Perspectives of hospitalized patients with mental disorders and their clinicians on vocational goals, barriers, and steps to overcome barriers

<div><p></p><p><i>Background</i>: People with mental disorders experience difficulties with finding competitive jobs. In countries with longer psychiatric hospitalization periods, the vocational rehabilitation process can start during hospitalization. Yet, rehabilitation can be hindered by a lack of focus by clinicians on the patients’ vocational goals and a lack of agreement between clinicians and patients.</p><p><i>Aims</i>: To compare (i) vocational goals, (ii) barriers to employment and (iii) support needed to overcome barriers faced by patients.</p><p><i>Method</i>: The paired data-set comprised 733 hospitalized patients and their 279 clinicians. Patients selected their vocational goals and clinicians indicated options that seemed realistic. Patients and clinicians indicated how many barriers exist and what support is needed to overcome barriers.</p><p><i>Results</i>: Almost 45% of patients prefer competitive jobs, while 32% of clinicians find this realistic, indicating a moderate relationship between patients’ goals and clinicians’ perceptions. Patients and clinicians also differ in their perception of the level of barriers and types of support to overcome them. Patients perceive fewer vocational barriers than clinicians and prefer less intense vocational support options.</p><p><i>Conclusions</i>: Patients and clinicians have different perspectives concerning vocational recovery. Improving vocational rehabilitation requires a stronger alignment between patients and clinicians’ vocational goals and barriers.</p></div

Additional file 2 of Experiences and needs of welfare benefit recipients regarding their welfare-to-work services and case workers

Supplementary Material

Table_2_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.docx

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Data_Sheet_1_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.PDF

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Table_3_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.DOCX

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Data_Sheet_1_Addressing victimization to enable societal participation in flexible assertive community treatment: A process evaluation of the implementation of a new intervention.docx

BackgroundIndividuals with severe mental illness experience more victimization and discrimination than other persons in the community. Effective rehabilitation and recovery-oriented care interventions aimed at addressing this issue are lacking. We therefore developed a victimization-informed intervention (accompanied by a training module for professionals) called the Victoria intervention. The purpose of the present study was to understand the trial effects by examining the implementation process and the factors that influenced it.Materials and methodsA process evaluation was conducted using a mixed-methods design. During the professionals’ intervision sessions, we used observations to understand the learning processes (n = 25). Subsequently, we studied the use of the intervention in practice through structured questionnaires (n = 215) and semi-structured interviews (n = 34) with clients and professionals. We used descriptive and inferential statistics for the quantitative data and the framework method for the analyses of the qualitative data.ResultsThe observations showed that the trainings were well received. The professionals shared the urgency of paying attention to victimization and discrimination and its harmful effects on participation. They also found the intervention steps to be logical and the intervention protocol easy to use. Nevertheless, they mentioned in the interviews that they had experienced difficulties initiating a conversation about victimization, and if they started one, they did not always follow the steps of the intervention as intended. Few clients said that victimization was placed on the agenda, though those who had discussed victimization with their caregivers expressed their appreciation in the interviews; they felt acknowledged and supported.DiscussionThe findings indicate that the intervention was considered helpful in raising awareness and the acknowledgment of victimization. However, professionals remain reluctant to talk about the subject, and the results show they need more practical training in this regard. This process evaluation has an important added value in that it helps us to understand the results of the effect evaluation of the intervention. The findings will facilitate the development and implementation of interventions that address clients’ victimization experiences in community mental healthcare settings and subsequently enable their participation in society.</p

Table_1_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.docx

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Table_4_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.DOCX

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Table_5_Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research.DOCX

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.</p

Results of confirmatory factor analysis: univariate proportions of the items and factor loadings of items N1-N4, N6, G5, G7, G13 and G16 of the PANSS (N = 1157).

<p>Results of confirmatory factor analysis: univariate proportions of the items and factor loadings of items N1-N4, N6, G5, G7, G13 and G16 of the PANSS (N = 1157).</p