“It’s about Living Like Everyone Else”: Dichotomies of Housing Support in Swedish Mental Health Care

The deinstitutionalization of psychiatric care has not only altered the living conditions for people with severe mental illness but has also greatly affected social services staff. In the Mental Health Act launched by the Swedish government in 1995, a new kind of service called ‘housing support’ and a new occupational group, ‘housing support workers,’ was introduced. However, housing support does not currently operate under any specific guidelines regarding the content of the service. This study explores housing support at local level in various municipalities of one Swedish county. The data is based on discussion with three focus groups: care managers, managers for home and community‐based support, and housing supporter workers. The perspective of institutional logics as a specific set of frames that creates a standard for what should or could be done, or alternately what cannot be questioned, is applied to analyze the constructed meaning of housing support. The meaning of housing support is constructed through three dichotomies: process and product, independence and dependence, and flexibility and structure. These dichotomies can be understood as dilemmas inherent in the work and organizing of housing support. With no clear guidelines, the levels of organizational and professional discretion create a space for local flexibility but may also contribute to tremendous differences in defining and implementing housing support. We discuss the potential consequences for housing support users implied by the identified discrepancies.

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Accessibility and pathways to psychiatric care in a community-based mental health system

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s001270170015 ◽

2001 ◽

Vol 36 (10) ◽

pp. 500-507 ◽

Cited By ~ 60

Author(s):

F. Amaddeo ◽

F. Zambello ◽

M. Tansella ◽

G. Thornicroft

Keyword(s):

Mental Health ◽

Health System ◽

Mental Health System ◽

Psychiatric Care ◽

Community Based

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Changing patterns of mental health care in Greece (1984–1996)

European Psychiatry ◽

10.1016/s0924-9338(99)00220-5 ◽

1999 ◽

Vol 14 (8) ◽

pp. 462-467 ◽

Cited By ~ 20

Author(s):

M.G. Madianos ◽

J. Tsiantis ◽

C. Zacharakis

Keyword(s):

Mental Health ◽

Technical Assistance ◽

Psychiatric Care ◽

Significant Shift ◽

Community Based ◽

Mental Hospitals ◽

Reform Programme ◽

Changing Patterns ◽

Community Based Services

SummaryGreece joined the European Community in 1981 and, three years later, the Commission of the European Communities provided financial and technical assistance under EEC Regulation 815/84 for the modernisation of the traditional psychiatric care system, with the emphasis on decentralisation of mental health services and the development of community-based services, as well as on deinstutionalization of long-stay patients and improvement of conditions in public mental hospitals. Over the last 11 years, the implementation of the EEC Reg. 815/84 programme contributed to a significant shift towards extramural care and rehabilitation. The role of the large mental hospitals has gradually been diminished and a large number of long-stay patients have been deinstitutionalised. It is commonly accepted that the EEC-funded psychiatric reform programme, despite inadequacies and constraints, had an impact on the changing mental health scene in Greece.

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Flying the Cuckoo’s Nest

From Asylum to Prison ◽

10.5149/northcarolina/9781469640631.003.0004 ◽

2018 ◽

pp. 69-97

Author(s):

Anne E. Parsons

Keyword(s):

Mental Health ◽

Community Mental Health ◽

Social Services ◽

Local Level ◽

Civil Liberties ◽

Partial Hospitalization ◽

Mental Hospitals ◽

The Creation ◽

Mental Health Centers ◽

The 1960S

This chapter charts the multiple factors that spurred the deinstitutionalization of mental hospitals in the 1960s. In 1963, Congress passed the Community Mental Health Act, which funded the creation of community mental health centers and provided inpatient and outpatient care, partial hospitalization, emergency services, and public education. The creation of Medicare and Medicaid also caused many states to reduce their reliance on custodial mental hospitals. Meanwhile, anti-psychiatry texts like Ken Kesey’s One Flew over the Cuckoo’s Nest spurred anti-institutionalism and advocates filed successful lawsuits against involuntary commitment laws. Institutionalized people gained a plethora of civil liberties, further reducing the mental hospital population. The chapter explores these national changes at the local level at places such as the Philadelphia State Hospital. That institution released large numbers of people, many of whom faced hardship when they left the hospital. That trend reflected how changes in mental health law and policy did not guarantee that people could access medical and social services in their home communities.

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FACTORS FACILITATING COLLABORATION AND ENGAGEMENT: BUILDING AND SUSTAINING STATEWIDE COALITIONS

Innovation in Aging ◽

10.1093/geroni/igz038.2973 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S807-S807

Author(s):

Cristine B Henage ◽

Ellen C Schneider ◽

Ellen Roberts ◽

Vicki Tilley ◽

Jan Busby-Whitehead

Keyword(s):

Mental Health ◽

Social Services ◽

Shared Governance ◽

Economies Of Scale ◽

Falls Prevention ◽

Community Based ◽

Community Based Organizations ◽

History Of ◽

Area Health ◽

Area Health Education Centers

Abstract Sustaining collaboration across multiple community-based organizations (CBOs) creates synergies and economies of scale to support age-friendly communities beyond the provision of direct services any single CBO can achieve. The Carolina Geriatrics Workforce Enhancement Program (CGWEP) created and sustained multiple statewide coalitions focused on geriatrics syndromes. More than 290 CBOs, including Area Health Education Centers, social services programs and nongovernmental organizations, meet quarterly to form linkages, promote education and build infrastructure to support rural and underserved older adults. Shared governance with pooled resources has been achieved because of a long history of partnership, mutually beneficial relationships, flexibility, and frequent communication. The strength of the partnership is evidenced by continued growth in number of CBOs, number of sponsored events, and number of referrals to CBOs. Two coalitions, focused on falls prevention and mental health respectively, have been adopted by partners and sustained beyond grant funding.

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Integration of eMental health technologies into traditional community-based interventions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.074 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

K Turmaine ◽

C Picot Ngo ◽

A Le Jeannic ◽

J L Roelandt ◽

K Chevreul ◽

...

Keyword(s):

Mental Health ◽

Digital Technology ◽

Digital Health ◽

Local Level ◽

World Health ◽

Local Network ◽

Local Health ◽

Community Based ◽

Health Technologies ◽

Health Programmes

Abstract Background Very little research has been conducted to appraise the merits of including municipalities and their local health providers in the promotion of digital health programmes. While more and more municipalities have locally implemented a health strategic plan and have focused on building local network of professionals, how do the latter react to the implementation of innovative e-mental health community-based programmes? Methods In 2018, 42 French municipalities volunteered to promote StopBlues, a digital health tool aimed at preventing mental distress and suicide. In each municipality, a local delegate was responsible for the promotion of the tool. Using observations, questionnaires and interviews with the delegates, we analysed how the promotion of StopBlues® was conducted in each setting. 2/3 of these municipalities started the promotion directly, and in 2019, a second wave of municipalities launched the promotion with a stronger support from the research team backed by the French World Health Organization Collaborating Centre for Research and Training in Mental Health (WHOCC). Results The use of digital technology in the implementation of a mental health programme received a mixed reception from the local health professionals because of its innovative aspect. 2/3 of the delegates declared that they were struggling to create a stronger network of local partners including private medical practioners. 63% of the respondents stated that their municipalities got involved in the programme for networking purposes. Conclusions Digital technologies have initiated a paradigm shift in the way community-based health programmes are set up but need to strengthen their territorial anchorage in order to be accepted and used at the local level. Key messages Digital technology can be a strong lever against health inequities but its effectiveness has to be studied carefully. Digital technolgy has to be implemented in local settings with the collaboration of local actors in order to be accepted and used.

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The one-day census in clinical audit

Psychiatric Bulletin ◽

10.1192/pb.16.10.614 ◽

1992 ◽

Vol 16 (10) ◽

pp. 614-615 ◽

Cited By ~ 2

Author(s):

Paul Lelliott ◽

Geraldine Strathdee

Keyword(s):

Social Services ◽

Psychiatric Care ◽

Occupational Therapists ◽

Psychiatric Nurses ◽

Hospital Nurses ◽

Community Based ◽

Community Psychiatric ◽

Wide Range ◽

Day Hospitals ◽

The One

Psychiatric care is delivered by a wide range of workers (psychiatrists, hospital nurses, community psychiatric nurses, occupational therapists, psychologists, social workers, counsellors and general practitioners) who work as teams with some patients and as individuals with others. Health authority resources for psychiatric care are widely distributed among facilities both hospital-based (wards, day hospitals, out-patient departments, social work departments, occupational therapy departments) and community-based (community psychiatric nursing departments, community mental health centres and facilities funded jointly with social services and voluntary agencies).

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Mental health among the Hmong population in the U.S.: A systematic review of the influence of cultural and social factors

Journal of Social Work ◽

10.1177/1468017320940644 ◽

2020 ◽

pp. 146801732094064

Author(s):

Cindy Vang ◽

Fei Sun ◽

Cindy C Sangalang

Keyword(s):

Mental Health ◽

Systematic Review ◽

Social Services ◽

Social Factors ◽

Mental Health Literacy ◽

Web Of Science ◽

Community Based ◽

Mental Health Literature ◽

Communication Challenges ◽

Shed Light

Summary As refugees of the war in Southeast Asia, Hmong experienced various traumatic events. Evidence suggests the persistence of psychiatric disorders related to trauma in refugees even after prolonged resettlement in their host country. This systematic review aimed to summarize the mental health literature on the Hmong population with a focus on cultural and social factors. The databases PsycINFO, PsycARTICLES, Social Services Abstracts, Web of Science, and PubMed were reviewed for peer-reviewed articles published up to April 2018. Forty articles were included in the final review. Findings Results highlight three primary themes: (1) mental health outcomes were associated with a variety of premigration and postmigration factors, (2) group and community-based treatment and interventions provided promising results, and (3) barriers to mental health care were primarily stigma, communication challenges, discrimination, and mental health literacy. The results of this systematic review shed light on the limited and small studies with the Hmong population. Applications Implications for social work and culture-sensitive research, practice, and policymaking for this population are discussed.

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Development of Community-Based Mental Health Interventions in The Philippines: An Ecological Perspective

Psychological Research on Urban Society ◽

10.7454/proust.v2i1.41 ◽

2019 ◽

Vol 2 (1) ◽

pp. 10

Author(s):

Ma. Regina M. Hechanova

Keyword(s):

Mental Health ◽

Social Services ◽

Mental Health Treatment ◽

Urban Poor ◽

The Philippines ◽

Health Interventions ◽

Community Based ◽

Mental Health Interventions ◽

Resilience Factors ◽

Key Drivers

Although urbanization is linked to modernization and economic growth, it is also associated with overcrowding, population density, poverty, inadequate social services, and violence, all of which put the urban poor at risk of environmental health problems and other dangers. Moreover, experiences of environmental and psychological adversity increase vulnerability to mental health disorders. Unfortunately, in low resource countries, mental health treatment is largely inaccessible to the poor. This paper describes the challenges in the development and implementation of community-based mental health interventions in the Philippines. It summarizes the internal and external resilience factors and vulnerabilities of clients. It also highlights the key drivers and barriers to establishing community-based mental health interventions in the Philippines.

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