Suchergebnisse

Collaboration in the field of mental health involves institutions with differing organizational structures and belonging to different administrative and political authorities. The institutions concerned include professionals with such varying roles as physicians, nurses, psychologists, social welfare secretaries, occupational therapists, home support personnel and others. The purpose of this article is to describe and analyse how different psychiatric and social services in a Swedish municipality can collaborate, in spite of obvious differences in organizational forms, legislative and administrative mandates, professional backgrounds and perspectives. A study of formal agreements and procedures for collaboration and other forms of documentation, in combination with an interview study of persons with different occupational roles in each respective organization, shows the importance of a comprehensive strategy based on a holistic view of the diverse needs of individual patients and clients. Such a strategy requires an overall structure including not only written agreements and procedures, but also arenas for meetings at all levels of the organizations involved, in which the role of leadership is to solidify the structure for collaboration and support individual professionals working in collaboration to provide care and service for individual patients or clients.

Collaboration in the field of mental health involves institutions with differing organizational structures and belonging to different administrative and political authorities. The institutions concerned include professionals with such varying roles as physicians, nurses, psychologists, social welfare secretaries, occupational therapists, home support personnel and others. The purpose of this article is to describe and analyse how different psychiatric and social services in a Swedish municipality can collaborate, in spite of obvious differences in organizational forms, legislative and administrative mandates, professional backgrounds and perspectives. A study of formal agreements and procedures for collaboration and other forms of documentation, in combination with an interview study of persons with different occupational roles in each respective organization, shows the importance of a comprehensive strategy based on a holistic view of the diverse needs of individual patients and clients. Such a strategy requires an overall structure including not only written agreements and procedures, but also arenas for meetings at all levels of the organizations involved, in which the role of leadership is to solidify the structure for collaboration and support individual professionals working in collaboration to provide care and service for individual patients or clients.

Background: User involvement, based on respect and carried out through dialogue, has been shown to lead to increased self-respect, self-confidence and positive identity. In Sweden, the Social Service Act requires that interventions be designed and implemented together with the individual concerned. The basic criterion for social support is prolonged severe mental illness (usually at least 6 months), with no criteria for specific diagnosis or institutional history. The most common form of social support is 'support in daily living', a community care intervention for people aged 18 years or older who have their own homes and living arrangements. Aim: This article aims to deepen our understanding of user involvement at the individual level in the provision of an ongoing social work intervention. What elements of user involvement can be found in users' and support workers' descriptions of helpful support in daily living? Method: Qualitative interviews were conducted with 18 users, who had experienced support in daily living as helpful, and 16 interviews with the users' support workers. Results: Three major, interconnected themes emerged: Constant dialogue; Framing the flexibility, in relation to formalized intervention plans and regulations; The importance of 'small things', decisions concerning daily life. Conclusion: Both users and support workers described user involvement at the individual, micro-level to be an integral part of helpful support in daily living. It was possible to create a space for dialogue and co-creation in which users were involved in formulating and deciding the contents of their support at an informal level, to influence their own everyday lives. While a formal framework of rules, restrictions and plans surrounds meetings between users and professionals, a facilitating factor may be the absence of too detailed plans and regulations, leaving trust to users and professionals and their capacity to manage most of the choices they have to make.

Persons with mental health problems and substance abuse often have complex needs requiring many kinds of help concurrently. In Sweden, an attempt has been made to counterbalance the effects of fragmentation by means of legislation on collaboration, requiring on the individual level the use of Coordinated Individual Plans (Sw. Samordnad Individuell Plan, SIP). The aim of the study is to explore collaboration as it is indicated in SIP and other case documentation with focus on how SIP is motivated, and what kind and degree of collaboration is indicated by the documentation. 12 individual case files have been studied in six local authorities and the results have been analyzed in relation to a regional collaboration agreement and local collaboration agreements. The results show unclear motivation for SIP and that SIP is primarily used for documentation of short-term planning. Use of SIP and participation in SIP appears also to be uneven. The authors characterize SIP as an unsystematic form of interagency meeting, with documentation indicating a relatively low to moderate level of collaboration. The authors question whether SIP is an optimal form for collaboration and suggest that more distinct models such as case management or multidisciplinary teams could be more effective.