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Sweden has a long tradition of providing social care and support to its citizens in their own homes through formal home care, delivered either by home care services or personal assistance. A majority of people given support by formal home care need assistance with personal and intimate care. The focus of this interview study was on exploring care recipients’, care workers’, personal assistants’ and care unit managers’ perceptions and experiences of intimate and personal care in the context of formal home care in Sweden. In total, 57 interviews were conducted with 42 persons. Three themes emerged in the analysis: Personal Hygiene, Personal Sphere, and The Contextual Variability of Intimacy. Interviewees described intimate care as being inseparable from a person’s service needs as a whole. Highlighted was how caring for and washing intimate body parts, intrusion into recipients’ personal spheres, and the need to preserve integrity vary depending on situational, temporal and relational aspects. To safeguard the care recipient’s influence, integrity and dignity in the reception/provision of care work, home care services and personal assistance, it is important to raise awareness of the variation in perceptions of intimate and personal care in education and inhouse training.

Sweden, as a welfare state, has a long tradition of providing formal home care and support to their citizens in their own homes, either through home care services or personal assistance. A large percentage of frail elderly and persons with disability who receive formal home care require personal and intimate care, such as help with eating, showering, getting dressed and personal hygiene. Managing intimacy and safeguarding the care recipient’s integrity pose particular challenges for staff. The aim of this qualitative interview study is to describe and analyse care workers’ (CWs) and personal assistants’ (PAs) strategies for managing situations and challenges related to provision of personal and intimate care in the context of formal home care. Semi-structured interviews with eleven CWs and nine PAs were conducted. Our analysis reveals a complex repertoire of relational and communicative strategies, within an overall approach - which we labelled 'empathetic attuning'—of relating to the current situation and task at hand whilst safeguarding integrity. These strategies were intertwined with dimensions of time. The possibility to accomplish satisfactory personal and intimate care rests on structural and organisational conditions that promote sustainable working conditions, where relations characterised by continuity, integrity and respect can be realised.

Perspectives on reproduction and developmental disabilities are gradually changing in Sweden. Through this change parents with developmental disabilities are gradually being included within an emergent discourse of “good enough parenting” on certain conditions. The present article explores discourses of reproduction and parenting among adults with developmental disabilities in two Swedish contexts: in a Swedish magazine, “Empowerment”, produced by and aimed at adults with autism, and interviews with people with intellectual disabilities in Sweden. Common to the materials from both studies are a normative reprosexual discourse of parenting and an underlying assumption that parenthood relates to adulthood in the sense that it requires maturity. The stories in the magazine “Empowerment” can be seen as expressing an emergent counter-hegemonic conditional discourse of “good enough parenting” which regards some people with autism as “good enough” parents. In general terms, the stories about parenting in the interview study depict parenting as related to age awareness and, unlike what is found in the material from “Empowerment”, there is no discussion of or reflection on whether or how impairment affects one's opportunity/ability to become a parent.

Young adults experiencing mental health problems are less educated than their peers, putting them in a more vulnerable position for employment and career possibilities. While Supported employment models have been widely implemented, educational supports may be necessary in order to contribute to longer term and sustainable employment. The aim of this study was to describe the state of current research regarding Supported education services for individuals with mental health problems, with a particular focus on studies that address both educational and vocational goals. A scoping review of articles published between 2000 and July 2020 was conducted. Eight databases were searched, titles/abstracts and full-text articles were reviewed for inclusion. The results, which built on 56 included articles, were analysed both descriptively and thematically. The results suggest that the focus in the literature has primarily been on adapting and implementing models for the needs of different populations and contexts. Many of these build on integrated models focusing on both vocational and educational needs. Despite addressing varied populations and working in varied contexts, it is possible to identify a number of essential components when delivering educational support. The review suggests a need to look at work and studies as equally important from a career development perspective. The knowledge base developed through studying supported education services and the educational components of newly emerging services, can contribute to the further development of integrated models for young adults.

Objective: Supported education (SEd) provides individualized support to people with mental health problems to achieve their educational goals. Individual placement and support (IPS) has emerged as a model through which SEd may be efficiently delivered. However, the components and characteristics of educational support for these employment-focused services have not been fully explored. Building on earlier studies, we constructed a preliminary model of SEd components that integrated with the IPS model. The SEd model included the eight original principles of IPS, developed to reflect the SEd component, and two new principles were suggested. The aim of the study is to investigate these adapted principles by exploring the feasibility of applying them within established IPS programs providing both employment and educational services.

Methods: An organizational learning approach was taken, involving five IPS programs providing both employment and educational services to young adults with mental health problems. Data were collected through focus groups, interviews, and workshops with 19 IPS specialists.

Results: The results suggest that while the IPS principles provide a feasible and relevant structure for the development and provision of integrated services, adaptations that reflect the educational context were considered valuable when supporting young adults in pursuing their career-related goals. Conclusions and

Implications for Practice: The respondents confirmed that the SEd principles and the focus on support in educational contexts helped them to further develop their knowledge and strategies. While challenging, integrating SEd in IPS models shows good potential for supporting young adults as they struggle to reach longer term career-oriented goals. 

Mental health problems among young adults often lead to obstacles to completing higher education and becoming established in the labour market. It is important to offer support that can help these individuals realize educational and vocational goals in order to become self-sufficient and achieve social inclusion. Individual Placement and Support (IPS) and Supported Education (SEd) are two methods developed for supporting people with mental health problems in attaining competitive employment and reaching educational goals. These methods have not been widely implemented in Sweden, therefore making it interesting to study management perspectives in organizations offering IPS/SEd. The study aimed to explore the reasoning and strategies managers described in offering vocational and educational support to young adults with mental health problems. This study is based on 12 qualitative interviews with managers from six units in Sweden offering support through IPS/SEd. Results show a variety in interpretation of legislation and responsibility for young adults with mental health problems. The managers were positioned between policy and practice, having to navigate between the organizational restraints and their professional assessment in offering this support and pushing traditional boundaries in prioritizing long-term individual goals over short-term economic and political considerations. These managers demonstrate the possibilities for how IPS/SEd can be implemented and made to fit different organizational contexts, even within a highly sectorized welfare system as in Sweden. However, the methods might need to be adapted and adjusted to not only fit local organizational restraints, but also to fit into the Swedish welfare system.

People with intellectual disabilities are commonly seen as "nonadult others" and as persons of limited credibility, and this view has implications in a number of areas. In this paper, the empirical findings from an interview study focused on lived experience are analyzed in relation to the intersections of intellectual disability and gender. In light of Fricker's (2007) work on epistemic injustice, and in recognition of Anderson's (2012) emphasis on the importance of transactional and structural injustice, a novel aspect of epistemic injustice is provided: as a consequence of conditioned lived space. The social identity of intellectual disability position persons thus identified to belong to a segregated and marginalized group. Although guided by the ambition to care for and protect this vulnerable group, structural transactions provided by the welfare system run the risk of simultaneously depriving individuals of both the experiences and the hermeneutical resources necessary to interpretatively frame and make sense of their limited situation and lack of possibilities – and thus from interacting epistemically in fruitful ways. A key structural feature of the epistemic injustice towards the group is shown to be a lived experience that to a large extent is conditioned by the constructions of disability and gender. 

People with intellectual disabilities are commonly seen as "nonadult others" and as persons of limited credibility, and this view has implications in a number of areas. In this paper, the empirical findings from an interview study focused on lived experience are analyzed in relation to the intersections of intellectual disability and gender. In light of Fricker's (2007) work on epistemic injustice, and in recognition of Anderson's (2012) emphasis on the importance of transactional and structural injustice, a novel aspect of epistemic injustice is provided: as a consequence of conditioned lived space. The social identity of intellectual disability position persons thus identified to belong to a segregated and marginalized group. Although guided by the ambition to care for and protect this vulnerable group, structural transactions provided by the welfare system run the risk of simultaneously depriving individuals of both the experiences and the hermeneutical resources necessary to interpretatively frame and make sense of their limited situation and lack of possibilities – and thus from interacting epistemically in fruitful ways. A key structural feature of the epistemic injustice towards the group is shown to be a lived experience that to a large extent is conditioned by the constructions of disability and gender. 

Support for developing a work identity has been shown to be essential for the recovery process of young adults with mental health problems. Since research shows that the development of a student role during the educational years for these young adults may be interrupted, this time period may be relevant to explore in order to support career development and the critical transition to adulthood for this target group. To explore young adults’ experiences of participating in supported education that is integrated with vocational and mental health services, reflecting the process of developing a student identity while struggling with mental health problems. A grounded theory design was used. The material consists of 17 individual interviews with young adults aged 18–29 years who were receiving supported education. Young adults who study while having mental health problems encountered structural barriers and challenged engagement in education that created a gap between the students and the regular education system. Access to supported education was reported to decrease this gap and formed a bridge that to facilitate educational achievements. The achievements were related to several personal benefits that were important for the experience of meaning and identity development in the future. Supported education can contribute to enabling the development of student identity for young adults with mental health problems. This involves an engagement process and positive identity formation that may reduce stigma and is therefore important for the personal recovery process and career advancement.

Mental health problems often appear at a young age. As the labour market places higher demands for education and competence, mental health services are focusing on young adults’ support needs for school and career opportunities. This study is a single case of an integrated supported education and employment unit in Sweden over an 18-month period. Multiple data sources illustrate the process of supporting careers and transition to school and work for young service users. This is a promising example of how careers can be supported through a flexible service that provides support for successful individual education and work trajectories among the youth. The service allowed for evolution of an identity process towards recovery through student and work roles.

Background: Recent studies have identified increased opportunities forparticipating in the community for young adults with intellectual disabilities.However, paternalistic and infantilising attitudes remains. People withintellectual disabilities are still commonly seen as “non-adult others” and aspersons of limited credibility. This view has implications in a number of areas,not at least in relation to the welfare system.

Method: The methodology is empirically grounded in semi-structured qualitativeinterviews with 13 middle-aged men and women in long-term receipt of disabilityservices. The analyses were conducted both thematically and by using discursivetools such as interpretative repertoires and subject position, and in light ofFricker’s (2007) work on.

Results: The analyses highlight that practices within disability services risk to create acircumscribed and conditioned lived space for people who receive such services. This isillustrated by discussing: Marginalising structures inflects understanding of oneself;Working life and paradoxical discourses; and Gendered ranges of socio-spatial mobility.All examples point at limited resources in the form of experiences and socialinteractions, and the social knowledge gained in such experiences.

Conclusion: Although guided by the ambition to care and protect, structuraltransactions provided by the welfare system run the risk of simultaneouslydepriving individuals of experiences as well as the hermeneutical resourcesnecessary to interpretatively frame and make sense of their situation. Theinterviewee are put in an unfair disadvantage when it comes to making sense ofsocial experience, as well as articulating expectations on support. Support thatoften is essential in relation to exercising choices and making claims of legalrights, and creating a, for one self satisfactory, everyday life.

The aim of this article is to analyse and discuss constructions of old age as they are reflected in disability research with the focus on ageing and what it means to be elderly. The results of this study show three tendencies. First, the consequences of the impairment tend to be at forefront in studies of experiences of ageing among persons with intellectual disabilities. This obscures the fact that people with intellectual disabilities partake in a common idealisation of youthfulness that often contains ambivalence towards old age. Second, the concept of old age in disability research embraces significantly wider chronological age groups than those considered in ageing studies. Third, both disability and ageing research tend to use a late modern perspective of individualization as a way to illustrate new options and strategies, including resistance against stigmatisation. This article illustrates that social constructions of disability and old age are tightly interwoven, and constitute negations of normatively defined ideals of normality in a society where ability are highly regarded. 

Det här kapitlet beskriver ålder som organiserande princip i bestämmelser om stöd och service till personer med nedsatt funktionsförmåga. Stöd och service syftar till att personer med även omfattande funktionsnedsättning ska ges möjlighet att leva som andra. Samtidigt visar flera studier att utformning och organisering av stöd riskerar att markera stödmottagare som avvikande, som personer som inte uppfyller samhälleliga krav och ideal (se t.ex. Järvinen & Mik-Meyer 2003). Det är dock mycket få studier som uppmärksammat ålder, och hur föreställningar om ålder inverkar i relationer mellan välfärdssystemet och personer med funktionsnedsättning.

Supported Education – an opportunity to reduce marginalization 

Introduction:Several studies have shown that people with mental health problems are less educated than their peers.While these young adults are more likely to drop out of school, many post-secondary institutions do not offer services readily available to students with mental health problems. Supported Education (SEd) is an intervention that focuses on helping young adults toachieve their educational goalsby providing specific expertise, concrete supports and coordinated services. While these services are delivered within a number of models, there is a lack of knowledge of components of SEd and how the model can be adapted in different welfare settings. 

The aimof this study was to investigate the development of SEd services in Sweden, with a particular focus on identified needs, authorities and responsibility issues related to resources and implementation issues particular to Sweden. 

Method:Ten group and two individual interviews with in total 55 persons were conducted. The informants included a broad sample of stakeholders who in their profession work with or have contact with educational support, as well as young adults experiencing mental health problems who have used educational support. 

Results: Educational supports were primarily described as an answer to an identified ‘problem’, a growing population of young people at risk of exclusion and long-lasting marginalised positions. The population were divided in threemore or less distinct categories of young adults: those with serious mental health problems; with neuropsychiatric disabilities and additional (‘school related’) mental health problems; and refugees with mental health problems due to harsh experiences. The need for educational support was in part ascribed to individual characteristics, but primarily as due to obstacles created by environmental conditions, e.g. school milieus not adapted to individual characteristic, increased demands, and contradictions within and between different regulations. Educational support was described as counteracting the effects of a highly differentiated welfare system, illustrated as separate pipelines (or which often fragment individual needs). According to the respondents, sufficient support is person-centred and individualised, and relies on staff well-informed of the individual’s current situation as well as of the welfare system and collaborations with respect for each actor’s scope and regulating framework. The social context, the ‘social infrastructure’, around individuals during studies are discussed more specifically in this study than how it occurs in other studies. The analysis points to the value of developing SEd in a Swedish context as dependent on and in collaborative forms with natural welfare system resources. The study suggests that this might be a first step towards considering needs related to educational and vocational goals from a holistic and long-term perspective, one that reflects the manner in which all young adults struggle to establish themselves as participatory adults. 

Previous research has shown that people with disabilities in many respects primarily are regarded and treated as persons with disabilities, there other categorization grounds, such as gender, is given subordinate importance alternatively is neglected. According to another central categorization ground, age, do several studies problematize the notion of ‘eternal children’ and barriers to achieve adult status for people with intellectual disabilities.

Less attention has been given to relations between constructions of old age and intellectual disabilities. The aim of this paper is to analyse and discuss how understandings of ageing and being old in relation to disability diverge slightly compared to how it is reflected in gerontological and sociological research about ageing and being old. The paper is based on a research overview that identified three tendencies. First, the concept of old age in disability research embraces significantly wider chronological age groups than those considered in ageing studies. Second, in studies of experiences of ageing among persons with intellectual disabilities tend consequences of the impairment to be put in forefront. This may obscure that people with intellectual disabilities partake in common idealisations of youthfulness, an idealisation that otherwise contains ambivalences towards old age. Third, research about both disability and ageing tend to use a late modern perspective of individualization as a way to illustrate new options and strategies, including resistance against stigmatisation. However, researches about being elderly as disabled rarely include such perspectives.

This paper illustrates that social constructions of disability and old age are tightly interwoven, and in a society where ability are highly regarded, they constitute negations of normatively defined ideals.

The aim of this thesis is to explore and analyse lived experience of social categorisations such as intellectual disability, gender and age. The following overarching questions will direct the focus of the thesis, on how 13 middle-aged (aged 38-60 years) women and men who receive disability services according to the Act (1993:387) concerning Support and Service for Persons with Certain Functional Impairments (LSS), describe their everyday life practices:

- In what way(s) are the social categorisations disability, gender, and age expressed in the interviews? How do the participants relate their lived experience of the social categorisation in relation to arenas such as work, family, and leisure time? How can this lived experience be understood in relation to the structures and conditions that form the institutions within the disability services?

With a hermeneutic-phenomenological approach, the thesis is based on repeated audio- and video-recorded qualitative semi-structured interviews and field visits. The altogether 16 participants were divided into two groups: the main group consisted of 13 adults and a reference group, which consisted of 3 younger informants (aged 25-29 years).

Despite political ambitions that state that people with disabilities should have opportunity to live like others, this thesis shows that their everyday life is, in fact, conditioned by institutional structures. The structures that conditions the disability services together with the social construction of disability, but also of age and gender, frames leisure time, social networks, family life, practicing partnership, mobility (especially for women), and working life – in short, these conditions their abilities to fulfil the expectations that are imbedded throughout the social construction of adulthood.

The relationship with the labour force can be seen as an illustrative example: The ability to be part of a regular working force was central for the interviewees. However, the analysis showed that the work that was available for the participants, is a welfare state effort, that is situated in an intersection where a logic of care meets a logic derived from the open labour market, thereby creating a situation filled with contradictions. On the one hand, the informants felt an obligation to fulfil an almost Protestant work ethic. One the other hand, their work efforts are not acknowledged by society as work. On the one hand, daily activity is a voluntary right, on the other hand; the informants have little opportunity to relinquish this right, depending on the particular organisation of the disability services. The participants also expressed concerns about losing this work, a worry that can be seen as paradoxical in respect of their legislative right to daily activity. 

The analysis has highlighted how the participants, in many situations, suffer a disadvantageous position with regard to hermeneutical resources to make sense of their experience. They also face structural obstacles to fully live an adult life. This could be described as experiencing societal norms of what one is expected to live up to, but at the same time be deprived of real opportunities to fulfil these requests – thereby, to live a contradiction. Lived experience of intellectual disability, gender and age, can therefore be considered as being a lived experience of a conditional adulthood.

Within disability research, studies have generally focused on either young adults or older people with intellectual disabilities. The in-between age group (adulthood and middle age) has rarely been of interest. The purpose of this article is to describe and discuss middle-aged adulthood in relation to work, as experienced by people with intellectual disabilities in Sweden in 2010. The methodology is empirically grounded in semi-structured, qualitative interviews with seven men and six women in long-term receipt of disability services. The findings show that work was the hub around which participants’ lives were organised and given meaning. However, the work situation can be seen as paradoxical. Even though Swedish disability policy gives people with disabilities extensive legal rights, those who might benefit are not always aware of policies, nor do they always make claims on that support. For middle-aged people with disabilities, marginalisation influences the opportunities to share and talk about experiences of life events, and to formulate lifestyle plans. As the capacity for a person to claim entitlement or make plans is dependent on social interaction and available interpretative frameworks, the challenge for service providers and others involved in the daily lives of people with intellectual disabilities is to encourage capacity-building to enable such choices and claims of rights to be exercised.

This article explores intersecting notions of leisure among middle-aged people with intellectual disabilities in the setting of the Swedish welfare state. The participants are recipients of long-term disability services and have experienced the changing ideological frameworks of the welfare effort, which has recently focused on normalisation, inclusion and participation. Structured activities are arranged by disability services in order to normalise living conditions and provide recreation for disabled people. However, the range of activities is constrained by financial resources, by notions of gender and age and by an institutionalised emphasis on the work ethic – leading to constructions of leisure partly as ‘time beside’ where ‘free time’ activities should not interfere with the duties of the working week. The participants’ limited resources and their lack of a strong voice limit their ability to demand their legal rights and leave many of them with ‘too much time with too little to do’.

This paper presents a critical synthesis of a selection of national and international research concerning the working life of people with intellectual disabilities who have left special upper secondary school. The 30 studies selected were carried out between 1996 and 2006, and involved two different wlfare state models. These studies have been scrutinized and associated with five themes that include factors of importance. The first result that the review indicates is that it is difficult for people with intellectual disabilities to get and keep a job, and the second is that to obtain and keep a job is a part of a process in which they are able (and/or should be able) to participate, because the process leads to the normalization of a pattern of life. It seems that the pathway to a job goes via some form of special organized support, which is often found within what is called welfare services/care for the disabled. The review also shows that this topic is mainly studied from a gender-neutral standpoint, and that individual factors are emphasized to a much higher gegree than factors related to the environment, such as organizations and attitudes.

Young adults experiencing mental health problems often need both individual support and educational accommodations to successfully complete their studies. Recent research also points to the need for career-related, educational services in a labor market that increasingly demands formal education or training.

The aim of this study was to investigate the development of supported education services in Sweden, in relation to pursuing educational and vocational goals. Interviews were conducted with a broad sample of stakeholders who are currently developing supported education services, as well as young adults utilizing educational support.

The results suggest a number of key factors for accommodating the needs of these students which include, in addition to basic academic, mental health and individual supports, attention to economic challenges, social contexts and improved mental health literacy for educational actors. The results additionally substantiate the relevance of educational supports to long-term vocational goals when providing employment support services.

Summary: An interview study was conducted with persons receiving home care services and personal assistance in Sweden (13 individuals, 25 interviews) with the aim to analyze their experiences of managing personal and intimate care. The analytical approach was guided by phenomenologically informed research and Erving Goffman's theoretical work on self-presentation and social life as it differs in frontstage and backstage settings.

Findings: A reflected approach to the complex challenges associated with becoming and being a person in need of personal and intimate care was revealed. This involved continuous adaptations and attuning to organizational and relational conditions of formal home care. Being a recipient of personal and intimate care does not mean being passive. It entails relating to and sustaining the care relation, where even choosing to accept suboptimal conditions is an act of agency. The recipients’ private homes were hybridized, transformed both into a waiting room, with the recipient on standby and into a workplace. The homes thus partly lost their character as a backstage realm where one could avoid the gaze of others. This also led to a hybridization of the personal sphere, in the form of marginal scope for true privacy, necessitating strategies for protecting one's own space.

Applications: It is important both to acknowledge the intrusive nature of personal and intimate care, which results in extensive hybridization of the home and personal sphere and to recognize care recipients’ agency in the relationship that care establishes.

I Sverige, liksom i övriga OECD-länder, deltar personer med funktionsnedsättning i arbetslivet i betydligt lägre utsträckning än befolkningen i övrigt. Detta förhållande verkar dessutom öka i omfattning, och framförallt unga med intellektuell funktionsnedsättning och neuropsykiatriska tillstånd samt personer med psykisk funktionsnedsättning verkar stå inför en svår situation i relation till arbetsmarknaden. För dessa grupper har det utvecklats olika former av insatser med fokus på sysselsättning. Socialstyrelsens öppna jämförelser visar att mycket få personer som deltar i kommunala sysselsättningsinsatser, meningsfull sysselsättning enligt Socialtjänstlagen respektive daglig verksamhet enligt Lag om stöd och service till vissa funktionshindrade, går från dessa verksamheter till anställning på den öppna arbetsmarknaden, lönebidragsanställning, praktikplats, Samhall eller annat skyddat arbete. Detta trots att en tidigare kartläggning visade att det inom drygt 40 % av de dagliga verksamheterna fanns personer (ca tio procent av det totala antalet deltagare) som både skulle kunna och vill gå från daglig verksamhet till annan sysselsättning alternativt arbete.

Föreliggande rapport är en kunskapssammanställning om insatser och aktiviteter som skapar förutsättningar för arbete för personer som omfattas av, eller kan komma att omfattas av, sysselsättningsinsatser från socialtjänsten. Kunskapssammanställningen grundar sig på två datainsamlingar: en forskningsöversikt omfattande 110, huvudsakligen internationella, studier om arbetsfrämjande insatser, metoder och aktiviteter för personer med funktionsnedsättning, samt två fokusgruppintervjuer med totalt 18 verksamhetsföreträdare. Dessa representerade verksamheter som tillhörde en grupp kommuner respektive stadsdelsförvaltningar som via Socialstyrelsens arbete med öppna jämförelser under perioden nov 2011–nov 2012 identifierats som framgångsrika i arbetet med att slussa ut personer från daglig sysselsättning respektive daglig verksamhet till arbete.

Resultatet visar att arbetsfrämjande stöd är komplext och att om man vill skapa bättre förutsättningar för inträde i arbetslivet för personer med funktionsnedsättning behöver man verka på flera nivåer samtidigt. Forskning har visat att ett systematiskt, riktat och individualiserat arbetssätt är mer framgångsrikt än generella insatser, och att arbetsfrämjande aktiviteter bör initieras tidigt, löpa parallellt och samordnas över myndighets- och verksamhetsgränser. Med individualiserade insatser menas att stödet ska vara grundat på den enskildes önskemål, färdigheter och att behov matchas med förutsättningar och förhållanden på en reell arbetsplats. Rekrytering av och placering på en arbetsplats bör, enligt forskningsöversikten, utgå från principen ”place-then-train” där stöd till den enskilde kombineras med stöd och information till arbetsplatsen. Detta individualiserade stöd utmanas dock av standardiserade och icke-flexibla strukturer. Med arbetsfrämjande stöd inbegrips också att undanröja eller minska barriärer som kan uppstå på grund av icke-arbetsrelaterade faktorer i den enskildes livssituation. Till detta ska adderas att både tidigare forskning och fokusgruppintervjuerna pekar på att ett långvarigt samt ett över tid vidmakthållet erbjudande om stöd är en väsentlig komponent för framgångsrikt arbetsfrämjande stöd.

Analysen av den tidigare forskningen och fokusgruppintervjuerna identifierade nio utvecklingsområden för arbetsfrämjande stöd, områden som är angelägna oavsett hur man för närvarande arbetar med dessa. Det handlar om hur man i den egna organisationen kan utveckla sitt sätt att arbeta med:

1)   att inventera, stötta och över tid bibehålla den enskildes motivation till arbete,

2)   individualiserade planeringar som uppmärksammar arbete,

3)   att befrämja individers syn på sig själva i framtida arbete,

4)    att befrämja personalens och omgivningens syn på individers möjligheter till arbete,

5)   att skapa reell samverkan över gränserna med andra myndigheter och verksamheter,  

6)   att skapa goda relationer och samverkan med potentiella och befintliga arbetsgivare, samt rekrytera arbetsplatser,

7)   att få till stånd en god matchning mellan individ och arbete,

8)   att ge stöd som samtidigt gagnar både den enskilde och arbetsplatsen,

9)   att ge stöd för att undanröja barriärer för arbete som uppstår inom andra delar av livet

Sammantaget visar kunskapssammanställningen att ovanstående områden har en nyckelroll när man inom olika verksamheter utvecklat strategier som tycks bidra till att underlätta övergångar från sysselsättningsinsatser till arbete. Det finns också en viss optimism inom området arbetsfrämjande stöd. Forskningsöversikten och fokusgruppintervjuerna speglar ett engagemang för dessa frågor och en ambition att finna framkomliga vägar. Konklusionerna av kunskapssammanställningen har kondenserats till följande områden: organisatorisk och individuell beredskap för arbete, individualiserad planering, stödfunktioner och samverkan. Dessa områden kan vara vägledande i arbetet med övergången från sysselsättning till arbete.

Rapporten har också identifierat aspekter av arbetsfrämjande stöd som inte fullt ut varit möjliga att analysera inom ramen för denna rapport, bland annat formell och reell kompetens och förhållningssätt. Vilka attityder som finns gentemot personer med funktionsnedsättning, och hur de kommer till uttryck i samhället, inverkar sannolikt också på arbetsgivares syn på personer med funktionsnedsättning som medarbetare. Här kan man skönja viss optimism. Synen på funktionsnedsättning som ett permanent tillstånd håller på att luckras upp, kanske mest påtagligt när det gäller personer med psykisk funktionsnedsättning. En växande medvetenhet om att grupperna är heterogena och att funktionsförmåga inte är en över livet statisk egenskap börjar få genomslag. 

This paper presents an overview of research about support-to-work in relation to psychiatric and intellectual disabilities. The overview shows that support-to-work services are multifaceted, and that work can be seen as a tool for individual rehabilitation or as a set of goals to achieve. Providers are presented with specific components, which are characterised by systematic, targeted, and individualized interventions. The overview illustrate a need of long-term engagement and cooperation of and between welfare services and agents within the labour market to dissolving the Gordian knot that transition from welfare interventions to employment seems to be.

This study explored the experiences and perceptions of professional service providers offering services to women with disabilities exposed to intimate partner violence (IPV). Eighteen in-depth interviews were conducted with service providers working in health care, social work, the police, women’s shelters, and the Centre for Violence Against Women. Our findings suggest that providing adequate IPV services to women with disabilities requires coordination and collaboration. IPV services were organized around five overarching themes: finding services; assessing the risk; identification; protection and care; and becoming independent. This approach was helpful for women who faced disability-related challenges in accessing IPV services.

Aim: The aim of this study was to explore the experiences and perceptions of the service providers on the wayexisting intimate-partner violence (IPV) services are organised to address the needs of people with disabilitiesexposedto IPV.

Methods: The researchers conducted in-depth interviews with 17 IPV service providers working in: health care,social work, police, women’s shelters and at the Center against violence. A semi-structured, open-ended interviewwere conducted between March 2020 and December 2020 and transcribed verbatim. A constructivist groundedtheory approach that is based on the principles of symbolic interactionism was used with the purpose ofexplaining how IPV services are organised for people with disabilities in Sweden.

Results: In the resulting theoretical framework service providers framed their experience and perceptions ofproviding IPV services to people with disabilities to require coordination and multisectoral collaboration betweendifferent sectors and actors was viewed as ideal for providing adequate services to women with disabilities,however this was not always the actual approach adoptedby all providers. The providers further illustrated thatservice provision for women with disabilities was organised around four overarching themes; pathways; screeningand identification; protection and care; empowerment and independence.

Conclusion: This study indicates that providing adequate IPV services to people with disabilities requiremultisectoral collaboration. This approach was considered instrumental for women with disabilities that often facedisability-related challenges that created difficulties in navigating several services on their own. 

Background: Current data suggests a high prevalence of intimate partner violence (IPV) among women withdisabilities (WWDs), yet there is still scanty research on the experiences of this population regarding access andutilization of IPV services.

Methods: Using qualitative in-depth data obtained from WWDs, our current study sought to identify factors thathinder WWDs from accessing and utilizing IPV services.

Results: This study showed that WWDs exposed to IPV encountered multilevel barriers nested at differentsocietal levels as they attempted to access violence-rated services. At the individual level, the identity category ofdisability, not knowing about certain forms of violence, and being better off silent were the main explanations fornot using IPV services. The role of personal connections was the main factor that influenced the utilization ofIPV services, at the interpersonal level while at the organizational level, a lack of effective communication, powerimbalances, inadequate resources, and failures to follow response standards were identified as the major barriers tousing IPV services. Societal incompetence, as exemplified by treating violence as a taboo and the lack ofregulations criminalizing psychological violence, was the main barrier at the societal level.

Conclusions: Our findings suggest that regarding WWDs, improving their access and utilization of IPV servicesrequires interventions that address barriers at societal multiple levels including the individual, interpersonal,organizational, and societal levels. This should include early interventions and programs that not only targetWWDs but also include other key players such as service providers on violence recognition and improve thequality of services. There is a need to also review laws and regulations regarding psychological violence and thenature of interventions in place for this type of violence. 

Aim: Research investigating outcomes related to evidence-based interventions such as Supported Employment have begun to suggest the need for more specific, career related, educational supports, as an essential aspect of supporting sustainable employment in a labor market that increasingly demands formal education or training. The aim of this project is to develop knowledge regarding the components of Supported Education that are feasible to develop within established IPS services and to study and describe the relevance of these services for young adults experiencing mental health problems in Sweden.

Method: It includes three studies that will generate knowledge regarding the essential components of these types of educational supports, investigate and describe potential outcomes related to educational needs, and develop specific knowledge of how these methods might best be implemented. Interviews with a wide range of actors and users will generate knowledge regarding the needs, obstacles and possibilities for integrating IPS och SEd in a Swedish context.

Results: Results related to the needs assessment in Sweden will be presented and discussed in relation to the international literature and experience. Results that suggest the potential for SEd services that build on the well-developed Swedish welfare model and educational opportunities and supports will be discussed. 

Conclusion: Methods such as Supported Employment and Supported Education, which contribute to opportunities for the individual to participate in studies and eventually meaningful and sustainable employment, can be most effectively implemented when adapted to particular welfare systems and reflect resources and pathways to participation in that context.

People with disabilities participate in the labor market to a lower extent than the general population. Welfare states have responded to this with different kind of programs and measures. Despite this efforts, the participation in the labor market in Sweden seems to decrease for especially young people with intellectual-, neuropsychiatric- and psychiatric disabilities. The paper is based on a research overview, comprising 110 studies on transition from welfare state provided efforts (eg. daily activities, sheltered work etc.) to employment. The focus in the paper is directed towards similarities and differences identified in the research regarding persons with psychiatric- or intellectual disabilities.

 The overview shows that one similarity is that support-to-work is complex and that systematic, targeted and individualized approaches is more successful than general measures. Support-to-work should also include an ambition to reduce barriers that arise due to non-work-related factors in the individual's life situation. The individualized support, is however, challenged by the non-flexible structures of the welfare state services.

One of the differences is that work related research in the field of people with psychiatric disabilities reflect a growing interest for employment as a key component for rehabilitation. Another differences is that in the field of intellectual disability the research can be characterized as small-scale qualitative studies focusing on experiences or studies that problematize employment in relation to intellectual disabilities while the research in the field of people with psychiatric disabilities mainly study outcomes and evidence-based work promoting models.

The research review also shows that the following areas are of importance when facilitating transitions from sheltered work to employment: identify, support and over time maintain the individual's motivation to work; individualized planning that focuses on promoting individuals' view of themselves in future work; to encourage staff´s and the environment´s views on individuals' as capable to work; collaboration with other welfare state services and potential work places; create good relationships with potential and existing employers; achieve a good match between the individual and work; provide support that simultaneously benefit both the individual and the workplace and to provide support to overcome barriers to work arising in other areas of life.

Personer med intellektuell funktionsnedsättning befinner sig i en utsatt position vid kriser som en pandemi, dels beroende på funktionsnedsättningen och dess konsekvenser, dels beroende på de levnadsförhållanden man lever under. Det saknas dock systematisk kunskap om hur personer med intellektuell funktionsnedsättning i Sverige upplevt de restriktioner och begränsningar som covid-19-pandemin inneburit och hur den påverkat deras vardagsliv. 

I denna studie har 34 vuxna med lindrig eller måttlig intellektuell funktionsnedsättning och som har någon form av stödinsats från samhället intervjuats om sina erfarenheter av ett drygt års pandemi. 18 män och 16 kvinnor i åldrarna 23 till 77 år från olika delar av landet har medverkat. Utöver dessa har nio representanter för intresseorganisationen FUB (Föreningen för barn, ungdomar och vuxna med utvecklingsstörning) intervjuats för att i första hand delge erfarenheter av vardagslivet under pandemin för personer med mer omfattande intellektuell funktionsnedsättning. 

Syftet med studien har varit att beskriva och analysera de erfarenheter och upplevelser av pandemin och dess konsekvenser i vardagen som personer med intellektuell funktionsnedsättning har. Huvudresultaten av intervjuerna sammanfattas i en typologi med tre typer: 

• Nästan som vanligt 

• En begränsad vardag 

• Att vara i “lock-down” 

Som namnen antyder finns en grupp personer med intellektuell funktionsnedsättning som upplever att de kunnat leva ett nästan vanligt liv under pandemin. De har påverkats av restriktionerna på samma sätt som andra medborgare men kunnat fortsätta med ett tämligen vanligt vardagsliv. Mellangruppen beskriver en begränsad vardag som periodvis dominerats av begränsningar av sysselsättning och aktiviteter liksom begränsade möjligheter till sociala kontakter. Den tredje gruppen; Att vara i “lock-down”, är den största till antalet personer och det är de individerna som upplevt de mest genomgripande och långvariga begränsningarna av vardagslivet. Besöksförbud, inställd sysselsättning och fritidsaktiviteter samt begränsningar i rörelsefrihet under långa perioder har mycket påtagligt påverkat deras vardag. Gemensamt för alla tre grupperna är upplevelser av att pandemin medfört ökad ensamhet och begränsningar i vardagslivet som påverkat deras välbefinnande. Studien visar att ju fler och mer omfattande begränsningar, desto mer upplevelser av ensamhet och mer negativ påverkan på välbefinnandet och det psykiska måendet. 

Det är personer som bor i bostad med särskild service enligt lagen om stöd och service till vissa funktionshindrade (LSS) och har sysselsättning genom daglig verksamhet som upplevt en hög grad av begränsande åtgärder, medan flertalet av de som inte bor i en särskild boendeform i stort sett kunnat leva som den övriga befolkningen. De som bedömts ha störst behov av stöd i vardagen och av en meningsfull sysselsättning har således erfarit ett mer begränsat vardagsliv under pandemin. Dessutom visar intervjumaterialet att det funnits stora skillnader i hanteringen av pandemin på kommunal nivå: från mindre anpassningar av verksamheter till total nedstängning, från stöd att hålla avstånd till förbud att ta emot besök i sitt eget hem. Vägledningen för den lokala funktionshinderverksamheten från nationella myndigheterna har, liksom tillgången på tillgänglig information för personer med intellektuell funktionsnedsättning om pandemin, varit begränsad och kommit sent. Den senfärdighet som nationella myndigheter uppvisat i relation till pandemins konsekvenser för personer med intellektuell funktionsnedsättning är anmärkningsvärd. 

De begränsande åtgärderna majoriteten av deltagarna i studien beskriver kan till viss del vara en konsekvens av bristande framförhållning och krisplanering. Det handlar om brister i alla sektorer i samhället: hälso- och sjukvård, statliga myndigheter, samt privata och kommunala utförare av insatser enligt LSS och Socialtjänstlagen (SoL). Bristerna bedöms ha lett till att personer med intellektuell funktionsnedsättning tvingats bära en oproportionerligt stor börda under pandemin. 

Studiens kunskapsbidrag kan samhället lära av. Erfarenheter som personer med intellektuell funktionsnedsättning själva, men också deras anhöriga och personal inom funktionshinderområdet, har gjort och fortsatt gör under pandemin behöver dokumenteras och utvärderas så att samhället på lokal, regional och nationell nivå blir bättre rustat att möta en utsatt grupps behov vid framtida kriser och utmaningar. 

För att framgångsrikt förbereda för framtida kriser är det väsentligt att människor med funktionsnedsättning får stöd som tillgodoser deras psykiska, fysiska och sociala behov (SOSFS, 2002:9). De har rätt till stöd, inte i första hand för att de har en funktionsnedsättning eller för att det finns lagstiftning, främst har de rätt till det för att de är människor. Med ett holistiskt och humanistiskt synsätt och vilja att lära av covid 19-pandemins erfarenheter kan fler och bättre lösningar vara tillgängliga nästa gång vi befinner oss i ett läge som kräver krishantering. 

Personer med funktionsnedsättning tillhör de grupper i samhället som har svårast att etablera sig på arbetsmarknaden. Flera olika faktorer har betydelse för möjligheterna att få ett arbete. Studier pekar på att det handlar om individuella förutsättningar och förmågor men också om omgivningsrelaterade faktorer som lagstiftning, tillgång till individuellt utformat och långsiktigt stöd, arbetsgivares attityder med mera. Majoriteten av unga vuxna med intellektuell funktionsnedsättning i Sverige står utanför arbetsmarknaden. 22 procent har förvärvsarbete i någon utsträckning, oftast med någon form av lönesubvention till arbetsgivaren. Om andelen personer med intellektuell funktionsnedsättning, särskilt kvinnor, i arbete ska öka behöver mer hänsyn tas till faktorer på olika nivåer, och till hur de samspelar. Mer kunskap behövs om vad personer med intellektuell funktionsnedsättning själva upplever som främjande för etablering på arbetsmarknaden, samt hur olika stödsystem påverkar möjligheterna till arbete.