Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned

PENGARUH MEDIA SOSIAL DAN SUASANA TOKO TERHADAP PROSES KEPUTUSAN PEMBELIAN (Survey Pada Pengunjung Eatboss Cafe Cabang Lengkong)

ABSTRAK Penelitian ini bertujuan untuk mengetahui pengaruh Media Sosial dan Suasana Toko terhadap Proses Keputusan Pembelian pada Eatboss Cafe Cabang Lengkong. Eatboss Cafe Cabang Lengkong merupakan sebuah cafe yang menjual berbagai produk makanan dan minuman. Metode penelitian yang digunakan adalah deskriptif verifikatif. Objek penelitian adalah konsumen Eatboss Cafe Cabang Lengkong dengan jumlah sampel sebanyak 100 responden. Analisis data yang digunakan yaitu menggunakan analisis korelasi berganda, dan koefisien determinasi. Berdasarkan hasil analisis pengaruh media sosial dan suasana toko terhadap proses keputusan pembelian secara simultan adalah sebesar 121,580. Sedangkan secara parsial suasana toko lebih besar pengaruhnya daripada media sosial, karena berdasarkan perhitungan standardized coefficients beta memiliki nilai tertinggi yaitu sebesar 0,474 dibandingkan media sosial

Processes towards employment among persons with psychiatric disabilities: a study of two individual placement and support programmes in Sweden

Individual placement and support (IPS) has been found to be an effective intervention for rehabilitation to work in the field of mental health. Being as the principles used in IPS reflect core values in the concept of personal recovery, several other outcomes than just the percentage of clients gaining employment are of interest. The purpose of the study was to describe a number of unique processes and analyze these with a special concern for circumstances perceived as important for the individual IPS process. A collective instrumental case-study design was used and five cases were included. Data from three different sources were collected, both quantitative and qualitative. The findings illustrate how a relationship characterized by curiosity, interest and engagement in the individual client, positive risk-taking and time for reflected experiences resulted in processes of change. It was concluded that providing IPS is a type of specialized relationship-based work that includes advanced problem solving

Staying the course? : Challenges in implementing evidence-based programs in community mental health services

This paper focuses on the second phase of the deinstitutionalisation of mentalhealth care in which the development of community-based interventions are supposed to beimplemented in local community mental health care systems. The challenge to sustainableimplementation is illustrated by the Swedish case where the government put forwarda national training program that sought to introduce Assertive Community Treatment(ACT) for people with severe mental illness. This study is based on document analysis andqualitative interviews with actors at the national, regional, and local levels covering a total offive regions and 15 municipalities that participated in the program. The analysis of the nationalexperiences is put in relation to both research on public administration and policy analysis aswell as to current research on implementation of evidence-based programs. The results showeda “drift” of the original model, which had already begun at the policy formulation stage andended up in a large number of different local arrangements where only a few of the originalcomponents of ACT remained. We conclude that issues with implementation can only be fullyunderstood by considering factors at different analytical levels

Den svenska psykiatrireformen : bland brukare, eldsjälar och byråkrater

In 1990, a government commission was formed with the task of improving care and services to persons with serious psychiatric disabilities. The government bill that resulted from the work of the Commission constitutes an attempt to clarify the responsibility of the municipal social services for residential and occupational services. The Swedish Mental Health Reform came into eff ect in 1995. The aims of the thesis are to describe, analyze and critically review the planning and implementation of the Reform and to present it within a historical perspective on caregiving. The thesis consists of two case-studies: One encompassing fi ve municipalities and their method of planning and implementing the Reform. The second is about a vocational rehabilitation project for persons with psychiatric disabilities which began in connection with the Reform. In addition to the two component studies, the substance of the report is composed of comprehensive written material. In the analysis it becomes evident that the report of the Commission is a document characterised by a strong ideology and one that takes a position regarding the questions of division of responsibility and work methods. The Commission’s problem lies in diffi culties in delineating and defi ning the target group. The result from the studies shows that the boundaries of responsibility between the social services and psychiatric care organization have become clearer, but grey zones continue to exist in the areas of rehabilitation and outpatient care. Few local policians, and a very small part of the local administrations were involved in the implementation of the Reform — the responsibility has rested with certain key individuals. The implementation has not been promoted by specifi c strong professions, and many eff orts to re-educate personell have been half-hearted and based on “old” knowledge. Personnel in the new settings express uncertainty, as they are unclear as to the expectations of the organization — those who were recruited from psychiatric care often feel degraded and insuffi ciently utilized. User- and family organizations have, in connection with the Reform, built up and developed their activities by means of earmarked funding provided by the state. As a result, an alternative knowledge base has developed in relation to work with the psychiatrically disabled. A conclusion is that the implementation of the Reform has been diffi cult, but that it is far from a complete failure. There are just too many positive experiences. However, much of the success must be attributed to the funding by the state. The long-term discourse will take shape and depend on how enduring the early initiatives prove to be