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  • 1.
    Grim, Katarina
    et al.
    Department for Psychological and Social Studies, Social Work, Karlstad University, Karlstad, Sweden.
    Bergmark, Magnus
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Argentzell, Elisabeth
    Department of Health Sciences, The Mental Health, Activity and Participation (MAP) Group, Lund University, Lund, Sweden.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Managing Peer Support Workers in Swedish Mental Health Services: A Leadership Perspective on Implementation and Sustainability2023Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 10, s. 313-329Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Even though it has been demonstrated that peer support contributes to positive outcomes for service users, organizational implementation issues remain. The aim of the current study was to examine an implementation of peer support from the perspective of managers in order to develop knowledge of factors influencing sustainability of this initiative. Eighteen managers were interviewed in connection with the introduction of peer support in sixteen mental health settings. Interviews were analyzed utilizing inductive and deductive approaches. The results suggested that managers were predominantly positive in their evaluation of peer support as a recovery-oriented addition to their services, but noted developmental issues regarding role, professional identity, supervision and financing in relation to other traditional personnel. The involvement of the user movement, especially with regard to training and supervision helped prepare staff and support peer workers, yet there was some apprehension attached to the critical scrutiny that this `outsider’ perspective might imply. The results confirm previously noted uncertainties regarding peer support as an integrated component of mental health systems and illuminate a number of culturally conditioned challenges that may hamper peer support from being implemented with the same approach as other interventions. In response, the present study suggests a number of focus areas that should be attended to in future implementation efforts, including issues related to staff roles, power dynamics, connection to the user movement and reconsideration of the value of experience-based knowledge. In the Swedish context, a government level commitment was identified as critical to ensure stable funding.

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  • 2. 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, E-ISSN 2198-963X, 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.

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  • 3.
    Hillborg, Helene
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Health Sciences/Centre for Evidence Based Psychosocial Interventions (CEPI), Medical Faculty, Lund University, Lund, Sweden; Region Va¨sternorrland, Research and Development Unit, Sundsvall Hospital, Sundsvall, Sweden.
    Lövgren, Veronica
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Health Sciences/Centre for Evidence Based Psychosocial Interventions (CEPI), Medical Faculty, Lund University, Lund, Sweden.
    Bejerholm, Ulrika
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Health Sciences/Centre for Evidence Based Psychosocial Interventions (CEPI), Medical Faculty, Lund University, Lund, Sweden.
    Integrating Interventions That Can Support a Career-Oriented Recovery for Young Adults: Building on the Supported Education Knowledge Base2021Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 8, nr 1, s. 35-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 4.
    Liljeholm, Ulrika
    et al.
    Department of Health Sciences/Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Argentzell, Elisabeth
    Department of Health Sciences/Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Hillborg, Helene
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Lövgren, Veronica
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Bejerholm, Ulrika
    Department of Health Sciences/Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    The Journey to My Student Identity: A Grounded Theory Study on Supported Education for Young Adults with Mental Health Problems2022Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, s. 203-219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 5.
    Liljeholm, Ulrika
    et al.
    Department of Health Sciences, Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden; Department of Research, Development and Education, Region Skåne, Lund, Sweden.
    Hillborg, Helene
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Research, Development and Education, Region Skåne, Lund, Sweden.
    Argentzell, Elisabeth
    Department of Health Sciences, Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    Lövgren, Veronica
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Research, Development and Education, Region Skåne, Lund, Sweden.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Department of Research, Development and Education, Region Skåne, Lund, Sweden.
    Bejerholm, Ulrika
    Department of Health Sciences, Mental Health, Activity and Participation, Lund University, P.O. Box 157, Lund, Sweden; Centre for Evidence-Based Psychosocial Interventions, Lund University, Lund, Sweden.
    The process of supporting careers for young adults with mental health problems: case study of a supported education program2023Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 6.
    Näslund, Hilda
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Grim, Katarina
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    User-focused monitoring as a strategy for involvement and mental health service development: an analysis of Swedish monitoring reports2022Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 9, nr 3, s. 303-316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    User-focused monitoring (UFM) is a method of evaluating mental health services, conducted by people with lived experience of mental ill health. Research on UFM and on user involvement focused on service monitoring and evaluation is lacking. This study addresses this knowledge gap by examining UFM as a strategy for user involvement. More specifically, this study aims to synthesize patterns in UFM reports to characterize the phenomenon, as well as to further discuss negotiation processes and political opportunities in UFM. The empirical material consists of 136 Swedish UFM reports that have been analyzed in two steps: All reports were mapped according to general characteristics and a sample of 20 reports were selected to provide additional information on the method. This study has been conducted in collaboration with actors representing the user movement and municipality-based mental health services. Our analysis shows that long-term contracts between user organizations and service providers are important to create a sustainable implementation of UFM. However, strategies to protect user autonomy must be carefully considered and employed in relation to such collaborations. We further highlight the risks of a restricted focus on consumer satisfaction, and discuss the current development towards including follow-ups in the UFM process as a strategy for counteracting tokenism.

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  • 7.
    Näslund, Hilda
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Grim, Katarina
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    User-Led Mental Health Service Evaluation: The Contribution of User-Focused Monitoring to Recovery-Oriented Quality Development2023Ingår i: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 10, s. 189-202Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    User-focused monitoring (UFM) is a method of user-led mental health service evaluation that focuses on strengthening user involvement and developing the quality of services. Despite an increased emphasis on user involvement and the recovery orientation of services, scientific knowledge remains limited regarding how such goals can be realised. In this study, our aim is to explore UFM with a specific focus on how recovery processes are examined through the method in order to discuss how UFM can be developed in order to support a recovery orientation in mental health service evaluation. We sampled 20 Swedish UFM reports for qualitative analysis, and we found that UFM is a promising method for integrating a personal recovery perspective in service evaluations. By being performed peer-to-peer, the method has the unique ability to gather experiential knowledge regarding the situation of service users. UFM especially contributes to exploring service users' experiences related to social connectedness and user involvement in services. We also discuss how the method can be developed to further support a recovery orientation in UFM. This might be achieved by integrating a process-oriented approach in the evaluations and by including the user informants' own goals and views on what constitutes meaningful support in UFM. Suggestions for future developments concern incorporating personal recovery perspectives in the training of user monitors and creating structures for aggregating the knowledge produced through UFM. 

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  • 8.
    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, E-ISSN 2198-963X, 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.

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