"I will never forget him". A qualitative exploration of staff descriptions of helpful relationships in supportive housing.

WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented studies show that the quality of the professional relationship plays an essential role in the recovery from mental illness. Within mental health care in general, previous studies show that helpful professional relationships are characterized by several reciprocal aspects, such as friendship resemblance and self-disclosure. The literature is scarce on in-depth explorations of professional relationships within the often long-lasting and intimate help context of institutional supportive housing. Explorations of staff members' experiences are absent. The scientific rationale of this study was to expand the current knowledge about professional rel…

“Everything is so relaxed and personal” – The construction of helpful relationships in individual placement and support

The relationship with professionals is an important factor in relation to the outcome of interventions directed to persons with severe mental problems. However, the current knowledge regarding the ...

Nothing matters: the significance of the unidentifiable, the superficial and nonsense

ABSTRACT Purpose: The aim of this study is to explore the ways in which “small things” may be of importance for people with mental health difficulties. Method: Empirical material from three different studies was reanalysed through a phenomenological, dialogical, approach. Results: We discovered some paradoxical aspects of small things: i.e., they could be about “something” that was difficult or even impossible to identify. The unidentifiable could be about bodily, sensual experiences that are superficial (i.e., belonging to the surface). The interaction with others highlighted as significant could be about doing something fun, talking nonsense or kidding around, and hence not at all about m…

Diversity, Complexity and Ordinality: Mental Health Services Outside the Institutions—Service Users’ and Professionals’ Experience-Based Practices and Knowledges, and New Public Management

In conjunction with the dismantling of psychiatric hospitals, social workers have been commissioned to help service users in their daily living in their homes and in the community. The consequences of these changes for experience-based knowledge and practices in their contexts remain relatively unknown. In this study, eighteen service users and the social workers they described as helpful for them were interviewed. The interviews were recorded, transcribed, and analyzed using Thematic Analysis. The following themes emerged: “Here, there and everywhere”, “Doing, being, becoming”, “Talking” and “Order, planning and improvisation” concerning the contradictions service users and professionals m…

Living in poverty with severe mental illness coping with double trouble

AbstractObjectives: Several studies have pointed at a co-occurrence between severe mental problems and relative poverty. Also users refer to their strained financial situation as one of their main problems. We lack knowledge about how persons ‒ still characterised in diagnostic manuals as having difficulty with their sense of reality and their ability to carry out goal-oriented actions ‒ manage the ‘double trouble’ of having a strained financial situation and mental problems.Method: Sixteen persons diagnosed with severe mental illness were interviewed about how they managed poverty in their everyday life. The interviews were tape-recorded and analysed using the thematic analysis method.Resu…

A time-geographic approach for visualizing the paths of intervention for persons with severe mental illness

Living conditions for persons with severe mental illness (SMI) in Sweden have changed dramatically in recent decades, mainly due to the closure of mental hospitals in the 1990s and the subsequent d ...

A place for the heart: A journey in the post-asylum landscape. Metaphors and materiality.

The downsizing of psychiatric hospitals has created a new institutional landscape in the local community to support people with severe mental problems in their daily living. This study explores meeting places in Norway from the users' perspectives. The users used four metaphors to describe these meeting places: "like a home", "like a family", "like a landing ground" and "like a trampoline". The users have decorated the interiors of the meeting places with hearts made from various materials, and these could be considered as symbols of the places. The metaphors used: the hearts and the rooms and interiors, reflect old ideas about calmness and dignity rather than new ideas based on New Public …

Going beyond: Users’ experiences of helping professionals

Background: Establishing a working alliance has been found to be of great importance for the outcome of professional interventions for people diagnosed with severe mental illnesses. Aim: The aim of ...

Money, Social Relationships and the Sense of Self: The Consequences of an Improved Financial Situation for Persons Suffering from Serious Mental Illness

During a 9-month period, 100 persons with SMI were given approx. 73 USD per month above their normal income. Sixteen of the subjects were interviewed. The interviews were analysed according to the methods of thematic analysis. The money was used for personal pleasure and to re-establish reciprocal relations to others. The ways in which different individuals used the money at their disposal impacted their sense of self through experiences of mastery, agency, reciprocity, recognition and security. The findings underline the importance of including social circumstances in our understanding of mental health problems, their trajectories and the recovery process.

Materialities in supported housing for people with mental health problems : a blurry picture of the tenants

Our daily lives and sense of self are partly formed by material surroundings that are often taken for granted. This materiality is also important for people with mental health problems living in supported housing with surroundings consisting of different healthcare services, neighbourhoods, buildings or furniture. In this study, we explored how understandings of tenants are expressed in the materialities of supported housing. We conducted ethnographic fieldwork in seven different supported accommodations in Norway and analysed the resultant field notes, interviews, photographs and documents using Situational Analysis. The analysis showed that supported housing materialities expressed a blur…

Experience of Psychotropic Medication -An Interview Study of Persons with Psychosis.

Psychotropic drugs, particularly antipsychotic types, are a cornerstone of the treatment of people with psychosis. Despite numerous studies showing that drug treatment with psychotropic drugs initially alleviates psychiatric symptoms, the proportion of people with mental health problems and symptoms that do not follow doctors' prescriptions, thus exhibiting so-called non-adherence, is considerable. Non-adherence is predominantly seen as a clinical feature and as a patient characteristic that is especially due to patients' poor understanding that they are ill. There is also a widespread notion that non-adherence is of great disadvantage to the patient. This article is based on interviews wit…

Small Things, Micro-Affirmations and Helpful Professionals Everyday Recovery-Orientated Practices According to Persons with Mental Health Problems

The aim of this study is to present concrete descriptions of the content in the construction of helpful relationships with staff, according to users. Starting with the re-occurring concept of the meaning of "little things" in recovery studies, a literature review was done. A thematic analysis shows that small things play an important role in improving a person's sense of self. Small things seem to be an invisible but effective parts of a recovery-orientated practice, but they might be defined as unprofessional and their efficacy negated.

A qualitative fallacy: Life trapped in interpretations and stories

This paper points out some problematic aspects of qualitative research based on interviews and uses examples from mental health. The narrative approach is explored while inquiring if the reality of life here is forced into the formula of a chronological story. The hermeneutic approach, in general, is also examined, and we ask if the reality of life in this scenario becomes caught up in a web of interpretations. Inspired by ideas from Bakhtin and phenomenology, we argue for interview-based research that stays with unresolvedness and constantly question the web of interpretations and narratives that determine our experiences. This also chimes with certain dialogical practices in mental healt…

‘It’s not just a lot of words’. A qualitative exploration of residents’ descriptions of helpful relationships in supportive housing

Author's accepted manuscript. This is an Accepted Manuscript of an article published by Taylor & Francis in European Journal of Social Work on 24/10/2019, available online: http://www.tandfonline.com/10.1080/13691457.2019.1682523.

Caring through Discipline? Analyzing House Rules in Community Mental Health Services in Norway

In Scandinavian countries, public housing and recreation programs for people suffering from mental health or substance abuse problems emphasize normalization of life and participation in a normal social life. The theoretical approach taken by community health care services has been de-institutionalization. To study if and how this movement from patient to fully participating citizen was reflected in these new institutions, written house rules in sheltered housing and day centers for adults were collected and analyzed by content analysis. The findings show that the formal language represents the voice of professionals, while the content pertained to regulation of the service user’s daily lif…

Mutual learning: exploring collaboration, knowledge and roles in the development of recovery-oriented services. A hermeneutic-phenomenological study

ABSTRACT Purpose The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Methods Eight pairs of participants were interviewed together, in accordance with the dyadic interview method. The dyads/pairs consisted of service users and professional helpers. A collaborative hermeneutic-phenomenological analysis was used to analyse data. Results Data were analysed into three overarching and entangled themes, exploring how recovery…

Studies regarding supported housing and the built environment for people with mental health problems : A mixed-methods literature review

Abstract Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their findings in a thematic analysis. The built environment of supported housing involves three important and interrelated themes: well-being, social identity and privacy. If overregulated by professionals or located in problematic neighbourhoods or buildings, the settings could be an obstacle to recovery. If understood as meaningful places w…

A Balancing Act-How Mental Health Professionals Experience Being Personal in Their Relationships with Service Users.

Although being personal in relationships with service users is commonly described as an important aspect of the way that professionals help people with severe mental problems, this has also been described to bring with it a need to keep a distance and set boundaries.This study aims to explore how professionals working in psychiatric care view being personal in their relationships with users.Qualitative interviews with 21 professionals working in three outpatient psychiatric units, analyzed through thematic analysis.Being personal in their relationships with users was described as something that participants regarded to be helpful, but that also entails risks. Participants described how they…

Things matter: about materiality and recovery from mental health difficulties

ABSTRACT Purpose The aim of this study is to explore how material things might become involved in the recovery process of people with mental health difficulties. Method Empirical material from three different studies on various aspects concerning mental health issues that each of the authors had conducted was reanalysed through a phenomenological item analysis. Results We discovered that mundane objects such as a mobile phone, a bench, a door and a key have agency to contribute to peoples’ recovery and wellbeing. Things became agents that created contexts that initiated physical, social and emotional movements. Conclusion By giving attention to materiality we might become aware of the impor…

A diversity of patterns: 10-year trajectories of men and women diagnosed with psychosis for the first time. A time-geographic approach

People with severe mental illness face a different interventional landscape compared to some decades ago, when mental hospitals were dominant, in Sweden as well as in the rest of the Western world. The aim of the research reported in this article was to follow men and women diagnosed with psychosis for the first time over a 10-year period, and to explore what interventions they experienced. The interventions, here defined as "spheres", were either community-based or institutional. A third sphere represents no interventions. Based on data from registers and using a time-geographic approach, the individuals were visualised as 10-year trajectories where their transitions between the different …

The costs of friendship: severe mental illness, poverty and social isolation

Background: The relationship between severe mental illness, poverty and social isolation has been explored in a number of studies.Aim: The purpose of the study was to explore the relationship betwe ...

The Art of Helpful Relationships with Professionals: A Meta-ethnography of the Perspective of Persons with Severe Mental Illness.

Relationships with professionals have been shown to be helpful to persons with severe mental illness (SMI) in relation to a variety of services. In this article, we aimed to synthesize the available qualitative research to acquire a deepened understanding of what helpful relationships with professionals consists of, from the perspective of persons with SMI. To do this, we created a meta-ethnography of 21 studies, through which ten themes and an overarching interpretation were created. The findings show that helpful relationships with professionals are relationships where the persons with SMI get to spend time with professionals that they know and trust, who gives them access to resources, s…

Institutional recovery: a 10-year follow-up of persons after their first psychosis diagnosis. A critical reflexive approach

Background: Despite repeated attempts, it has not been possible to reach a consensus on the definition of recovery. In this paper, we use the term “institutional recovery” and focus on the persons’ ...

Non-helpful relationships with professionals – a literature review of the perspective of persons with severe mental illness*

The relationship with professionals has proved to be important with regard to outcome for persons with severe mental illness (SMI). The understanding of non-helpful relationships is important complementary knowledge to that regarding helpful relationships.To review the available qualitative research providing knowledge of non-helpful relationships from the perspective of persons with SMI.A review of qualitative studies, based on an earlier systematic search, analyzed through thematic analysis.The main themes were "non-helpful professionals", "organization versus relation" and "the consequences of non-helpful relationships with professionals". Examples of professionals described as non-helpf…

You realise you are better when you want to live, want to go out, want to see people: Recovery as assemblage

Background: The lack of social and material perspectives in descriptions of recovery processes is almost common in recovery research. Aim: Consequently, we investigated recovery stories and how people with mental health and/or addiction challenges included social and material aspects in these stories. Method: We conducted focus group and individual interviews. We investigated how the participants narrated their stories and how they assembled places and people in their recovery stories. Results: We found that narratives of recovery became assemblages where humans and their environments co-exist and are interdependent. Conclusion: As such, narratives about recovery are about everyday assembla…

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