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  • 1.
    Bergmark, Magnus
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Bejerholm, Ulrika
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Critical Components in Implementing Evidence-based Practice: A Multiple Case Study of Individual Placement and Support for People with Psychiatric Disabilities2018Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 52, nr 3, s. 790-808Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When developing Community Mental Health Services to support people with psychiatric disabilities, European countries are advocating evidence-based practice (EBP). Individual Placement and Support (IPS) is an evidence-based model designed to support people in acquiring and maintaining competitive employment. Implementation science is a growing research field, with a focus on components that impact the process of implementing EBP programmes. In this multiple case study, we have followed three IPS demonstration sites for two years, in order to describe and analyze barriers and facilitators for implementation, according to constructs described in the Consolidated Framework for Implementation Research (Damschroder et al. 2009). The results highlight the importance of strategic networking, as well as the need for planning and preparations carried out before the start of an EBP programme, since deficiencies related to these constructs are difficult to compensate for.

  • 2.
    Bergmark, Magnus
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Bejerholm, Ulrika
    Lunds universitet, Institutionen för hälsovetenskaper..
    Markström, Urban
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years2017Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 51, nr 1, s. 95-113Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The deinstitutionalization of mental health care has changed the responsibilities of involved authoritiesand has led to a continuous need for new treatment forms and interventions. This articledescribes this development in Europe, and in particular how these new conditions have been handledin Sweden over the past 20 years at the level of governmental policy-making. Three major policydocuments from 1994, 2009 and 2012 were included in this study. To increase our understandingof the policies’ contents, we have used theoretical concepts concerning governance,implementation and political risk management. Although our main interest was to find out howthe government handles interventions for users of the mental health care system, we found that thepolicy work is progressing stepwise. The first document, from the deinstitutionalization era, did notdiscuss interventions clearly. Instead, it was mainly concerned with both practical and economicalareas of responsibility. The second document, from the post-deinstitutionalization era, was morefocused on what services should be delivered to the users, while the most recently published documentto a greater extent addressed the question of how the support is supposed to be designed. The trendin European community mental health policy has been to advocate services in open forms that areintegrated into the society’s other care systems. This is also the case in Sweden, and continuous workis being done by the government to find strategies to support the development, and to meet the needs atboth political and local levels.

  • 3.
    Edlund, Jonas
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Johansson Sevä, Ingemar
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Is Sweden Being Torn Apart? Privatization and Old and New Patterns of Welfare State Support2013Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 47, nr 5, s. 542-564Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article examines the potential impact of institutional change on popular welfare support. The encompassing welfare state of Sweden provides an interesting case where the privatization of socialservice delivery has been widespread over the last decades. We use survey data from five rounds of the Swedish Welfare State Survey (1992, 1997, 2002, 2006 and 2010) in order to study how public preferences for the financing and organization of welfare services have changed over time. Based on a theory describing an ideal-typical pattern of public support for an encompassing welfare model, we derive three types of public preferences: support for a pure state model, a pure market model and a mixed model (welfare services are funded by taxes but provided by private firms). We begin by tracking the development of these ideal-typical attitude patterns between 1992 and 2010. We then investigate how preference patterns vary across municipalities displaying different degrees of privatization of social service delivery. Our results show that welfare support among Swedes over the last decades is better characterized as dynamic rather than stable. Swedes seem to take an overall more ideologically based position on the role of the welfare state over time. The share of respondents expressing such ideologically based preferences has increased from 54 per cent in 1992 to 78 per cent in 2010. This change is principally manifested in increased support for the state and mixed models. This trend seems to be parallel to the increasing share of private welfare service providers over the last decade. We also find a link between the municipal degree of privatization and support for ourthree ideal-typical welfare models. Public support for a mixed welfare model and, to some extent, a market model, is comparatively stronger in municipalities where welfare services to a large extent are carried out by private actors. Conversely, data shows that public support for the traditional Swedish state model is more widespread in municipalities having a low degree of welfare services privatization. Lastly, we discuss some theoretical implications of our findings.

  • 4.
    Hardell, Sanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Johansson Sevä, Ingemar
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Öun, Ida
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Welfare service privatization and opinions about service quality: The role of political ideology among local politicians and the public2020Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 54, nr 1, s. 45-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this article, we join the discussion about the potential consequences of welfare service privatization by examining the relationship between the privatization of welfare service delivery and public opinion about service quality in Sweden. Due to the politically polarized debate about welfare service privatization in Sweden, we also examine the extent to which individuals' ideological orientations influence this relationship in both local politicians and ordinary citizens. For local politicians, the results show that a higher municipal degree of privatization is generally associated with slightly lower levels of satisfaction overall with welfare services, although no such relationship exists for the public. Most importantly, however, the results indicate that political ideology constitutes an important moderator in the relationship between privatization and opinions about service quality. Local politicians and, to some extent, ordinary citizens who place themselves to the left on the ideological left–right scale tend to be less satisfied with services as the municipal degree of welfare service privatization increases. For local politicians who position themselves far to the right on the scale, the relationship between welfare service privatization and satisfaction is positive. These findings suggest that there is no clear-cut relationship between privatization and individuals' opinions about services; rather, this relationship depends on the ideological predispositions of local politicians and ordinary citizens.

  • 5.
    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; Research and Development Unit, Sundsvall hospital, Region Västernorrland, Sundsvall, Sweden.
    Bergmark, Magnus
    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
    Department of Health Sciences/Centre for Evidence Based Psychosocial Interventions (CEPI), Medical Faculty, Lund University, Lund, Sweden; Department of Health Sciences/Mental Health, Activity and Participation, Medical Faculty, Lund University, Lund, Sweden.
    Implementation of individual placement and support in a first‐episode psychosis unit: A new way of working2021Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 55, nr 1, s. 51-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study is to explore the IPS implementation process in a first‐episode psychosis (FEP) mental health service team in Sweden. More specifically, the study explores how integration processes and critical situations are perceived over time by team members who originated from two diverse welfare organizations. A serial interview design was used (initially, at 6 and 12 months) to describe experiences of 16 team members. Material was analyzed using a constant comparison grounded theory approach. Team members dealt with the ambivalence of sharing mental health information, and whether the new way of working was a risk or benefit for users. They gradually learned new perspectives and knowledge, built trust and shared common views. After a year, the team workload perceived reduced and became person‐centred. Some members described remaining unclear roles and requested further support. Negotiated goals for integration and early knowledge transfer are critical. Organizational change and trusting team relationships have to be facilitated. Anticipated gains of integration should be clearly described and discussed early on, and continuous support for sustainability should be considered. This study confirmed the importance and potential of integrating IPS into FEP teams.

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  • 6.
    Lindh, Arvid
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Public opinion against markets?: attitudes towards market distribution of social services - a comparison of 17 countries2015Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 49, nr 7, s. 887-910Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article studies how citizens view the appropriateness of market criteria for allocating services commonly associated with social citizenship rights and welfare state responsibility. The article focuses specifically on a potential role for the market in the provision of social services. The relationship between welfare policy institutions, socio-economic class and attitudes is explored by comparing attitudes across 17 countries of the Organisation for Economic Co-operation and Development, using multilevel modelling and data from the 2009 International Social Survey Programme. Results show that public support for market distribution of services is relatively weak in most countries, a result suggesting that public opinion is unlikely to pose a driving force within ongoing processes of welfare marketization. Still, attitudes are found to vary a lot across countries in tandem with between-country variation in welfare policy design. First, aggregate public support for market distribution of services is stronger in countries with more private spending on services. Second, class differences in attitudes are larger in countries with more extensive state-led delivery of services. Together, these results point to the operation of normative feedback-effects flowing from existing welfare policy arrangements. The theoretical arguments and the empirical results presented in this article suggest that future research exploring the relationship between welfare policy and public opinion from a country-comparative perspective is well advised to place greater focus on the market institutions that, to varying extents in different countries, act as complements to the state in the administration of social welfare.

  • 7.
    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.

  • 8.
    Svallfors, Stefan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    A bedrock of support? Trends in welfare state attitudes in Sweden, 1981–2010:  2011Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 45, nr 7, s. 806-825Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article reports findings about Swedes' attitudes towards the welfare state from 1981 to 2010, building on data from the Swedish Welfare State Surveys. Attitudes towards social spending, willingness to pay taxes, attitudes towards collective financing and public organization, suspicion about welfare abuse, and trust in the task performance of the welfare state are tracked. Overall, there is a large degree of stability in attitudes, and where change is registered, it tends to go in the direction of increasing support. More people state their willingness to pay higher taxes for welfare policy purposes; more people want collective financing of welfare policies; and fewer people perceive extensive welfare abuse in 2010 than was the case in previous surveys. Class patterns change so that the salaried and the self-employed become more similar to workers in their attitudes. Hence, the unprecedented election loss of the Swedish Social Democrats in 2010, and the rise of the Moderates (conservatives) as the dominant party cannot be explained by changing attitudes towards the welfare state. Nor can any corrosive effects from increased marketization of the Swedish welfare state on public support for welfare policies be detected.

  • 9.
    Svallfors, Stefan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Class, attitudes and the Welfare State: Sweden in comparative perspective2004Ingår i: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 38, nr 2, s. 119-138Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One of the most important arenas for contemporary class politics is the welfare state. In this article, attitudes towards welfare policies among different classes in Sweden are compared with other Western countries and over time. In the first part of the article, attitudes towards state intervention among different classes are compared across four Western countries: Sweden, Germany, Britain and the USA. The data come from the 1996 survey on "The Role of Government" conducted within the International Social Survey Programme. In the second part of the article, more detailed national data sets are used in order to track developments within Sweden from the early 1980s until 2002. Attitudes towards welfare spending, financing of welfare policies and service delivery are used to track developments of class differences in attitudes over time. It is concluded (a) that class differences are particularly large in Sweden, and (b) that changes over time indicate stability in overall class differences, combined with changes in attitudes among non-manual employees. The implications of the results for recent arguments about the restructuring of class relations and the impact of welfare policies on stratification are discussed.

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