The recovered subject. A socio-cognitive snapshot of a new subject in the field of mental health.

Recovery represents a new paradigm in the field of mental health. It refers hereby less to the possibility of relief from symptoms than to the individual\u27s capacity to develop a meaningful life and a self-concept beyond the illness. Several countries adopted recovery oriented approaches to implement mental health service reforms and attracted considerable scientific interest on that subject matter. A comprehensive theory of the recovery process is however still missing. The present article argues for an analytic approach to the socio-cognitive components in the di?erent stages of the subject\u27s recovery process. By the means of narratives from mental health patients, a dramatic loss of internal territoriality ("locus") is evidenced in psychiatric treatment, whereby a subject in crisis renounces its internality to the professionals\u27 authority. The eventual process of a subject\u27s recovery, we suggest, has to be regarded as an inverse process, in which internality is privately and socially reclaimed and defended in terms of ownership and responsibility. The phenomenon of users\u27 social movements, such as Madpride, is suggested as a form of re-conquest of social territory by the means of emancipatory pride. The mental components of the recovery process represent, in a large part, concepts from the theoretic framework of Cristiano Castelfranchi and his associates. A conception of the subject emerges whereby recovery is ideated literally as a process of "re-covering" aka protecting the subject\u27s internality against the psychiatric/institutional gaze and rule of private affairs

Introduction: Open Dialogue around the world – implementation, outcomes, experiences and perspectives

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Open Dialogue services around the world: a scoping survey exploring organizational characteristics in the implementation of the Open Dialogue approach in mental health services

ObjectiveThis cross-sectional study investigates the characteristics and practices of mental health care services implementing Open Dialogue (OD) globally.MethodsA structured questionnaire including a self-assessment scale to measure teams’ adherence to Open Dialogue principles was developed. Data were collected from OD teams in various countries. Confirmatory Composite Analysis was employed to assess the validity and reliability of the OD self-assessment measurement. Partial Least Square multiple regression analysis was used to explore characteristics and practices which represent facilitating and hindering factors in OD implementation.ResultsThe survey revealed steady growth in the number of OD services worldwide, with 142 teams across 24 countries by 2022, primarily located in Europe. Referrals predominantly came from general practitioners, hospitals, and self-referrals. A wide range of diagnostic profiles was treated with OD, with psychotic disorders being the most common. OD teams comprised professionals from diverse backgrounds with varying levels of OD training. Factors positively associated with OD self-assessment included a high percentage of staff with OD training, periodic supervisions, research capacity, multi-professional teams, self-referrals, outpatient services, younger client groups, and the involvement of experts by experience in periodic supervision.ConclusionThe findings provide valuable insights into the characteristics and practices of OD teams globally, highlighting the need for increased training opportunities, supervision, and research engagement. Future research should follow the development of OD implementation over time, complement self-assessment with rigorous observations and external evaluations, focus on involving different stakeholders in the OD-self-assessment and investigate the long-term outcomes of OD in different contexts

Psicofarmaci: Sulla necessit? di rompere un tab? econtrastare il riduzionismo biologico nel campo della salute mentale

A widely recognized value of Whitaker\u27s work lies in the non-propagandistic divulgation of scientific data on the use of psychoactive substances. In our opinion, this work has at least two other and even more remarkable merits: (1) it contributes to the break of a taboo concerning the heavy use of medication to treat mental distress discussing its effects and (2) it introduces an important reflection about the consequences of the reductionist paradigm in the field of mental health

Introduction : Open Dialogue around the world – implementation, outcomes, experiences and perspectives

nonPeerReviewe

Open Dialogue services around the world: a scoping survey exploring organizational characteristics in the implementation of the Open Dialogue approach in mental health services

Objective: This cross-sectional study investigates the characteristics and practices of mental health care services implementing Open Dialogue (OD) globally.// Methods: A structured questionnaire including a self-assessment scale to measure teams’ adherence to Open Dialogue principles was developed. Data were collected from OD teams in various countries. Confirmatory Composite Analysis was employed to assess the validity and reliability of the OD self-assessment measurement. Partial Least Square multiple regression analysis was used to explore characteristics and practices which represent facilitating and hindering factors in OD implementation.// Results: The survey revealed steady growth in the number of OD services worldwide, with 142 teams across 24 countries by 2022, primarily located in Europe. Referrals predominantly came from general practitioners, hospitals, and self-referrals. A wide range of diagnostic profiles was treated with OD, with psychotic disorders being the most common. OD teams comprised professionals from diverse backgrounds with varying levels of OD training. Factors positively associated with OD self-assessment included a high percentage of staff with OD training, periodic supervisions, research capacity, multi-professional teams, self-referrals, outpatient services, younger client groups, and the involvement of experts by experience in periodic supervision.// Conclusion: The findings provide valuable insights into the characteristics and practices of OD teams globally, highlighting the need for increased training opportunities, supervision, and research engagement. Future research should follow the development of OD implementation over time, complement self-assessment with rigorous observations and external evaluations, focus on involving different stakeholders in the OD-self-assessment and investigate the long-term outcomes of OD in different contexts

The Recovery House of Trieste: Beginning a Recovery Journey in an Innovative Experience

The Trieste mental health care model is the result of a process of change that took place in Italy in the 1970s initiated by the psychiatrist Franco Basaglia. This change resulted in the closure of the psychiatric asylum and the creation of a network of 24- hour community-based services. To this day Trieste is regarded as an international reference in deinstitutionalization practice and is a World Health Organization (WHO) Collaborating Centre for Research and Training. To improve quality and good practice, the Trieste Mental Health Department is continually investing in innovative practices and strategies. One of the most recent examples has been the establishment of the Recovery House, a facility that fosters recovery processes and meaningful changes in the lives of young people who are already using mental health services. Objectives: This article explores the changes in the relationships of the group of young people who participated in the piloting of the Recovery House experience. Method: This qualitative study used participant observation of the daily meetings at the Recovery House and was considered to be the central component in ensuring co-production. Twelve people regularly participated in the meetings, including the six young people. The study took place over a period of about six months. The meetings were registered in the researcher’s field diary and qualitatively analyzed. Results: The study provides insights into the group processes and dynamics, including the gradual sharing of experiences, stories, and coping strategies. Trusting relationships and dialogue were the centre of the experience, requiring particular attention to the determination of roles, the issue of power, and the use of language. &nbsp

Dialogue as a Response to the Psychiatrization of Society? Potentials of the Open Dialogue Approach

In recent decades, the use of psychosocial and psychiatric care systems has increased worldwide. A recent article proposed the concept of psychiatrization as an explanatory framework, describing multiple processes responsible for the spread of psychiatric concepts and forms of treatment. This article aims to explore the potentials of the Open Dialogue (OD) approach for engaging in less psychiatrizing forms of psychosocial support. While OD may not be an all-encompassing solution to de-psychiatrization, this paper refers to previous research showing that OD has the potential to 1) limit the use of neuroleptics, 2), reduce the incidences of mental health problems and 3) decrease the use of psychiatric services. It substantiates these potentials to de-psychiatrize psychosocial support by exploring the OD’s internal logic, its use of language, its processes of meaning-making, its notion of professionalism, its promotion of dialogue and how OD is set up structurally. The conclusion touches upon the dangers of co-optation, formalization and universalization of the OD approach and stresses the need for more societal, layperson competencies in dealing with psychosocial crises.peerReviewe