The overall aim was to explore the experiences and knowledge of Personligt Ombud (PO) (a Swedish version of Case Management) and how they relate to the client's recovery as well as their own role of supporting clients in the recovery process. The thesis consists of four original papers (I-IV), and both quantitative and qualitative methods were used. Paper I showed that there were differences in knowledge and attitude toward recovery between three personnel groups: psychiatric outpatient services (POPS), the supported housing team (SHT) and the PO service, where the POs showed greater knowledge about recovery than both POPS and SHT. The results also indicated that university education and training in recovery was positive related to knowledge and attitudes towards recovery. Findings from papers II - IV showed that the clients' choices permeated all of the work that the POs and clients did together. The strategies used by the POs put the client in an active changing process, where he/she became involved in every aspect of the process. The work of the PO included discussions and collaboration with clients. The relationship with the client was the foundation of the work, and it was important to build a working alliance, which also involved a personal dimension. The findings also showed that POs experienced their role as unbounded, where they didn't have to consider any organizational frames, and POs solely represent the client. However, the free role was also connected with responsibilities concerning their work, and POs had to be able to work independently. The role as POs also enables to get a holistic view to both the client as well as to the welfare system. However, the freestanding role demanded legitimacy, and the POs had to work for this. It was important for the PO service to develop good platforms for cooperation with other actors in the society. In conclusion, it is interesting and leads to the question of whether POs and personnel in POPS can relate to two different kinds of recovery: personal vs. clinical. It may be important to consider the need for university education and training in recovery developing recovery-oriented practices. Findings showed that the PO service has developed a method in accordance to the NBHW guidelines, which in many cases, may benefit the clients' recovery process; however, there were aspects the PO service needed to develop. They seemed to use a problem-oriented approach, and they need to change this and look at the clients' strengths, both individual and environmental, and use them in order to support the client to reach goals in life. In Strengths Model Case Management, the Strengths assessment exists, that may be useful. The POs' service also needs to strengthen their organization and possibly develop support among colleagues. / Det övergripande syftet var att undersöka Personligt Ombuds (PO) (en svensk variant av Case Management) erfarenheter och kunskap om återhämtning och hur de använder sig av detta samt deras roll i klientens återhämtningsprocess. Avhandlingen består av fyra originalarbeten (I - IV), där både kvantitativa och kvalitativa metoder användes. Paper I visade att det fanns skillnader i kunskap om återhämtning mellan tre personalgrupper: personal inom psykiatrisk öppenvård, boendestöd och PO verksamheter där det visade sig att POs hade mer kunskap om återhämtning än personal både inom psykiatrisk öppenvård samt boendestödet. Resultatet visade även att universitetsutbildning samt fortbildning i återhämtning hade positiv inverkan på kunskap om återhämtning. Resultaten från paper II - IV visade att klientens val genomsyrade allt arbete som PO och klienten gjorde tillsammans. De strategier som PO använde satte klienten i en aktiv förändringsprocess, där han/hon blev involverad i varje del av processen. Det var viktigt för PO att diskutera och samarbeta med klienterna. I klientarbetet var relationen med klienten en grundbult, där det var viktigt att bygga en allians med varje klient, som även innehöll en personlig dimension. Resultatet visade även att PO upplevde sig obundna i sin roll där de inte behövde anpassa sitt arbete utifrån organisatoriska ramar och tillhörighet, viket bidrog till att PO upplevde att de enbart representerade klienten. Men den fria rollen innebar även att ta ansvar i sitt arbete då PO måste kunna arbeta självständigt. Rollen som PO möjliggör att skapa en helhetssyn på både klienten samt välfärdssystemet. Den fristående rollen krävde legitimitet där PO där det är betydelsefullt att utveckla goda plattformar för samarbete med andra aktörer i samhället. Sammanfattningsvis är det intressant att reflektera om olika yrkesgrupper relaterar till två olika definitioner av återhämtning: personlig vs klinisk återhämtning. I utvecklingen av en återhämtningsinriktad praktik kan det vara betydelsefullt att beakta behovet av personal som är utbildade på universitetsnivå samt fortbildning i återhämtning. Resultaten visade att PO har utvecklat en metod utifrån Socialstyrelsens riktlinjer, vilket i många fall möjligtvis kan gynna klientens återhämtningsprocess, men det finns delar i PO verksamheten som behöver utvecklas. De verkade använda ett problemorienterat förhållningssätt och de bör utveckla verksamheten till att identifiera klienten styrkor, både individuella och miljömässiga och använda dessa för att stödja klienten att nå mål i livet. I Strength Model Case Management finns ett instrument där man tillsammans med klienten inventerar styrkor. Dessa kan bli användbara i processen. PO verksamheten bör även stärka organisationen och eventuellt utveckla stöd bland kollegor.

Students with psychiatric disabilities are the largest subgroup of students with disabilities enrolled in postsecondary education. However, their high enrollment rate does not equate to a high retention rate. Approximately 86 percent of students with psychiatric disabilities withdraw prior to degree completion. As a result, calls for improved disability services in postsecondary education have been plentiful. In an effort to take a step toward answering these calls, the current study began the exploratory process of identifying knowledge, skills, and attitudes that are important for disability service professionals to possess in order to provide beneficial services to students with psychiatric disabilities in postsecondary education. The current study began with the developing of a survey instrument using (a) a three-round Delphi survey with expert panels consisting of disability service professionals and students with psychiatric disabilities and (b) a pilot group of disability service professionals. The final instrument with 54 knowledge, skills, and attitudes was rated by a sample of 402 disability service professionals who were members of the Association on Higher Education and Disability (AHEAD). A principal components analysis was used to analyze the data. Five factors emerged: (a) Ethical and Legal Considerations, (b) Accommodations and Supports, (c) Disability Aspects, (d) Community Resources, and (e) Campus Considerations. A post-hoc analysis with a MANOVA and descriptive statistics was also conducted. Each factor was explored within the context of the literature. Further, differences between professional and student perceptions were highlighted. Lastly, implications, assumptions, limitations, and recommendations for future research were discussed.

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In the wake of deinstitutionalization, people with psychiatric disabilities are, to a great extent, living in the community. In this thesis everyday life of people with psychiatric disabilities, living in independent housing with community-based social support to manage their daily life, is investigated. Special attention is paid to the characteristics and meaning of community-based social support. Through participating observational studies, interviews and time-geographic diaries, data have been gathered about everyday life of seventeen men and women. It is the interpersonal social conditions that have been the main target of the study, addressed as social networks and social support. Everyday life conditions are dependent on social as well as physical and material circumstances. Although the social conditions are emphasized in the study they are not looked upon as isolated dimensions but as part of everyday life circumstances. The everyday life perspective offers an opportunity to reveal the structures within which everyday life takes place. The time-geographic concepts “community-organized projects” and “individual-organized projects” were used to investigate the structures of everyday life, resulting in four substructures. Four types of everyday life and four patterns of networks connected to the different substructures were identified, showing great variations. The characteristics of community-based social support can be summarized as “the doing”, “the talking” and “the being with” in a reciprocal type of relationship. The meaning of support is shortly described as solution of and relieving problems, social companionship, security, protection and control. Community-based social support show similar importance regardless of the type of everyday life when it comes to solution of problems and different importance when it comes to aspects of support such as social companionship.

Made available in DSpace on 2016-03-15T19:40:40Z (GMT). No. of bitstreams: 1 Carla Renata Lacerda.pdf: 584019 bytes, checksum: da6e2dc2299fbf21969da31d29908fec (MD5) Previous issue date: 2009-01-27 / Fundo Mackenzie de Pesquisa / The family is still the main basis for children psychological development, despite changes within its formation, structure and function in the last years. The child acquires within the family a sense of identity, capacity and own acceptance, as well as receiving a series of values charged roles that support the establishing of social identity, in a broader sense. The presence of mental illness in one of the parents may bring to family group adverse and critical situations to established relationships, with effects and consequences that can disturb the child s healthy development, as well as being a risk factor to abuse and future psychopathologies. The aim of this research was to analyze the relationship between the referral of children to psychological service and the presence of psychiatric disabilities in records of a Mental Health Public Service. Based on the information extracted from the registry in the children and their parents records, four categories appeared: 1- presence of mental illness in one of the parents diagnosed with CID; 2- presence of mental illness in any family member living with the child or responsible for her, such as grandparents and uncles clinically diagnosed with the CID; 3- reference to mental illness in one of the parents, without clinical diagnosis because there was not a file opened; 4- problems in family environment of the referred child, the four categories related with the motive of referral and kind of abuse. It may be concluded that there is a significant relation between symptoms presented by children and adverse situations in family environment, involving mental illness, crisis and conflict situations, as well as being an increased factor for abuse against the child. It s evident the need for a family intervention approach in those cases, including preventive actions in health and education. / A família, apesar, das transformações sofridas nos últimos tempos quanto à sua formação, estrutura e função, ainda constitui o principal núcleo para o desenvolvimento psicológico dos filhos. É no ambiente familiar que a criança adquire um senso de identidade, capacidade e aceitação próprias, além de fornecer uma série de papéis carregados de valores que auxiliam no estabelecimento das identidades sociais, num sentido mais amplo. A presença de doença mental num dos pais pode trazer ao grupo familiar situações adversas e críticas nas relações estabelecidas, cujos efeitos e conseqüências podem ser perturbadoras tanto para o desenvolvimento saudável da criança, quanto constituir importante fator de risco para a ocorrência de situações de abuso e desenvolvimento de futuras psicopatologias. O objetivo desta pesquisa foi analisar a relação entre o encaminhamento da criança para atendimento psicológico e a presença de transtorno psiquiátrico em um dos pais, baseada nos dados dos prontuários de um ambulatório público de Saúde Mental. A partir das informações extraídas dos registros feitos nos prontuários das crianças encaminhadas e de seus pais, surgiram quatro categorias de análise: 1-presença de doença mental num dos pais diagnosticada com a CID, 2- presença de doença mental em algum familiar que reside com a criança ou esta se encontra sob sua responsabilidade como avós e tios clinicamente diagnosticados com a CID, 3- referência de doença mental num dos pais, porém não há diagnóstico clínico por não constar abertura de prontuário, 4 - adversidades no ambiente familiar da criança encaminhada, relacionando as quatro categorias com o motivo de encaminhamento da criança e o tipo de abuso ocorrido. Pode-se concluir que existe uma relação significativa entre os sintomas apresentados pelas crianças e as adversidades do ambiente familiar envolvendo doença mental, situações de crise e conflitos além de ser um fator agravante para a ocorrência de abuso contra a criança. É nítida a necessidade de uma abordagem de atendimento familiar nestes casos, incluindo ações preventivas em saúde e educação.

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No description available.

Given the increasing number of undergraduate students with psychiatric disabilities enrolling in college and the disproportionately high attrition rates among this group, it is important that researchers understand the experiences of these students and identify and address the barriers to higher education that face this population. While most college campuses make a number of modifications, accommodations, and services available to students with registered disabilities, researchers suggest that many students with psychiatric disabilities fail to either register or make effective use of such services. Research has found that the endorsement of disability identity impacts the proactive utilization of valuable academic accommodations and promotes students’ academic success. However, little is known about how disability identity is shaped and maintained within the context of college. Still, even less is known about the experiences of students with psychiatric disabilities or how they construct meaning pertaining to their disability within college. The current study explored the processes by which undergraduate students with psychiatric disabilities make meaning of their disability identity through interaction and participation within the college context. Furthermore, I explored students’ decisions regarding disability disclosure and the utilization of support services as one means of understanding a motivated action indicative of disability identity. I employed an interpretative phenomenological approach to gain insight into the perceptions, meaning making, and lived experiences of undergraduate college students with psychiatric disabilities regarding the contextualized construction of disability identity. The results of the analysis suggest that disability identity is dynamic and constructed through interactions with others and participation in various activities and experiences presented in the college environment. These findings contribute to the literature on identity formation in college students with psychiatric disabilities and provide important implications for theory, research, and practice. / Educational Psychology

The aim of this study was to comprehend and explain the idea and function of Case Management and its diffusion in Swedish municipalities. More specifically its aim was to investigate factors for the diffusion of Case Management and its differences to similar professional roles. The study was based on interviews with four managers at various levels and two case managers representing two municipalities in Sweden. Five themes were identified that were especially interesting when discussing the function of Case Management, its differences to similar professional roles and its diffusion in Swedish municipalities. The themes were: shortcomings in the welfare system, the functions of Case Management, differences to similar professional roles, descriptions of Case Management and factors for the diffusion. The analysis was based on organizational institutionalism and translation, as well as previous research on Case Management and the diffusion of ideas. As a conclusion Case Management was described as a revolutionizing method that would import evidence based social work in the organization. That, and the obvious effort to adapt and integrate Case Management in the institutionalized metods and values of Swedish welfare organizations were factors for the diffusion. Case Management also turned out to be a similar method to the already established profession personligt ombud, wherefor Case Management can be seen as a relaunch of personligt ombud.

This thesis investigates the access to IVF-treatment for people with psychiatric disabilities who intend to carry the child themselves. It explores how the Swedish welfare state resonates around people with psychiatric disabilities wanting to become parents, and how their reproductive rights might differ from others seeking the same treatment. Therefore, different official reports from the Swedish government and documents from the National Board of Health and Welfare that deals with the legal framework and state-sanctioned guidelines for medical professionals regarding IVF has been examined in a qualitive discourse analysis. Two interviews with two medical professionals working with IVF has also been conducted. The focus has been on the psychosocial interviews every treatment-seeking individual has to go through to determine if they are fit as parents. The main body of theory consists of work surrounding feminist disability studies, crip theory, discourse analysis, repronormativity and critical studies of the welfare state. This thesis set out to investigate how the demand from the government to put the best interest of the child first when deciding over who gets access to IVF are used to resonate around if people with psychiatric disabilities can be seen as fit parents. It also seeks to understand what these state-sanctioned guidelines and the way medical professionals interacts with them can say about the reproductive politics of the Swedish welfare state regarding people with psychiatric disabilities. The general conclusion is that the welfare state has implemented tools for reproductive control over the group that has been studied (particularly women and trans people) since at least the 1930’s, and while there has been significant change, the gatekeeping practises surrounding IVF can be seen as another tool for reproductive control. It is evident that people with psychiatric disabilities have to prove themselves in order to be seen as fit parents, and it is assumed that there is a risk trying to combine their psychiatric disabilities with the best interest of the child. While there is no legal framework denying this group access to IVF outright, this thesis shows that they face challenges to gain that access that people without psychiatric disabilities does not.