Villa Voortman : carte blanche or not?

Purpose - Influenced by evolutions in mental health, a meeting house, "Villa Voortman", was recently developed. It is based on an integration of therapeutic community (TC) and psychoanalytical Lacanian thinking. The purpose of this paper is to investigate the position of Villa Voortman in the treatment continuum for dually diagnosed clients. Two research questions are addressed: how does Villa Voortman operate ? and how do clients perceive the Villa? Design/methodology/approach - The first question was tackled by a personal account of the founders of Villa Voortman. The second question was addressed by a qualitative study using video-material of 19 visitors' personal accounts. Findings - The visitors mentioned three themes: social inclusion, personal development and equality. These aspects are further refined into sub-themes including the provision of "asylum"; the instalment of a warm and welcoming atmosphere; the focus on real human encounter; a permissive, supportive and "waiting" environment; a minimal but "good enough" structure; the necessity of a place where persons can develop themselves; the striving for social inclusion and future perspectives; and the support in becoming inclusive citizens again. Originality/value - The value of the paper lies in disclosing the visitors' lived experience. This is an essential part of shedding light on the "active ingredients" of support, In reference to the title, visitors nor treatment staff have "carte blanche" with regard to how support develops, as this is driven by the dialectal course of everything that occurs during the support process

A qualitative exploration of service users’ and staff members’ perspectives on the roles of inpatient settings in mental health recovery

Background: Today, international mental health care increasingly focuses on creating recovery-oriented systems of support. This study aims to unravel the daily practice of an inpatient psychiatric ward that engages with persons with complex mental health needs. Methods: 17 in-depth interviews were conducted with patients and staff of the ward. Data was analyzed by means of thematic analysis. Results: Three important functions of the ward were identified in the participants’ experiences. First, it functions as an asylum, a safe environment where patients can ‘simply be’. Second, the ward is experienced as a particularizing space, as support is organized in an individualized way and patients are encouraged to reconnect with their own identity. Third, the ward functions as a transitional space towards a valuable community life, in which finding adequate housing is of central importance. Conclusions: The results show that inpatient forms of support tally with personal and social dimensions of recovery and fulfill important roles in recovery-oriented systems of support

The perception of persons with anorexia nervosa on quality of life: an initial investigation

Anorexia nervosa (AN) is an illness with a large impact on an individual's quality of life, affecting relationships with friends and family, social inclusion, employment, personal development, and physical health, among other domains. However, most QoL studies primarily focus on health-related QoL without paying attention to the psychosocial and subjective aspects of QoL. In this study, QoL in persons with AN is investigated from a broad perspective. More specifically, this study aims at (1) gaining insight into the personal meaning of QoL of persons recovering from AN, (2) specifying the indicators of the QoL model of Schalock (J Intellect Disabil Res 48(3):203-216, 2004) for persons with AN, and (3) exploring the relationship between a specific treatment program and the perception on QoL of persons with AN. Therefore, in-depth interviews were conducted with 17 persons recovering from AN, who are supported by Empathie, a therapeutic center in Flanders, using solution-focused therapy and client-centered therapy, combined with a systemic orientation. The participants spontaneously mentioned the following themes when asked which elements are important to have a good QoL: interpersonal relationships, personal development, being able to relax, self-determination, and having a healthy lifestyle. Each domain of the QoL model of Schalock was operationalized into specific indicators for persons with AN. These indicators can help service providers to tailor their support strategies to the needs of each patient. The participants reported that being in therapy had positively influenced the following domains: interpersonal relationships, emotional well-being, self-determination, and social inclusion

A systems approach to social entrepreneurship

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Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries:a cross-sectional survey

Background: Recovery colleges were developed in England to support the recovery of individuals who have mental health symptoms or mental illness. They have been founded in many countries but there has been little international research on recovery colleges and no studies investigating their staffing, fidelity, or costs. We aimed to characterise recovery colleges internationally, to understand organisational and student characteristics, fidelity, and budget. Methods: In this cross-sectional study, we identified all countries in which recovery colleges exist. We repeated a cross-sectional survey done in England for recovery colleges in 28 countries. In both surveys, recovery colleges were defined as services that supported personal recovery, that were coproduced with students and staff, and where students learned collaboratively with trainers. Recovery college managers completed the survey. The survey included questions about organisational and student characteristics, fidelity to the RECOLLECT Fidelity Measure, funding models, and unit costs. Recovery colleges were grouped by country and continent and presented descriptively. We used regression models to explore continental differences in fidelity, using England as the reference group. Findings: We identified 221 recovery colleges operating across 28 countries, in five continents. Overall, 174 (79%) of 221 recovery colleges participated. Most recovery colleges scored highly on fidelity. Overall scores for fidelity (β=–2·88, 95% CI 4·44 to –1·32; p=0·0001), coproduction (odds ratio [OR] 0·10, 95% CI 0·03 to 0·33; p&lt;0·0001), and being tailored to the student (OR 0·10, 0·02 to 0·39; p=0·0010), were lower for recovery colleges in Asia than in England. No other significant differences were identified between recovery colleges in England, and those in other continents where recovery colleges were present. 133 recovery colleges provided data on annual budgets, which ranged from €0 to €2 550 000, varying extensively within and between continents. From included data, all annual budgets reported by the college added up to €30 million, providing 19 864 courses for 55 161 students. Interpretation: Recovery colleges exist in many countries. There is an international consensus on key operating principles, especially equality and a commitment to recovery, and most recovery colleges achieve moderate to high fidelity to the original model, irrespective of the income band of their country. Cultural differences need to be considered in assessing coproduction and approaches to individualising support. Funding: National Institute for Health and Care Research.</p

From monologue to dialogue in mental health care research : reflections on a collaborative research process

In today's recovery-oriented mental health care practice and research, the perspectives of service users are considered of great importance. However, academic research into mental health care still mainly produces a scientific monologue in which the researcher (without lived experience) has the last word about the subject's experiences. A fundamental question that remains underexposed in mental health care research is one of relational ethics: how can these monological dynamics be reshaped into a real dialogue between people with and without lived experience? The aim of the current paper is to reflect on the research process that we, an academic researcher and an expert by experience, have conducted in a co-creative way in order to draw a number of key lessons on dialogical research ethics