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  • 1. Augustis, Marika
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hillborg, Helene
    The meaning of work: Perceptions among persons with maintenance treatment for opioid addiction who are employed2015Ingår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 146, s. e212-e212Artikel i tidskrift (Refereegranskat)
  • 2. Augutis, Marika
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hillborg, Helene
    The Meaning of Work: Perceptions of Employed Persons Attending Maintenance Treatment for Opiate Addiction2016Ingår i: Journal of Social Work Practice in The Addictions, ISSN 1533-256X, Vol. 16, nr 4, s. 385-402Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    For most people, work is important and a normal part of everyday life. However, research studies focusing on the significance of employment for successful outcomes in maintenance treatment for opiate addiction from the users' perspective are scarce. The aim of this study was to explore the experiences of individuals who were employed while undergoing opiate treatment, with regard to the perceived meaning of work. Semistructured interviews were conducted with 32 individuals in Sweden and analyzed using content analysis. In addition to the importance of receiving maintenance treatment, all regarded work as an indispensable tool for staying drug-free and for personal development. Further studies are needed regarding the potential for integrating vocational support models into maintenance treatment programs.

  • 3. Bostedt, Göran
    et al.
    Hillborg, Helene
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Unga och arbete: Strukturella faktorer och individuella lösningar i arbetsmarknadspolitiska projekt - En kunskapsöversikt2012Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Syftet med denna studie har varit att analysera effekterna av de olika ar-betsmarknadspolitiska insatser som gjorts i Västernorrland för unga. Som underlag till analys har erfarenheter från olika arbetsmarknadspolitiska insatser i såväl Sverige som helhet (sekundäranalyser av genomförda utvärderingar för Sverige som helhet) som i Västernorrland (primärana-lys av utvärderingar som gjorts av genomförda projekt) använts. Därtill har inläsning av relevant teoretisk litteratur gjorts i syfte att sätta in det empiriska materialet i ett sammanhang. I studien har de olika inventerade projektens problemfokus kontrasterats mot en analys av ungdomars ut-satthet idag. Vi har intresserat oss för om problemfokus har utgjort en relevant översättning/förståelse av ungdomars behov idag.

    Studiens målgrupp har varit ungdomar i åldern 16-24 år. En mycket vik-tig och central del av vår studie har varit att inventera olika arbetsmark-nadspolitiska projekt som genomförts för ungdomar i Västernorrland åren 2007-2012 och analysera upplägg och resultat av dessa projekt. In-venteringen har medfört behov av olika typer av avgränsningar. Det em-piriska underlaget kan därför mer karaktäriseras som ett urval av det to-tala antalet projekt i länet än en total sammanställning.

    Studiens slutsatser kan sammanfattas i följande punkter:

     Ett allt för stort fokus på individ kan medföra att de struktu-rella hindren glöms bort.

     Ett medicinskt perspektiv vid arbetsmarknadsåtgärder för-stärker fokus på individens beteenden och brister, d.v.s. att arbetslöshet riskerar att medikaliseras.

     Tillstånd eller process? Utanförskap framställs ofta som ett individuellt tillstånd där åtgärderna framförallt inriktas mot individen. Vi ställer frågan om inte andra begrepp, som t.ex. marginalisering, social exkludering eller etablering, kan lyfta fram en process där strukturella hinder får större fokus?

     Ett utvidgat problemfokus kan leda till nya former av sam-verkan med fler aktörer och alternativa arbetssätt.

     Socialt kapital utgör en viktig del av problemlösning. Ung-domarna själva, men även litteraturen, har tagit upp bris-tande socialt kapital, oftast en brist av kontakter, som ett av de största hindren att etablera sig i arbetslivet.

     Samverkan är något viktigt och betydelsefullt. Vid samver-kan behöver dock helhetsperspektivet förstärkas i förhål-lande till en sektoriserad specialisering. 

     Samtidigt som vi menar att samverkan är viktigt, är det inte ensamt tillräckligt. Samverkan som kortsiktig lösning av ungdomars sammansatta behov får inte utesluta funderingar kring behov av institutionell förnyelse.

  • 4.
    Dahlqvist-Jönsson, Patrik
    et al.
    Department of Research, Region of Halland.
    Schön, Ulla-Karin
    Dalarna University.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Sandlund, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Svedberg, Petra
    Halmstad University.
    Service users' experiences of participation in decision making in mental health services2015Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, nr 9, s. 688-697Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.

  • 5.
    Dalin, Rolf
    et al.
    Mid Sweden University, Department of Information Technology and Media and Kommunförbundet Västernorrland, FoU-enheten.
    Rosenberg, David
    Kommunförbundet Västernorrland, FoU-enheten.
    An Approach to Measurement and Statistical Description of Participation in Community Life for People with Psychiatric Disabilities2010Ingår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 12, nr 1, s. 47-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Participation has emerged as a central concept in defining the goals of disability policy in Sweden as well as internationally. Yet it has rarely been operationalized as a foundation for planning services. As part of an attempt to survey the needs of individuals experiencing psychiatric disabilities, the authors have developed a scale for measuring participation in five areas of community life. The scale uses four distinct categories as levels, specific for each area of life, and a set of statistical descriptive techniques designed to illustrate and communicate information regarding levels, capacities, and wishes related to a participatory life in the community. Based on a pilot study, the article illustrates how the collective needs of a population of individuals experiencing psychiatric disability can be described and presented to practitioners as a support for system planning.

  • 6.
    Fjellfeldt, Maria
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Psykisk hälsa - ett mångfacetterat uppdrag: analys av behovsbilder och handlingsstrategier i 21 länsplaner sammanställda inom ramen för statens satsning inom området psykisk hälsa2017Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    För att få del av de statliga stimulansmedlen inom ramen för överenskommelsen mellan Regeringen och Sveriges Kommuner och Landsting (SKL) 2016 var kommuner och landsting skyldiga att länsvis sammanställa en handlingsplan med avseende på området psykisk hälsa. Forskare vid Umeå universitet fick i uppdrag att analysera dessa planer. Både kvantitativa och kvalitativa sammanställningar och innehållsanalyser genomfördes. Under en forskarpanel bidrog experter inom olika områden med sina kunskaper till att fördjupa och nyansera analyser av preliminära resultat. Preliminära resultat presenterades under en seminariedag i Stockholm där representanter för länen samt företrädare för SKL, Socialstyrelsen och Folkhälsomyndigheten samlats. I samband med denna presentation inkom kompletterande uppgifter som innebar att vissa revideringen av rapporten genomfördes. Inför länens arbete med handlingsplanerna föreslog regeringen i överenskommelsen med SKL att kommuner och landsting skulle beakta fem fokusområden: 1, förebyggande och främjande insatser 2, tillgängliga tidiga insatser 3, enskildas delaktighet och rättigheter 4, utsatta grupper och 5, styrning, ledning och organisation. Dessa fem områden är aktuella för barn och unga, vuxna och äldre. I samtliga handlingsplaner förhåller sig länen till dessa fokusområden. I 18 av 21 län har man strukturerat sina handlingsplaner i relation till fokusområdena. Tre län förhåller sig friare till de angivna fokusområdena. Sveriges län skiljer sig åt på många sätt, vilket återspeglas i handlingsplanerna som varierar till form och innehåll. Vissa län har gjort behovsanalyser utifrån ett folkhälsoperspektiv på psykisk hälsa, medan andra behovsanalyser undersöker faktorer som är mer relaterade till ett perspektiv på manifest ohälsa och sjukdom. I vissa län finns detaljerade målsättningar som specificeras i långsiktiga mål och kortsiktiga delmål. I andra län har målformulerandet just påbörjats. I en del handlingsplaner finns detaljerade åtgärdsförslag medan det i andra län presenteras mer övergripande och generella åtgärder. Variationsrikedomen i handlingsplanerna är mycket stor. När det gäller beskrivningen av arbetsprocessen i samband med att handlingsplanerna utarbetats varierar graden av insyn i hur arbetet gått till. I vissa handlingsplaner beskrivs processen i detalj, och personer som deltagit är namngivna. I andra handlingsplaner går det inte att utläsa vare sig hur arbetsprocessen har gått till eller vilka som varit delaktiga. I ett län har ett ägarskap skrivits in i handlingsplanen som innebär att instanser utsetts som ansvariga för att handlingsplanen i sin helhet omsätts i praktik. I några län utses ansvariga inom respektive insatsområde, medan vissa län inte berör ansvarsfrågan alls. I såväl den nationella policyn som i handlingsplanerna finns en komplexitet när det gäller den tredelade målgruppsbeskrivningen om ”allas” psykiska hälsa, utsatta gruppers psykiska hälsa och personer med omfattande psykiatrisk problematik.

    Hur kommuner och landsting hanterat frågan om brukarmedverkan i arbetet med planerna varierar; alltifrån att inte ha någon brukarmedverkan dokumenterad alls, till att en brukarorganisation är en av tre jämbördiga parter. I ett län anläggs ett folkhälsoperspektiv på brukarmedverkan genom att representanter från ett brett spektrum av brukar- anhörig- och patientföreningar finns representerade, liksom representanter för skola. Att använda sig av länsnivån som avsändare för planerna innebär utmaningar. Vilken grad av struktur som finns varierar mellan länen – se Länsinventering Psykisk Hälsa (SKL 2015). Det finns ingen självklar politisk struktur vilket innebär att det är svårt att förankra handlingsplanerna i en politisk kontext. I 9 län beskrivs politisk förankring av varierande grad. I återstående 12 län framgår det inte om handlingsplanerna är politiskt förankrade eller inte. Graden av politisk förankring påverkar möjligheten att omsätta handlingsplanen i praktiken. En annan utmaning rör tillgången till tjänstemän på länsnivå som kan arbeta med länsgemensamma uppdrag. Även detta skiljer sig åt mellan länen och påverkar arbetet med länsgemensamma planer och målsättningar. När det gäller målsättningar presenteras det i drygt hälften (12 av 21) av handlingsplanerna långsiktiga mål som är nedbrutna i kortsiktiga delmål. I fyra län är långsiktiga och kortsiktiga målsättningar fristående ifrån varandra. Målsättningar strukturerats antingen utifrån de fem fokusområdena eller tematiskt utifrån prioriterade områden i länen. I fem av länen har man hanterat målsättningar på andra sätt. De slutsatser som dragits utifrån analysen av de 21 länens handlingsplaner är följande:

    • Strukturer för att arbeta på länsnivå ser mycket olika ut i länen. Därför skiljer sig handlingsplanerna åt, både till form och innehåll. I vissa län tycks arbetet med länsplanen innebära ett mervärde för de inblandade aktörerna, i andra inte. Om principen från regeringen och SKL att använda sig av länsnivån i kommunikationen ska bestå, bör strategier för stöd till länen övervägas.

    • Generellt sett rör länsplanerna utvecklingsarbete och endast i liten utsträckning organisationernas kärnverksamhet.

    • Länsplanerna handlar främst om kommunerna och landstingens gemensamma arbete och om samverkan mellan organisationerna. Detta innebär att de enskilda huvudmännens verksamheter endast uppmärksammas i mycket liten utsträckning. Följaktligen saknas en stor del av den reguljära kärnverksamhet som bedrivs av kommuner och landsting var för sig, som till exempel den specialiserade psykiatrins behandlingsarbete eller primärvårdens insatser. Inriktningen är särskilt tydligt under fokusområdet ”ledarskap och organisering” där handlingsplanerna företrädesvis rör samordning och samverkan.

    • Det finns en hög ambition i länen att främja psykisk hälsa hos barn och unga, och att samarbeta mellan huvudmännen kring barn och unga som har utvecklat någon form av psykisk ohälsa.

    • I länen finns en hög ambition att samarbeta huvudmän emellan och tillsammans med det civila samhället för att bli bättre på hälsofrämjande insatser riktade till asylsökande och nyanlända, samt att bli bättre på insatser som riktas till asylsökande och nyanlända som utvecklat någon form av psykisk ohälsa.

    • Två insatsområden som återkommer frekvent i länen är arbetet med suicidprevention och arbetet med att erbjuda dem som får stöd från de båda huvudmännen en samordnad individuell plan (SIP) samt att utveckla formerna för SIP.

    • I handlingsplanerna finns en ansats att främja den psykiska folkhälsan i länen. Detta sker parallellt med att insatser riktas till riskgrupper och grupper där psykisk ohälsa redan utvecklats. Detta innebär att kommuner och landsting tagit emot de nationella styrsignalerna, och fortsatt vidga sitt fokus från PRIO-satsningen till att omfatta folkhälsoperspektivet inom området psykisk hälsa. Dock sker detta endast i mindre utsträckning för grupperna vuxna och äldre personer.

    Avslutningsvis ges exempel på några aspekter utifrån vilka ”en lyckad plan” kan förstås. En lyckad plan kännetecknas av ett tydligt ägarskap, systematisk analys, realistiska mål och ett val av tydliga aktiviteter som kan implementeras och följas upp. Vi ger även tre rekommendationer till länen i det fortsatta arbetet med att formulera länsgemensamma handlingsplaner: 1, att skriva planerna för sin egen skull 2, att öka genomförbarheten i planerna genom aktiva prioriteringar mellan de breda och olikartade målsättningar som staten lanserat 3, att ta frågan om ansvar för planerna på allvar genom att klargöra vem eller vilka som ansvarar för handlingsplanen och dess implementering.

  • 7. Grim, Katarina
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Schön, Ulla-Karin
    Development- and usability testing of a web-based decision support for users and health professionals in psychiatric services2017Ingår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, nr 3, s. 293-302Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.

  • 8. Grim, Katarina
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Schön, Ulla-Karin
    Shared decision-making in mental health care: a user perspective on decisional needs in community-based services2016Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikel-id 30563Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

    Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

    Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

    Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

    Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system. 

  • 9. Grim, Katarina
    et al.
    Tistad, Malin
    Schön, Ulla-Karin
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The Legitimacy of User Knowledge in Decision-Making Processes in Mental Health Care: An Analysis of Epistemic Injustice2019Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, Vol. 6, s. 157-173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The experience-based knowledge of users is considered to provide vital input in shared decision making (SDM). However, mental health service users frequently express having negative experiences from meetings with providers, which are of an epistemic nature (e.g., being ignored or not regarded as credible). This study aimed to explore the barriers involved in legitimizing user knowledge in decision-making processes. Interview data from service users and providers were viewed from a theoretic framework of epistemic injustice. Abductive content analysis was conducted on data collected during a project to develop and implement SDM in mental health services. In describing obstacles to legitimize user knowledge, service users highlighted relational issues: being dependent, often dismissed and choosing to edit their testimonies. Service providers typically described workflow issues, users’ insufficient decision- making competence and users’ vulnerability to stress factors. The findings suggest that greater epistemic justice might be achieved by a SDM process in which the service user is engaged as a full partner in collaboration in various activities related to their care.

  • 10. Heatherington, Laurie
    et al.
    Bonner, Bryan L.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Patterson, Robert D.
    Linsley, Jane
    Sustaining outcomes research in residential treatment: a 15-year study of the Gould Farm program2019Ingår i: Psychological services, ISSN 1541-1559, Vol. 6, nr 4, s. 675-686Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We present findings from a study of outcomes of residential treatment for people who have mental illness, primarily schizophrenia-spectrum and bipolar disorders. The study assesses a range of individual variables before and after participation in the program, to examine clinical and personal recovery and facilitate program improvement. To our knowledge, it is the longest ongoing outcomes study (15+ years) of its kind. The program, Gould Farm, provides recovery-focused, milieu treatment on a 700-acre working farm. It integrates counseling and medication with a work program that provides opportunities for the development of daily living, social, and work skills as well as mental and physical health. Clients were interviewed in person at intake and at discharge. Also, since study year 10 when the follow-up arm began, former clients were interviewed at 6, 18, and 36 months postdischarge via phone. Interview protocols included standard measures of psychiatric symptoms and functioning, substance use, quality of life, and treatment satisfaction. Follow-up interview protocols also assessed individuals’ living, working, family, and social situations as well as their satisfaction in these areas of recovery. Statistically significant improvements on all measures were found at discharge, and were not moderated by key demographic or clinical factors. Preliminary follow-up data showed maintenance of treatment gains, and high treatment satisfaction. We discuss clinical implications of the findings as well as limitations, directions for future research, and recommendations for sustaining outcomes research in organized care settings.

  • 11. Hillborg, Helene
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Ett förtroendeuppdrag: Kartläggning av hinder och framgångsfaktorer för brukarråd och brukarinflytande inom missbruks- och beroendevården2012Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Brukarmedverkan nämns ofta som en grundläggandedel i en kunskapsbaserad praktik. SKL har inom ramen för projektet ”Kunskap till Praktik” satsat på att utveckla brukarråd inom missbruk-och beroendevård som en metod för att öka brukarinflytande. Rapporten som presenterats här är en del i projektet. Syftet var att kartlägga och beskriva hinder och framgångsfaktorer som kan göraskillnaden mellan passiv brukarmedverkan och ett riktigt inflytande på kollektiv nivå. Studienbestårav en enkätundersökning, ett antal intervjuer och enkunskapsöversikt. Enkäten riktade sig till brukarrådsmedlemmar och myndighetsrepresentanter i fem utvalda län som har ingått i SKLs projekt. Intervjuer har utförts med nyckelaktörer i dessa råd. Resultaten visade att de hinder och framgångfaktorer som brukarrådsmedlemmar och myndighetsrepresentanter beskrev stämde överens med varandra och med den internationella litteraturen. Både brukare och professionella har i litteraturen och i studien lyft fram faktorer kopplade till maktrelationer, förankring, resurser, delaktighet och långsiktighet. Ofta anges dessa hinder både som hindrande och möjliggörande beroende på hur omständigheterna serut. Kunskapsöversikten och vår undersökninghar också enhälligt beskrivit brukarinflytande på kollektiv nivå som en positivoch värdefull del i verksamhets-och systemutveckling. Hinder finns, men presenterades som problem som kunde lösas. Den litteratur som vi funnit fokuserar framförallt på processer för att öka brukarinflytande. En viktig utmaning för framtidenär nu att utveckla studier som fokuserar på brukarråds inflytande och de effekter som detta ger i missbruks-och beroendevården.

  • 12. Jakobsson Lund, Anna
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    En handbok om brukarrevision: Kvalitetsutveckling genom egen erfarenhet av psykiska funktionshinder2008Rapport (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Som en del av Nationell Psykiatrisamordnings projekt om brukarinflytande; Inflytandeprojektet, genomfördes under 2005 och 2006 försöksverksamhet med brukarrevisioner. Brukarrevision innebär att personer som har egen erfarenhet av psykiska funktionshinder granskar verksamheter som ger stöd åt personer med psykiska funktionshinder.

    Denna bok kan ses som en introduktion till brukarrevisioner som verktyg. Den beskriver orsaker att använda brukarrevision och ger praktiska råd om hur brukarrevisioner kan genomföras. Grunden för handboken är de erfarenheter som gjorts av fyra brukarrevisionsgrupper från 2005 till idag.

  • 13. Lindqvist, Rafael
    et al.
    Bengtsson, Steen
    Fredén, Lars
    Larsen, Frode
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Ruud, Torleif
    Wahlbeck, Kristian
    Från reformintention till praxis: hur reformer inom psykiatri och socialtjänst översatts till konkret stöd i Norden2011Rapport (Övrigt vetenskapligt)
  • 14.
    Lindqvist, Rafael
    et al.
    Sociologioska institutionen, Uppsala Universitet.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Psykiska funktionshinder i samhället2010 (uppl. 1)Bok (Övrigt vetenskapligt)
  • 15.
    Lövgren, Veronica
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hillborg, Helene
    Bejerholm, Ulrika
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Supported Education in a Swedish Context: Opportunities and Challenges for Developing Career-Oriented Support for Young Adults with Mental Health Problems2020Ingår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 22, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 16.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    A working life on the horizon: Supported education for young adults with mental health problems in Sweden2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    A working life on the horizon - Supported education for young adults with mental health problems in Sweden

     

     

    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.

     

     

    David Rosenberg PhD – Umeå University; David.rosenberg@umu.se

    Helene Hillborg PhD  - Landstinget Västernorrland

    Veronica Lövgren PhD – Umeå University

    Ulrika Bejerholm Professor – Lund University

  • 17.
    Rosenberg, David
    Gould Farm, Monterey, CA USA.
    It also takes a village: developing community mental health2002Ingår i: International Social Work, ISSN 0020-8728, E-ISSN 1461-7234, Vol. 45, nr 3, s. 305-314Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The community mental health philosophy which guides the development of the limited resources available in Africa, is one that offers us in the developed world much to consider, as we continue to struggle with issues of community integration for those experiencing psychiatric illness. Interviews with practitioners and policy-makers in Ghana, West Africa, as well as a review of local projects and publications, comprise an attempt to describe and contrast our various approaches.

  • 18.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Obstacles and possibilities for implementing SDM in Swedish mental health services: Supporting interactivity and participation2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Obstacles and possibilities for implementing SDM in Swedish mental health services; Supporting interactivity and participation.

    Main author: David Rosenberg, Associate Professor, Department of Social Work, Umeå University, Sweden

    Co authors: Katarina Grim, Ulla-Karin Schön & Petra Svedberg

     

    Introduction Despite Swedish health care policy, which emphasizes patient participation in the planning of health care services, few programs have concrete methods for achieving this goal. Previous studies have shown that staff attitudes and systems which maintain power differentials, create obstacles for achieving participation despite methods such as SDM.

    The purpose of the study was to explore implementing SDM with an interactive digital decision tool, designed for users in community mental health services in Sweden. The tool was specifically developed, in collaborative research with users, to overcome disempowering experiences as they attempt to participate in treatment decisions.

    Method

    A process evaluation design (Moore et al. 2015) was utilized in order to investigate obstacles and possibilities for a structured intervention to facilitate participation in decision making. The design utilized in the study included collecting qualitative and quantitative data focused on three identified evaluation components; Context, Implementation and Mechanism of impact.

    Results Staff considered that SDM was most appropriate for formal treatment planning and that the use of the digital decision tool, which enabled interactive communication between staff and users, did support the user to be prepared for decisions, as well as helping staff to stay focused on user wishes.

    SDM was most often used voluntarily by each staff member, based on their experience and attitude, rather than a common practice for the service. Another barrier concerned capacity, with staff sometimes feeling they did not have formal power regarding treatment planning decisions, and expressing doubt as to the patient's willingness and ability to participate in decisions.

    Discussion

    The results suggest that contextual barriers to implementing shared decision making can be addressed by utilizing interactive decision tools which concretely structure the interaction between users and staff and are connected to formally required treatment planning processes that are essential for user participation.

    Key words: Implementation, participation, Shared Decision making Preferred conference theme: 1. Recovery for different groups

    Oral presentation

  • 19.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Psychiatric disability in the community: Surveying the social landscape in the post-deinstitutional era2009Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    This dissertation presents a discussion of life in the community for people experiencing psychiatric disabilities in the post-deinstitutional era, with the goal of developing knowledge that can suggest a focus for planning more relevant services and supports. While evaluations of deinsitutionalization have focused on possibilities for providing community, rather than hospital-based services for these individuals, the intention was to support a participatory life in the community, a life defined by much more than just care and treatment. The Mental Health Care Reform of 1995 in Sweden paved the way for this more community-based view of needs related to psychiatric disabilities, as local social services became responsible for supports to a participatory life, “like all others”.  The general aim of this dissertation was to explore and analyze the results of a series of surveys of psychiatric disability, in order to develop knowledge of the social context of the lives which individuals experiencing these disabilities live in the community. More specifically, the aim was to;

    • describe contacts/interactions between these individuals and the societal organisations with which they seek services or support.

    • describe characteristics and needs of the individuals identified in these studies as expressed by representatives of the helping system and users who participated in the studies.

    • develop knowledge of the mechanisms involved in these patterns of seeking support by exploring and analyzing the empirical results within the context of theoretical (social) approaches to understanding psychiatric disability.

    The findings of this research are based on an analysis of the quantitative and qualitative results of three studies involving seven municipalities in northern Sweden. Of the 2385 individuals who personnel identified as meeting the criteria for a serious psychiatric disability, approximately half did not have active contact with the formal mental health system. They did however seek services, supports and opportunities that they saw as relevant to their lives and needs as community members. These included health, housing and financial assistance as well as opportunities for education and employment. Various mechanisms operating in the community, including stigmatizing attitudes, exclusionary practices and organizational systems and rules, were seen by respondents as obstacles to these individuals developing meaningful and participatory roles.

    Social approaches, when utilized to explore and understand issues regarding psychiatric disability in the community, support a focus on the social landscape in which ndividuals experience disability-related needs, as well as the dynamics of the disability experience. While in the deinstitutional era, needs were assessed relative to the individual’s relationship to the psychiatric care system, in the post-deinstitutional era, they should be assessed from a participation-relative perspective, where their position as community member, rather than as patient or client, describes the social location of need. Specialized support to general community resources and services in addition to psychiatrically defined supports, would likely reach many, especially younger individuals who might otherwise become seriously disabled.

  • 20.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The effects of peer support workers on psychiatric environments: Recovery orientation as outcome2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    While an increasing number of studies point to the positive effects of peer support workers in mental health services, there is a continuing call for research that targets individual outcomes which can be measured and provide evidence for the effectiveness of this method. Individually oriented outcomes tied to specific interventions, such as those called for in the Swedish national guidelines for mental health services, may not however capture the broader effects of hiring individuals with lived experience in traditional psychiatric services.

    Method

    An interview study of users who had contact with peer support workers in five Swedish psychiatric outpatient services was completed as part of a broader study that also targeted staff and program managers. This study occurred at the same time that the new national guidelines in Sweden were being developed, based on an international review of evidence, with peer support being considered as an intervention.

    Results

    While the interviewed users confirmed many of the outcomes that had been reviewed in the international literature regarding hopefulness, strategies for recovery, trust and mutuality, they also described their perception of the environmental implications of employing these workers. They describe the peer support workers as mediating the distance between patient and staff, as creating a more equal standing on the units, and as

    40

    confirming that the professionals believe in recovery and can therefore be trusted.

    Discussion

    These findings suggest that the outcomes of peer support are not solely individual and significantly contribute to the development of recovery-oriented services with wide-ranging benefits. These results will be discussed in relation to the development of the national guidelines and other evidence-based recommendations, which are challenged by innovations which influence the social context of care.

  • 21.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Argentzell, Elisabeth
    Service users experience of peer support in Swedish mental health care: a "tipping point" in the care-giving culture?2018Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, Vol. 5, nr 1, s. 53-61Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Service Users Experience of Peer Support in SwedishMental Health Care: A ‘‘Tipping Point’’ in the Care-GivingCulture?David Rosenberg.Elisabeth ArgentzellReceived: 21 November 2017 / Accepted: 27 January 2018The Author(s) 2018AbstractPeer support workers are increasinglyconsidered an essential ingredient in recovery-ori-ented mental health services. While research continuesto point to promising results concerning the ability ofthese workers to positively impact service users’experience of hope, quality of life and even health,peer support workers have only recently been intro-duced in Sweden and the aim of this study was toinvestigate service users’ experience of receiving peersupport in Swedish mental health services. The resultswere described with three main themes correspondingto three levels of focus from the service user perspec-tive; experience-based knowledge, competence andnon-judgmental awareness (individual level), peersupport as impacting the relationship with the caringenvironment (organizational level), and awakeninghope for a life beyond the illness (community level).The results suggest the addition of peer supportworkers as contributing not just to individual out-comes, but to a more trusting relationship to Swedishpsychiatric services, which are often considered towork primarily from a medically oriented treatmentparadigm.

  • 22.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Ershammar, DavidBogarve, Camilla
    Rehabilitering och stöd till återhämtning vid psykiska funktionshinder: Möjlighetens metoder för en ny praktik2012Samlingsverk (redaktörskap) (Övrig (populärvetenskap, debatt, mm))
  • 23.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hillborg, Helene
    Systematizing knowledge of user influence: A study of user advisory boards in substance abuse and mental health services2016Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 50, nr 3, s. 336-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    While there is a great deal of interest in, and literature describing user influence in mental health and substance abuse services at the individual level, there are fewer studies of collective user influence at the organizational level. This article presents the findings of a study of the development of user advisory councils in regional organizations providing substance abuse services, which were part of a national implementation project in Sweden. A survey of both users and professionals involved in the local projects, in addition to interviews with key actors at the national level, were completed and analyzed with reference to the results of a literature review. The overall aim of the study was to identify obstacles and success factors related to the development of collective user influence at the programme and system levels. The results indicated that there was an overwhelmingly positive attitude towards experience-based knowledge and the potential for developing formal, collective user influence in these organizations. Users and professionals had common viewpoints regarding the obstacles and success factors, which included: addressing power relations, establishing legitimacy, assigning resources, investing in sustainability and planning for real participation. They were also substantially in agreement as to the strategies that would be needed in the future in order to move from ideology to action. These factors form the basis for a model that might be used to support the systematic implementation of this type of organized user influence.

  • 24.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lindqvist, Rafael
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Rehabilitering för personer med psykiska funktionshinder2004Ingår i: Rehabilitering och välfärdspolitik / [ed] Rafael Lindqvist och Antoinette Hetzler, Lund: Studentlitteratur, 2004, s. 149-184Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 25.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lindqvist, Rafael
    Uppsala Universitet.
    Fredén, Lars
    Högskolan Väst.
    Den svenska psykiatrireformen i nordisk belysning2011Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 88, nr 6, s. 524-533Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    I artikeln diskuteras den svenska psykiatrireformen i ett nordiskt perspektiv när det gäller vård, stöd och service till personer med psykisk funktionsnedsättning. Det finns många likheter mellan de nordiska länderna i fråga om servicesystemens utformning och arbetsformer. Den svenska reformen kännetecknas, i jämförelse med Opptrappingsplanen Norge, av att förändringarna varit ”sektorsinriktade”. Många framgångsrika men kortsiktiga utvecklingsprojekt har genomförts lokalt, men stödinsatserna har inte betraktats ur ett helhetsperspektiv (systemperspektiv) och fått nationellt genomslag. Det har i Sverige inte heller utvecklats mellanvårdsformer i samma utsträckning som i flera andra nordiska länder. Två områden som i Sverige framstår som väl utvecklade är boendestöd och personliga ombud. Artikelns slutsats är att ett systemperspektiv behöver utvecklas där pusselbitar från  ett fragmentiserat servicesystem bidrar till en helhetssyn på individens behov av samhällsbaserad vård och stöd.

  • 26.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lindqvist, Rafael
    Department of Social Work, Gothenburg University.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The social location of need – surveying psychiatric disability in the community2009Ingår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 11, nr 1, s. 1-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The majority of studies related to the needs of individuals with psychiatric disabilities focus on their meeting with, and use of, the traditional mental health system. Environmentally relative conceptions of disability have only shown limited success in expanding the views of the field of community psychiatry to include social and organizational contexts. Swedish disability policy emphasizes the individual's ability to participate in community life and may therefore be said to reflect a social approach to disability, in contrast to an exclusively medical perspective that focuses on deficits and the individual's need for psychiatrically defined services. In this study, inventories of need for people with psychiatric disabilities, a legislated responsibility of the social service system in Sweden, were completed for three municipalities. Results indicated that these individuals resist psychiatrically defined categories as they seek supports based on their own experience of need in the community.

  • 27.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Markström, Urban
    Lindqvist, Rafael
    Transcending the care paradigm: Developing participation-related services in the community2012Ingår i: Refocus on Recovery 2012 conference, 2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    Despite the ideological direction described in Swedish legislation, which emphasizes rehabilitation and the right to participation in community life “as all others”, the development of recovery oriented services has been sluggish. The authors question whether the comprehensive welfare system, which includes many potential supports to the recovery process, might begin to redefine the service structures and professional cultures which frame the experience of individuals seeking support. Methods

    A recently completed national research project included a series of surveys of community-based need related to serious psychiatric impairment, interviews with municipal service providers and documentation studies. The surveys included non-traditional, generic services and supports, in order to collect data from a broader population than those exclusively in contact with formal mental health services. The overall aim of the study was to investigate the meeting between individuals experiencing serious psychiatric impairments and welfare system structures, including but not limited to, community- based mental health services.

    Results

    Up to 50% of those identified in the surveys avoided contact with formal mental health services. They instead, in many cases, utilized generic community services in order to satisfy their self-defined need for support to participate more actively in community life. Jobs, studies, social contacts and other natural community involvements were not seen as being supported by the mental health system, which tended to categorize need based on a medically-based care paradigm. A lack of rehabilitation and recovery-oriented services was also experienced by the majority of active clients.

    Discussion

    Knowledge of recovery may be utilized to analyze and explain the manner in which individuals negotiate their contact with traditional mental health services. The research studies presented here describe areas of need related to participation in community life and possibilities for recovery that service systems working from a care paradigm are not currently prepared to address. 

  • 28.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lindqvist, Rafael
    Sociologiska institutionen, Uppsala universitet.
    Öppna dörrarna - möjligheter till ett liv i samhället2012Ingår i: Rehabilitering och stöd till återhämtning vid psykiska funktionshinder: Möjlighetens metoder för en ny praktik / [ed] Camilla Bogarve, David Ershammar, David Rosenberg, Stockholm: Gothia Förlag AB, 2012, s. 42-63Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 29.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Högskolan Dalarna.
    Ett återhämtningsorienterat arbetssätt i Jönköpings län: erfarenher från ett uppföljningsarbete2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Under de senaste åren har forskning om återhämtning från psykisk ohälsa resulterat i ny kunskap som fått relevans för såväl socialtjänstens som psykiatrins verksamhetsfält. Allt fler verksamheter som ger stöd och vård till människor med psykisk ohälsa syftar att bli mer återhämtningsinriktade. Det innebär att verksamheter fokuserar mer på insatser som främjar individens önskemål och delaktighet, och mindre på omsorgsinriktade insatser som främst fokuserar på symtom eller funktionsnedsättning. De brukare som beskriver sin återhämtning lyfter fram delaktighet, hopp för framtiden, meningsfullhet och egenmakt som centrala i den individuella återhämtningsprocessen. Det utbildningsarbete som sedan 2010 har bedrivits i Jönköpings län kring ett återhämtningsinriktat arbetssätt, dialogutbildningar, resurspersoner och återhämtningsombud, ligger i linje med nationell och internationell forskning och utveckling. Syftet med dessa utbildningar har varit att utveckla värderingar och attityder i socialtjänst och psykiatri för att främja brukares återhämtning samt att omvandla återhämtningsperspektivet till konkreta arbetssätt. Under hösten 2013 kontaktades författarna till denna rapport av representanter från Regionförbundet i Jönköping för en diskussion om hur ett återhämtningsperspektiv kan omvandlas till konkreta arbetssätt. Återhämtningsombud hade utbildats och varit aktiva i de dialogutbildningar som genomförts. Man ville nu genomföra ett utvärderingsarbete av dialogutbildningarna för att undersöka vilken betydelse de hade på personalens förhållningssätt och bemötande, samt studera om det hade haft någon betydelse på brukarnas upplevelser av de insatser de får från psykiatri och socialtjänst. Föreliggande rapport är ett resultat av det utvärderingsarbetet.

  • 30.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Återhämtning: från idé till praktik2014Ingår i: Att leva med psykisk funktionsnedsättning: livssituation och effektiva vård- och stödinsatser / [ed] David Brunt och Lars Hansson, Lund: Studentlitteratur, 2014, 2, s. 355-374Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 31.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Nyholm, Maria
    Grimm, Katarina
    Svedberg, Petra
    Shared decision making in Swedish community mental health services: an evaluation of three self-reporting instruments2017Ingår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 26, nr 2, s. 142-149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers. Aim: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context. Method: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity. Results: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden. Conclusions: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

  • 32.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Svedberg, Petra
    Establishing a Recovery Orientation in Swedish Mental Health Services: From attitudes to instruments.2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction: Although there has been an emphasis on developing knowledge of recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Educational initiatives focused primarily on changing attitudes have not produced concrete outcomes. Instruments that define the components of recovery as measurable dimensions of change may provide a framework for implementing recovery-oriented services.

     

    Aims: The aim of this study was to investigate whether the use of instruments which measure a recovery orientation in services could provide program level outcome indicators, that could point to concrete needs for change. An additional aim was to study the contribution of peer support workers to this process.

     

    Methods: Two internationally tested and validated instruments were distributed to 85 clients from 6 community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. These focused respectively on the recovery orientation of services (RSA) and the recovery orientation of relationships with the primary contact person (Inspire). An additional instrument (RKI) was distributed to all staff at these clinics to assess their knowledge of recovery paradigms.  Peer support workers participated in the translation, administration and reporting of results.  

     

    Results: The instruments were translated to Swedish, tested and found to have acceptable psychometric properties. The reports produced from these instruments highlighted specific areas for improvement which these user assessments had indicated. These included for example; opportunities to influence services and care plans, to receive support for activities outside of psychiatry, to have their strengths included in assessments and to have more access to experience-based knowledge. The peer support workers provided valuable support to the process and were additionally seen by the clinic staff as a valuable resource in future work.  

     

    Conclusions: Instruments which measure a recovery orientation in mental health services can contribute to a focus on specific knowledge, attitudinal and skill gaps that service organisations can target in their quality development activities.  In the present study, staff were more accepting of this feedback since it came directly from their clients and was collected and presented systematically

  • 33.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Skoog, Viktoria
    FoU Västernorrland.
    Gardemyr, Birgitta
    FoU Västernorrland.
    Barns brukarmedverkan i den sociala barnavården: Västernorrlands modell för att göra barnens röster hörda2012Rapport (Övrigt vetenskapligt)
  • 34.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Halmstad University.
    Schön, Ulla-Karin
    Dalarna University.
    Establishing a Recovery Orientation in Mental Health Services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish Context2015Ingår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 38, nr 4, s. 328-335Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context. Methods: The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results. Results: The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study. Conclusions and Implications for Practice: Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden.

  • 35.
    Rosenberg, David
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Schön, Ulla-Karin
    Sandlund, Mikael
    Dahlqvist Jönsson, Patrik
    Shared decision-making in mental health services: Users experiences of participation in decisions2014Ingår i: Jubilee Congress 50 years WASP World Association of Social Psychiatry, London, November 13-15, 2014., 2014, 2014Konferensbidrag (Refereegranskat)
  • 36. Schön, Ulla-Karin
    et al.
    Grim, Katarina
    Wallin, Lars
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study2018Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, nr 1, artikel-id 1421352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.

    Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.

    Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.

    Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

  • 37.
    Schön, Ulla-Karin
    et al.
    Dalarna Högskola.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Transplanting recovery: research and practice in the Nordic countries2013Ingår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, nr 6, s. 563-569Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of recovery orientation within other cultures and mental health systems is still limited. 

    Aim: The aim of this study was to compile, describe and discuss the research on personal recovery and recovery-oriented practice within the psychiatric and social fields in the Nordic countries. 

    Method: A systematic literature review of Nordic research on recovery from mental illness. 

    Results: The research literature is limited, and primarily replicates designs and confirms findings first presented in studies conducted in the USA and Great Britain. The majority of the studies are qualitative, and point to the importance of social relations, environmental factors and peer support. 

    Conclusions: There is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery-oriented health system.

  • 38.
    Schön, Ulla-Karin
    et al.
    Högskolan Dalarna.
    Svedberg, Petra
    Halmstad Universitet.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context2015Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, nr 4, s. 275-281Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Recovery is understood to be an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardized measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff. Aim: The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services and in order to promote recovery in mental illness. Method: The sample consisted of 85 participants from six community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation, 78 participants completed the questionnaire 2 weeks later. Results: The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability. Conclusions: While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden.

  • 39.
    Winberg, Kerstin
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Bertilsdotter Rosqvist, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Inclusive spaces in post-secondary education: exploring the experience of educational supports for people with a neuropsychiatric disability2019Ingår i: International Journal of Inclusive Education, ISSN 1360-3116, E-ISSN 1464-5173, nr 12, s. 1263-1276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to investigate the experiences of studying among people with a neuropsychiatric disability who received support from a Supported Education (SEd) programme, and people who did not receive this support. The research employed a narrative approach, where 14 participants with a neuropsychiatric diagnosis were asked to write a short reflective narrative about their experience of studying, with/without support from a SEd intervention. The results show that the persons without support from the model relied on their family as their primary support, and that support from formal support providers was not available prior to receiving a formal diagnosis. Those who received services from SEd were generally satisfied with the support they received, and did not emphasise the family as support givers in the same way. The study points to the importance of developing neurodiverse spaces, which can serve as transitional environments and that can help supported education models adapt to the needs of this group.

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