<p>The aim of this study is to explore how the people with a mental functional disorder experience living support. This studies research questions are; What kind of help do the clients receive from living support? Do they feel that they need more help or do they receive more help then they fell that they need? What does the relationship look like between the clients and the supporter? To answer these questions a qualitative research approach was used. Four clients where interviewed. The results are presented using themes and quotations. The themes that are used are; Activities done together with living support, the experience of social control, the experience of taking part in the planning and the experience of time limitation, and finally the relationship to the supporter. The results are analyzed using symbolic interactionism and normalization perspective. The results show that the clients receive help with housekeeping and other ordinary chores. The clients also experience that the support is a kind of social control, which they experience as positive. The clients feel that the supporter feels like a friend, even though most of the clients feel that there are limits to the friendship.</p>

The aim of this study is to explore how the people with a mental functional disorder experience living support. This studies research questions are; What kind of help do the clients receive from living support? Do they feel that they need more help or do they receive more help then they fell that they need? What does the relationship look like between the clients and the supporter? To answer these questions a qualitative research approach was used. Four clients where interviewed. The results are presented using themes and quotations. The themes that are used are; Activities done together with living support, the experience of social control, the experience of taking part in the planning and the experience of time limitation, and finally the relationship to the supporter. The results are analyzed using symbolic interactionism and normalization perspective. The results show that the clients receive help with housekeeping and other ordinary chores. The clients also experience that the support is a kind of social control, which they experience as positive. The clients feel that the supporter feels like a friend, even though most of the clients feel that there are limits to the friendship.

<p>Syftet med studien har varit att ta reda på de idéer som unga vuxna (18-24 år) med psykiskt funktionshinder har kring hur en sysselsättningsverksamhet skulle vara uppbyggd och om det är möjligt att någon form av organiserad verksamhet kan hjälpa dem i övergången till vuxenlivet. Metoden som användes var en kvalitativ intervjustudie. Urvalet var fem personer, tre män och två kvinnor, som har kontakt med Stockholms läns landstings öppenpsykiatriska mottagning eller Täby kommuns socialpsykiatriska enhet. Teoretiska utgångspunkter har varit symbolisk interaktionism. I studien kan utläsas att det är viktigt för gruppen unga vuxna med psykiskt funktionshinder att få möjlighet till ett socialt liv utanför hemmet. Några känner sig ensamma med sin problematik, men menar att det skulle gå lättare om de fick stöd och hjälp att ta sig vidare av någon som förstår deras problematik och kan finnas till hands när de behöver extra stöd. Ett resultat är att de unga vuxna tycker det är av vikt att få stöd med studier och arbete i övergången till vuxenlivet och att det inom dessa verksamheter finns människor som tar hänsyn till deras funktionshinder. Ytterligare ett resultat visar att de unga vuxna upplever att det är svårt att få den hjälp de behöver. Slutsatsen är att det behövs ett närmare samarbete mellan landsting och kommun, kanske i en ny organisation som skulle kunna erbjuda både medicinska och rehabiliterande åtgärder för att kunna erbjuda unga vuxna en bra verksamhet. En sådan verksamhet skulle även kunna inrymma samarbete med övriga aktörer som arbetsförmedling, försäkringskassa, gymnasium och högskola.</p>

Syftet med studien har varit att ta reda på de idéer som unga vuxna (18-24 år) med psykiskt funktionshinder har kring hur en sysselsättningsverksamhet skulle vara uppbyggd och om det är möjligt att någon form av organiserad verksamhet kan hjälpa dem i övergången till vuxenlivet. Metoden som användes var en kvalitativ intervjustudie. Urvalet var fem personer, tre män och två kvinnor, som har kontakt med Stockholms läns landstings öppenpsykiatriska mottagning eller Täby kommuns socialpsykiatriska enhet. Teoretiska utgångspunkter har varit symbolisk interaktionism. I studien kan utläsas att det är viktigt för gruppen unga vuxna med psykiskt funktionshinder att få möjlighet till ett socialt liv utanför hemmet. Några känner sig ensamma med sin problematik, men menar att det skulle gå lättare om de fick stöd och hjälp att ta sig vidare av någon som förstår deras problematik och kan finnas till hands när de behöver extra stöd. Ett resultat är att de unga vuxna tycker det är av vikt att få stöd med studier och arbete i övergången till vuxenlivet och att det inom dessa verksamheter finns människor som tar hänsyn till deras funktionshinder. Ytterligare ett resultat visar att de unga vuxna upplever att det är svårt att få den hjälp de behöver. Slutsatsen är att det behövs ett närmare samarbete mellan landsting och kommun, kanske i en ny organisation som skulle kunna erbjuda både medicinska och rehabiliterande åtgärder för att kunna erbjuda unga vuxna en bra verksamhet. En sådan verksamhet skulle även kunna inrymma samarbete med övriga aktörer som arbetsförmedling, försäkringskassa, gymnasium och högskola.

The overall aim of this thesis is to investigate if the somatic comorbidity and increased mortality among persons with psychiatric disability (residents in supported housing facilities) can be influenced. The thesis comprises four papers. Paper I describes the lived experience of health and body. Papers II and III examine the effects of a lifestyle programme on physiological markers (II) and on psychological and quality of life parameters (III). Paper (IV) illustrates the meaning of participating in a life style programme. The data in Papers I and IV comprises narrative interviews with residents (n=11). The studies in Papers II and III are focused on residents and were carried out with a randomized design. The randomization was performed on a group level (supported housing facility). The 12 month intervention consisted of study circles with a theoretical and practical application of dietary information and physical activity for two hours, on a twice weekly basis under the supervision of a study circle leader. The controls were offered an aesthetic study circle and met once a week. The data in Paper II comprises physiological quantitative data from both residents (n=41) and staff (n=41) and in Paper III questionnaires on symptoms and quality of life completed only by residents (n=41). The data was analysed with Qualitative description (I), Phenomenological-hermeneutics (IV), and for papers II and III relevant statistical calculations were used. Health is described in paper I as “having a life as others have” and discloses the losses of important life domains (family, work, security) and the experiences of being deviant and stigmatized. Health is described as “absence of psychological and physical problems” and its hampering effects on quality of life and self-esteem. Health is understood as a phenomenon that could “be influenced by one self”, and there is an insight that health is manageable. Participating in a life style intervention (paper II) meant a significant improvement in risk factors for metabolic syndrome among the residents in comparison with controls. No differences were seen on weight, BMI and improved physical capacity. In paper III a significant positive increase in the Sense of Coherence compared to controls was seen. However no effect was seen on quality of life, psychosocial function or on reduction of symptoms in comparison with controls. Participating in a lifestyle intervention can be understood as the gaining of insights that health can be improved and that the daily life is partly given a changed content (paper II). The participation is also described as meaning an increased sense of closeness and equality in relation to the staff and sometimes a painful insight of their life situation. Participating is also described as entailing a hope that one’s life situation can be affected. In summary this thesis shows that there is some possibility of influencing the physical health (reduced risk of metabolic syndrome) among persons with psychiatric disability by participating in a 12 month intervention programme. The intervention does not show any effects on measures such as quality of life, psychosocial function and presence of symptoms. However, the participants describe that the participation had a meaning in a number of respects. This is a finding that is confirmed by the positive change in sense of coherence. The need to develop preventive care for persons with psychiatric disability and the importance of monitoring the treatment with neuroleptics and its side effects on physical health is an important clinical implication. Furthermore the importance of the responsibility of the care staff is emphasized as well as the importance of supporting a change in lifestyle.