| 1. |
- Andersson, Maria, 1976-, et al.
(författare)
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The implementation of a Free-choice Market System in Swedish Community Mental Health Services by the Example of Day Centres
- 2014
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Ingår i: Jubilee Congress 50 years WASP World Association of Social Psychiatry, London, November 13-15, 2014..
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Konferensbidrag (refereegranskat)abstract
- Marketization in community mental health services is a new phenomenon and might be the most comprehensive reform in the field since the deinstitutionalisation that occurred during the second half of the twentieth century. Historically, mental health services have been characterized by discipline and paternalistic practices.There has been an absence ofwhat is now, due to the new organizational model based on individual freedom of choice, is to be introduced. The aim of this study was to investigate the implementation of a free-choice market system in community mental health services, using the example of day centres for people with psychiatric disabilities. The study was conducted in a major city that was about to implement a free-choice market system due to a new legislation. Eighteen semi-structured interviews were conducted. Agents situated in different parts of the organization were interviewed one year before and two years after the free-choice system was launched in 2010. Data showed a top-down political process. The policy intentions of the new Act were in focus when studying the relation between policy and practice during the implementation process. A majority of the policy intentions of the new Act advocated individual autonomy as the market system’s main purpose, only one intention concerned organizational efficiency. Interview data reflected, however, that financial efficiency dominated the agents’ experiences of the implemented system. The twofold market purpose was clearly reflected in the interviews. Front-line staff hoped for improvements mainly for the users, when managers mainly focused on the market as a resource allocator.
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| 2. |
- Hadding, Cecilia, 1976-
(författare)
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”Att nästan inte få existera” : före detta sektmedlemmars erfarenheter – med fokus på psykisk hälsa och mötet med sjukvården
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The controlling culture of a cult can be harmful to its members. Living in and leaving a cult can be challenging, lead to mental illness and experience the need for support.Aims: I - To explore former cult members' perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations. II - To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources. III - To explore exposure to violence and coercive control in cults, and its consequences for mental health.Design: A qualitative approach was used in all studies. Semi structured interviews (I, III) and the cultural formulation interview from DSM -5 (II) were used to collect data. Studies I and II were analyzed using qualitative content analysis with systematic text condensation. Study III was analyzed using reflexive thematic analysis.Participants: Adult former members of ideological or religion-based cults. Studies I and III include nineteen participants who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement. Study II include eleven participants.Results: Being a cult member involved constant exposure to threats and violence. The acculturation process after leaving the cult put them in an in-between state and it took time and effort to resettle in mainstream society. They struggled with a persisting coercive bond to the cult's ideals, shame, trauma, and mental health sequalae. In their consultations with healthcare professionals the former cult members remained affected by the cults rules and belief system. This made it harder for them to communicate their needs and accept care.Conclusion: Former cult members face a complex acculturation process while they struggle in several aspects of life with mental health, shame, problems with trust and personal boundaries. To effectively understand and support former cult members, healthcare professionals must consider both the cultural and existential aspects of former cult members' lives, in addition to their mental health and persisting bond to the cult.
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| 3. |
- Hadding, Cecilia, et al.
(författare)
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Being in-between; exploring former cult members' experiences of an acculturation process using the cultural formulation interview (DSM-5)
- 2023
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources.Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation.Participants: Eleven Swedish former members of ideological or religion-based cults.Setting: Swedish mainstream, secular society.Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress.Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.
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| 4. |
- Hadding, Cecilia, 1976-, et al.
(författare)
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How can I trust someone who lives in the darkness? : former cult members’ perceptions of consultations with healthcare professionals
- 2022
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Ingår i: International journal of coercion, abuse, and manipulation. - : International Cultic Studies Association. - 2710-401X .- 2710-4028. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study explores former cult members’ perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations.Design: Qualitative methods using semi-structured interviews that were analyzed using systematic text condensation.Participants: Nineteen former cult members who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement.Results: Former cult members remain affected by cult belief systems, rules, and ideations even after leaving a cult. This leads to ambivalence and inner conflict for the former cult member in a healthcare consultation. Care providers are perceived as ignoring cult experiences and lacking knowledge of a cult’s impact on an individual.Conclusions: To understand, help, and work with former cult members, healthcare professionals need to know about cults and the possible impacts of cult involvement. Person- and patient-centeredness in the form of non-judgmental attitudes, validation of experiences, and awareness of the psychosocial situation are important in consultations with these patients. More over, healthcare providers need to acknowledge cultural and existential aspects of a former cult member’s life, both in the present and from earlier experiences in the cult.
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| 5. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Attitudes in healthcare students towards mental illness : a pre- and post multicenter university program study
- 2011
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Ingår i: The Internet Journal of Allied Health Sciences & Practice. - : Nova Southeastern University. - 1540-580X. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the study was to investigate the effects of naturalistic educational interventions on attitudes towards persons with mental illness. Methods: In a pre-post test design, 456 students in vocational University programmes to become nurses, social workers, occupational therapists, physiotherapists, psychologists, and public health workers were studied after a course in mental illness, using questionnaires focusing on familiarity with mental illness and attitudes towards the mentally ill in general and towards schizophrenia in particular. Results: The results revealed a significant improvement for the total group in their being afraid of people with mental illness in general and being more positive towards having mentally ill people living in their neighbourhood. Differences between the student groups were found. Some educational features positively influencing stigmatizing attitudes were identified. Conclusion: Education has some effect on attitudes towards patients with mental illness, mostly on fear. To understand the effective educational ingredients for change, further research is needed.
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| 6. |
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| 7. |
- Markström, Urban, 1969-, et al.
(författare)
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Case management for people with psychiatric disabilities in rural Sweden : Experiences from the implementation of a national policy
- 2009
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Ingår i: European Journal of Social Work. - London : Routledge. - 1369-1457 .- 1468-2664. ; 12:4, s. 495-508
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Tidskriftsartikel (refereegranskat)abstract
- The aim is to analyse the implementation of a case manager-model in rural Sweden. A sample of 15 case managment team was selected. Written materials were collected and interviews on location were carried out. Results: rural case managers design their work methods themselves, wich entail several deviations from the national guidelines in this field. The case managers boards have a low capacity to direct and manage the activities of the case managers. Consequently, case managers develop into welfare entrepreneurs. One salient risk is that teams become isolated from the surrounding welfare system. In conclusion, the Swedish version of case management in rural areas is a result of local processes of adaptation and negotiations that result in services that differ from those envisaged in national policy guidelines.
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| 8. |
- Nygren, Ulla, et al.
(författare)
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Rehabilitering till arbete för personer med psykiskt funktionshinder : Ettårsuppföljning av en verksamhet enligt Supported Employment-metodik i Umeå
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En majoritet av de människor som har ett psykiskt funktionshinder vill arbeta. Trots detta står de flesta idag utanför den öppna arbetsmarknaden. Orsakerna kan spåras till bl.a. negativa attityder till personerna i målgruppen, en arbetsmarknad som är dåligt anpassad till gruppens behov, och ett bristfälligt stöd från samhällets sida när det gäller rehabilitering till arbete. Supported Employment enligt den s.k. IPS-modellen är en metodik särskilt utformad för att stödja personer med konsekvenser av psykisk sjukdom att skaffa och behålla ett lönearbete. Arbetssättet har med goda resultat de senaste decennierna utprövats i många olika länder. I Sverige är dock metoden ännu inte en etablerad del av utbudet av arbetsrehabiliteringsinsatser till personer med psykiskt funktionshinder. Föreliggande rapport är en ettårsuppföljning av en verksamhet som arbetar enligt Supported employment-metoden (SE). Syftena med studien är att undersöka hur klienternas situation har utvecklats under ett år efter att de börjat i SE, och hur klienterna har upplevt sitt deltagande. Rapporten redovisar även personalens bild av hinder och möjligheter i rehabiliteringsarbetet. Ettårsuppföljningen är initierad av Samordningsförbundet i Umeå och är en del i ett forskningsprojekt som drivs av Socialpsykiatriskt Kunskapscentrum i Västerbotten och Centrum för Evidensbaserade Psykosociala Insatser (CEPI).
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| 9. |
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| 10. |
- Schückher, Fides, 1956-
(författare)
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Alcohol use disorder in socially stable women receiving outpatient treatment : Individual characteristics of importance for onset age and treatment outcome
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Socially stable women with alcohol use disorder (AUD) are seldom studied separately and are often marginalized in treatment of substance abuse. The overall aim of this thesis was to examine variables of importance in relation to age at onset of AUD and treatment outcome.Study I, which included 338 men and women being treated for AUD, showed that women had a significantly later onset and shorter duration in excessive alcohol use as well as less weekly pure alcohol intake than men. Participants with earlier onset of excessive alcohol use reported significantly more psychiatric symptoms and more immature personality traits than those with later onset. Study II-IV included 75 women with AUD receiving outpatient treatment. Of the participants, 68% reported a history of childhood maltreatment. Emotional abuse and their mother’s alcohol and/or substance problems were independent predictors of earlier age at onset of AUD. In Study III treatment outcome was measured as a change in alcohol consumption. A more positive change, especially with regard to abstinence, was found in women who did not report childhood abuse. Study IV showed that, at 12month follow up, most of the participants had reached their end-oftreatment goal either abstinence or low-risk drinking. However, those with a goal of abstinence at the end of treatment showed significantly less risk drinking than those with low-risk drinking as a goal. The most important predictor of abstinence at the 12-month follow up was having abstinence as an end –of –treatment goal. These results indicate the importance of identifying and addressing childhood trauma in treating socially stable women with AUD. Focusing on motivational changes during treatment may also be of importance, especially in patients with relapses, as abstinence still is the most stable treatment option.
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| 11. |
- Svensson, Bengt, et al.
(författare)
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Health care students attitudes towards people with schizophrenia : a survey of eight university training programs
- 2014
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Ingår i: Open Journal of Psychiatry. - : Scientific Research Publishing. - 2161-7325 .- 2161-7333. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Discrimination and stigmatization of people with mental illness are a global andcomplex phenomenon and there is evidence that negative attitudes and discrimination are alsoprevalent among health care staff and health care students. Methods: Attitudes towards peoplewith schizophrenia among 1101 students in eight different university programs providing trainingfor work in the health care and social sectors were explored, using a cross-sectional design.Results: In five of the eight training programs the majority of the students’ perceived people withschizophrenia as a danger to others. In several aspects police students were found to hold morenegative attitudes than students from other programs. Students with previous experiences ofwork in mental health services and students knowing a person with schizophrenia showed morepositive attitudes. Discussion: In order to decrease negative attitudes and prejudices towardspeople with schizophrenia among students, it is essential that the training includes personal contactwith people with experience of being mental illness.
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