective quality of life was associated to self-reported symptoms, social network and unmet needs. However, these determinants varied in importance between points of assessment. Longitudinal predictors of subjective quality of life were changes in self-reported symptoms and social network. CONCLUSION: There was a rather consistent set of determinants of subjective quality of life over time. Social network seems to be an important factor with relevance for improvements in subjective quality of life, however largely overlooked in earlier studies within the field.
Asunto(s)
Indicadores de Salud , Trastornos Psicóticos/psicología , Calidad de Vida , Apoyo Social , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , SueciaRESUMEN
The Manchester Short Assessment of Quality of Life (MANSA) is a short interview, which has received a recent interest in research investigating quality of life in people with mental illness. In the present study, the Swedish version of MANSA is examined with regard to reliability, in terms of internal consistency and construct validity. Ninety-two persons with severe mental illness were interviewed regarding quality of life, social network, psychosocial functioning, psychiatric symptoms, needs for care, empowerment and experiences of stigma. Internal consistency was adequate (alpha = 0.81). Positive correlations were found between MANSA and social network, empowerment and psychosocial functioning, and negative correlations with psychopathology, number of needs for care, perceived devaluation and discrimination, and rejection experiences. Social network, psychosocial functioning and beliefs of devaluation and discrimination altogether explained 67% of the variance in quality of life. The Swedish version of MANSA showed a satisfactory reliability in terms of internal consistency. The construct of validity of the scale was satisfactory insofar as associations with validation measures were of considerable magnitude and in expected directions.
Asunto(s)
Trastornos Mentales/psicología , Calidad de Vida/psicología , Encuestas y Cuestionarios , Adulto , Anciano , Cultura , Femenino , Estudios de Seguimiento , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Psicología , Rechazo en Psicología , Reproducibilidad de los Resultados , Apoyo Social , EstereotipoRESUMEN
Empowerment has become a widespread concept in various social policy contexts referring to different marginalized groups. Empowerment has also been focused within the mental health field although little empirical research exists. The aim of the present study was to investigate internal consistency and construct validity of the Swedish version of an empowerment scale developed for people with a mental illness, Making Decisions. Ninety-two persons were subject to an interview also comprising assessments of quality of life, needs for care, psychiatric symptoms, psychosocial functioning, aspects of the social network, rejection experiences and attitudes of devaluation/discrimination towards people with mental illness. The results showed that the overall scale and the subscales had a good internal consistency, except for the subscale power-powerlessness. A factor analysis revealed two superordinate factors, self-esteem and activism and community and power, with a satisfactory internal consistency. These two factors showed a good construct validity with expected associations to validation measures. Stigma was most markedly associated with self-esteem and activism, and a higher level of education was most strongly associated with community and power. In conclusion, the Swedish version Making Decisions may well be used in further studies of empowerment among people with a mental illness.
Asunto(s)
Trastornos Mentales/psicología , Poder Psicológico , Estudios de Seguimiento , Humanos , Entrevistas como Asunto , Encuestas y Cuestionarios , SueciaRESUMEN
BACKGROUND: The outcome of less intensive case management services, such as the strengths model, is still inconclusive, which suggests a need for more controlled studies. The aim of the present study was to investigate the outcome of a strengths model of case management service (SCM) compared to standard care. METHODS: Seventy-seven clients with a mental illness and a serious impairment in functioning in social contacts, housing or work situation were randomly allocated to SCM or standard care. Outcome was assessed with regard to use of psychiatric services, changes in symptomatology, psychosocial functioning, social network, needs for care, quality of life and client satisfaction with care. The follow-up period was 36 months. RESULTS: The results showed a greater reduction in needs for care in clients receiving SCM. No differences in clinical or social outcome were shown. Clients receiving SCM also used significantly less days in psychiatric inpatient services and were generally more satisfied with the psychiatric services offered. CONCLUSIONS: SCM failed to improve clinical and social outcome compared to standard care, but was more successful in reducing days spent in hospital, and the clients were also more satisfied with the service compared to standard care.