Protecting mental health clients' dignity — The importance of legal control

The original publication is available at: http://dx.doi.org/10.1016/j.ijlp.2009.09.008Protecting human beings' dignity is a fundamental value underlying the UN's Universal Declaration of Human Rights as well as several recommendations and conventions derived from this, among them the European Convention of Human Rights (ECHR), a declaration that also takes precedence over Norwegian legislation. Still, clients' stories inform us that their dignity is not always protected in the mental health service systems. The aim of the study has been to investigate violations of dignity considered from the clients' points of view, and to suggest actions that may ensure that practice is brought in line with human rights values. The method used has been a qualitative content analysis of 335 client narratives. The conclusion is that mental health clients experience infringements that cannot be explained without reference to their status as clients in a system which, based on judgments from medical experts, has a legitimate right to ignore clients' voices as well as their fundamental human rights. The main focus of this discussion is the role of the ECHR and the European Court of Human Rights as instruments for protecting mental health clients' human rights. To bring about changes, recommendations and practices should be harmonized with the new UN Convention on the Rights of Persons with Disabilities (2006). Under this convention, the European Court of Human Rights has support for the application of the ECHR without exemptions for special groups of people

Politiske intensjoner bak satsingen på Grønn omsorg

Norsk: I dette notatet ser vi på politiske intensjoner bak satsingen på ulike tiltak og tjenester som faller inn under Grønn omsorg. Vi gir et historisk tilbakeblikk på BU-satsingen (bygdeutvikling) fra 1990 og utover, opprettelsen av Vilje Viser Vei og videreføringen av dette i NAVs nasjonale strategiplan for arbeid og psykisk helse. Flere departementer har vært involvert i satsingen på Grønn omsorg, men med varierende engasjement. Vi har gått gjennom noen policydokumenter fra de ulike departementer og direktorater, inkludert NAV, for å få en nærmere forståelse av hvordan partene ser på Grønn omsorg og hvem som i sterkest grad målbærer intensjonen om å gjøre Grønn omsorg til et alternativ og supplement til eksisterende tjenester. Vårt fokus er psykisk helse og rus og i mindre grad andre områder som barnevern, eldreomsorg eller pedagogiske tilbud. Vi håper notatet kan kaste lys over de ulike og til dels tvetydige, politiske signalene og hvordan disse er med på å forme feltet.English: In this brief research report we look at the political intentions behind the various activities and services comprising Green Care. We provide a historical sketch of the rural development initiative (BU) from 1990 onwards, the establishment of the ’Will Shows the Way’ program and the continuation of this in NAV’s (Labour and Welfare Administration) national strategic plan for work and mental health. Several ministries have been involved in developing Green Care, but with varying commitment. We have gone through a selection of policy documents from the various ministries and agencies, including NAV, to gain a deeper understanding of how these actors view Green Care and to discern to what extent they promote the intention of making Green Care an alternative or supplement to existing services. Our focus is mental health and substance abuse and to a lesser degree other areas such as child welfare, elderly care or educational services. We hope that this brief report may shed light on the diverse, and at times ambiguous, political signals and how these are shaping the field

Narratives of Natural Recovery: Youth Experience of Social Inclusion through Green Care

This is an open access article. You can find it online by following this link: http://www.mdpi.com/journal/ijerph. The article is published under a Creative Commons Attribution 3.0 License. Please follow this link to read about it: http://creativecommons.org/licenses/by/3.0/The aim of this study has been to investigate the effects of Green Care services for youth in vulnerable situations risking social exclusion. Green Care enterprises represent alternative arenas in which people can work with animals, agriculture and other tasks related to nature. We interviewed nine persons, aged 17–27, working in three different places, two or more times over a two-year period. We looked at essential beneficial factors in order to better understand how the “green” element could add to more traditional recovery factors. We found that the youth described core success factors corresponding to well-known recovery factors such as recognition, supportive relationships, motivation, meaning, positive coping, self-esteem, confidence and hope. The effective factors can be described as: (a) The leader’s ability to create a good group atmosphere, (b) the varied tasks which allow step-wise increases in self-efficacy, and (c) experiences with animals and in nature that provide comfort for youth who lack trust in people and need safe situations to recover a positive sense of self. We followed a process in which several persons gradually regained self-respect and the motivation for further education or a job outside the Green Care enterprise. The study illustrates that Green Care can be an important supplement in helping people back to a satisfying life and meaningful roles in society

The Meaning of Social Support in Nature-Based Services for Young Adults with Mental Health Problems

In previous studies, social context and social support have been found to be important in nature-based services. However, no studies have previously focused on the meaning of different dimensions of social support in these contexts. The aim of this study is therefore to uncover dimensions of social support in relation to mental health among young adults with mental health problems participating in nature-based services in Norway. This study applies data from a survey of 93 young adults participating in nature-based services; in addition, qualitative interview data from 20 interviews are also used. The data are analysed using qualitative content analysis, descriptive statistics, and correlation analysis. The results indicate that participants in nature-based services experience emotional, esteem, informational, and instrumental support in addition to social integration and opportunities for nurturance in these services. The service leader, other participants, and the animals are important contributors to these dimensions of social support. Nature-based services may be a helpful intervention for young adults with mental health problems. The unique context of these services, including nature and animals, adds special qualities to mental health and social work practices.publishedVersio

In Defence of a Humanistic approach to Mental Health Care – Recovery processes investigated with the help of clients’ narratives on turning points and processes of gradual change.

Dette er forfatterens pre-print versjon av artikkelen. Artikkelen slik den foreligger her er ikke fagfellevurdert, og mangler forlagets layout, sidetall og siste korrekturrettelser. Artikkelen publisert i Journal of Psychiatric and Mental Health Nursing er fagfellevurdert.Engelsk sammendrag (abstract): Several studies in recent years have shown that recovery factors as experienced by clients are not always compatible with professional approaches. For example, clients often emphasise the importance of relationships and the satisfaction of universal human needs. The aim of the study has been to explore clients‟ descriptions of beneficial factors and to discuss the implications of those factors for the delivery of mental health services. Method has been qualitative content analysis of 347 user narratives. The study confirms findings in earlier recovery studies, but also demonstrates that the investigation of clients‟ stories leads to a range of existential dilemmas. Fundamental beliefs about what constitutes effective and necessary treatment are challenged. Recovery is a fundamentally personal process that involves finding a new sense of self and feeling of hope. Furthermore it is not only an internal process; it also requires external conditions that facilitate a positive culture of healing

Brukarens roll i välfärdsforskning och utvecklingsarbete

Tekstene er fra forelesninger samt fra doktorantkurset "Brukarmedverkan i forskning och utvecklingsarbete inom hälso- och sjukvård, socialt arbete och omsorg". Kurset ble avholdt våren 2009.Fra omslag: På 1980-talet blev ”brukare” ett modeord i offentlig förvaltning och förvaltningsforskning. Termen betecknar den som använder sig av välfärdsservice (jfr. engelskans service user), eller ”slutmottagare” av offentlig nyttighet eller åtgärd. Brukare av välfärdstjänster vet hur hjälp och service fungerar i praktiken och kan därför ge synnerligen viktig återkoppling enligt devisen: ”Den som har skorna på fötterna vet var de skaver”. Välfärdsorganisationer har all anledning att involvera brukare i planering och policyarbete i syfte att utveckla förmågan att göra rätt saker. Det finns inte mycket dokumentation och forskning kring brukarmedverkan i utvecklingsarbete och forskning på välfärdsområdet. I synnerhet saknas kunskap om hur välfärdstjänster tas emot och realiseras i brukarens livssammanhang. En ambition i doktorandkursen ”brukarmedverkan i forskning och utvecklingsarbete inom hälso- och sjukvård, socialt arbete och omsorg” var att samla och presentera kunskaper på området. Kursen genomfördes våren 2009 i ett unikt samarbete mellan Karlstads Universitet, Sheffield University i England, Högskolan i Hedmark i Norge, Hälsohögskolan i Jönköping och Högskolan i Borås/FoU Sjuhärad Välfärd. Texterna i denna bok härrör från kursens föreläsningar och paperarbeten. De ger många exempel på hur brukare kan involveras i forskning och utvecklingsarbete, och presenterar en rad praktiska metoder för brukarsamverkan. Boken rekommenderas till välfärdens politiker och yrkespersoner, till studenter som förbereder sig för välfärdens yrken liksom till forskare och utvecklingsarbetare som vill utveckla samarbete med brukare och brukarorganisationer. Den vänder sig givetvis även till brukare och brukarorganisationer som vill engagera sig i forskning och utvecklingsarbete

Protecting mental health clients' dignity — The importance of legal control

Protecting human beings' dignity is a fundamental value underlying the UN's Universal Declaration of Human Rights as well as several recommendations and conventions derived from this, among them the European Convention of Human Rights (ECHR), a declaration that also takes precedence over Norwegian legislation. Still, clients' stories inform us that their dignity is not always protected in the mental health service systems. The aim of the study has been to investigate violations of dignity considered from the clients' points of view, and to suggest actions that may ensure that practice is brought in line with human rights values. The method used has been a qualitative content analysis of 335 client narratives. The conclusion is that mental health clients experience infringements that cannot be explained without reference to their status as clients in a system which, based on judgments from medical experts, has a legitimate right to ignore clients' voices as well as their fundamental human rights. The main focus of this discussion is the role of the ECHR and the European Court of Human Rights as instruments for protecting mental health clients' human rights. To bring about changes, recommendations and practices should be harmonized with the new UN Convention on the Rights of Persons with Disabilities (2006). Under this convention, the European Court of Human Rights has support for the application of the ECHR without exemptions for special groups of people

Social Networks for Mental Health Clients – Resources and Solution

English: Background: Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a reduced need for professional services, but also help to facilitate access to professional help. The interplay between social networks and professional services is complicated and invites further investigation. Aim: Compare aspects of clients’ experiences with social networks to experiences with professional services and discuss the implications of the findings for service delivery. Method: Quantitative analyses of a sample of 850 informants. Results: Supportive networks exist for a majority of the informants and can also be a substitute for professional services in many respects. Regarding help to recover, social networks may offer qualities equal to those of professional services. Furthermore, there is a positive relationship between trust in a social network and trust in public professional services. Trust in a social network also increases the probability of achieving positive experiences with professional services. Conclusion: Our findings imply that more network qualities should be included in professional services, and also that professionals should assist vulnerable groups in building networks

Sosiale nettverk for personer med psykiske lidelser – både ressurs og løsning

English: Background: Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a reduced need for professional services, but also help to facilitate access to professional help. The interplay between social networks and professional services is complicated and invites further investigation. Aim: Compare aspects of clients’ experiences with social networks to experiences with professional services and discuss the implications of the findings for service delivery. Method: Quantitative analyses of a sample of 850 informants. Results: Supportive networks exist for a majority of the informants and can also be a substitute for professional services in many respects. Regarding help to recover, social networks may offer qualities equal to those of professional services. Furthermore, there is a positive relationship between trust in a social network and trust in public professional services. Trust in a social network also increases the probability of achieving positive experiences with professional services. Conclusion: Our findings imply that more network qualities should be included in professional services, and also that professionals should assist vulnerable groups in building networks.Norsk: Dette notatet bygger på en undersøkelse der 850 medlemmer av brukerorganisasjonen Mental Helse svarte på spørsmål om erfaringer med ulike deler av hjelpeapparatet og i hvilken grad de hadde et sosialt nettverk og hvordan dette fungerte. Det ble også krysset av for alder, kjønn, sivilstand, skole- eller yrkestilknytning og bosituasjon. Bakgrunnen for undersøkelsen var et ønske om å forstå mer av samspillet mellom sosiale nettverk og profesjonelle tjenester. Mange studier har illustrert betydningen av sosial støtte og sosiale nettverk for personer med psykiske problemer eller lidelser, og dessuten vist at sosiale nettverk både kan bety redusert behov for profesjonelle tjenester og bedre tilgang til slike tjenester. Vi har likevel begrenset kunnskap om hvordan samspillet mellom sosiale nettverk og profesjonelle tjenester fungerer. Ca. 4000 medlemmer fikk tilsendt spørreskjemaet og knapt 1000 svarte. Støttemedlemmene ble ekskludert fra den kvantitative analysen (men inkludert i kvalitative analyser av det samme utvalget). Cirka 1/3 av respondentene var menn og alderen varierte fra 20 til 80 år, med hovedtyngden mellom 40 og 60 år. 67 % hadde uføretrygd, 13 % var i jobb og 20 % kombinerte trygd med jobb eller studier. Respondentene har erfaringer fra alle deler av hjelpeapparatet, d.v.s. fra tradisjonelle psykiatriske sykehus, DPS-er, dagsentra, individualterapi, familieterapi, hjelpetelefoner, krisesentra, kunst- og kroppsorienterte terapier m.m. Dataene viste at de aller fleste opplever å ha støttende sosiale nettverk. Videre fant vi at disse nettverkene på flere måter kan sies å erstatte profesjonelle tjenester. Når det gjelder hjelp til bedring, kan sosiale nettverk tilby kvaliteter som er på høyde med de profesjonelle tjenestene. Videre fant vi en positiv sammenheng mellom tillit til et sosialt nettverk og tillit til profesjonelle tjenester. Tillit til et sosialt nettverk øker også sannsynligheten for at erfaringene med de profesjonelle tjenestene blir positive. Det er flere konklusjoner som kan trekkes av denne studien. Bl.a. tilsier funnene at nettverkskvaliteter i større grad burde inkluderes i de profesjonelle tjenestene. De åpne nettverksmøtene, hvor profesjonelle og nettverksmedlemmer møtes på mer likeverdig basis, kan her være en god modell. Videre vil det ha stor betydning om profesjonelle kan hjelpe utsatte grupper med å bygge egne nettverk

Narratives of natural recovery: Youth experiences of social inclusion through Green care

The aim of this study has been to investigate the effects of Green Care services for youth in vulnerable situations risking social exclusion. Green Care enterprises represent alternative arenas in which people can work with animals, agriculture and other tasks related to nature. We interviewed nine persons, aged 17–27, working in three different places, two or more times over a two-year period. We looked at essential beneficial factors in order to better understand how the “green” element could add to more traditional recovery factors. We found that the youth described core success factors corresponding to well-known recovery factors such as recognition, supportive relationships, motivation, meaning, positive coping, self-esteem, confidence and hope. The effective factors can be described as: (a) The leader’s ability to create a good group atmosphere, (b) the varied tasks which allow step-wise increases in self-efficacy, and (c) experiences with animals and in nature that provide comfort for youth who lack trust in people and need safe situations to recover a positive sense of self. We followed a process in which several persons gradually regained self-respect and the motivation for further education or a job outside the Green Care enterprise. The study illustrates that Green Care can be an important supplement in helping people back to a satisfying life and meaningful roles in society