When Norway established a post graduate program in mental health work in 1997, its curriculum increased the focus on user involvement and recovery. Our study is based on recovery studies, but shifts the focus from the recovery process to the experience of good mental health. In this article we present a phenomenological study of good mental health. Five users of mental health services were asked to write their account of an experience of good mental health. We have analyzed these accounts using Giorgi’s descriptive phenomenological method. The analysis reveals two significant themes: Time experienced as an expanding moment, and the importance of belonging. These two themes are described and elaborated on. Good mental health appears as a lasting moment during which a person may experience calmness, a sense of fitting in, and a sense of belonging. Consequently, patience and attentive presence must be central in the practice and development of good mental health work.
How do CR/HT members describe their hopeful practice, and how can this practice be understood? To answer this we performed multistage focus group interviews with members in a CR/HT team. The transcripts were analyzed using a phenomenological-hermeneutic method inspired by Ricoeur. Our comprehensive understanding of what the staff’s hopeful practice involves is that they move back and forth between being inspiring and arranging things in order to create motion in a deadlock situation. We found that their actions could be subdivided into three categories: «to get in position to create motion», «to set the patient in motion», and «to support the motion of the patient». We discuss whether hopeful practice is a professional ideal, whether it has professional legitimacy, cultural preconditions about predictability, belief in progress and independence, and the ethical dilemma encountered when the patient moves towards suicide.
The article is based on twelve Scandinavian autobiographies published during the period 1918 to 2008. The autobiographies are all written by persons who by themselves or by others were seen as having mental health problems. This study describes and analyzes the authors’ experiences with the public health care system. Significant similarities are identified in these experiences across periods and geography. The authors’ state that the staff as individuals, and the material conditions where the treatment takes place, have great significance. The staff that offered more than a purely professional approach were described as good helpers, and homely surroundings contributed to create a sense of respect. However, with respect to medication, the authors are all critical. The findings indicate that quality mental health care should include professionals focusing on human relations and the interaction between people and materiality. At the same time we have to address the question of whether medication ought to be included in the definition of quality mental health care.
Research regarding migration reveals that unaccompanied refugee minors often struggle with loneliness and finding their own identity. At the same time it is crucial for them to experience safety, affiliation and a sense of community in order to develop a healthy mental state and to master everyday life. Therefore, municipalities in the reception area have a great responsibility to provide this group with appropriate, health-promoting programs. This article discusses a video-analysis of an expressive arts therapist’s role in a group program offered for refugee girls by a local community. The focus of the discussion is on the emotional availability in the arts-related analogous approach where the therapist works with spontaneity, imagination, and creativity to obtain the perspective and cooperation of the client. The data leads to the hypothesis that this approach stimulates the creativity of refugee girls and helps them strengthen their mastery of social interaction. From a theoretical viewpoint the analysis is based on recent scientific research in the fields of infant developmental psychology, migration, and psychotherapy research, and the theory behind expressive arts therapy.
There is a need for a paradigm shift in the view on how services to people with mental health problems should be shaped, towards a contextual perspective deeply rooted in the community mental health work. This shift in paradigm will also happen in the areas of knowledge and competence. The services are now dominated by the specialized health services when it comes to finances, staffing and research. Supporters of such a paradigm shift must have a strategy for clarifying the community mental health services, give authority to it, validate it and make it visible. A defining element in strengthening community mental health as a discipline and field of practice is to involve users routinely, both at an individual and a system level, in evaluating the services. In the future, the professional community must develop competence that ensures both the alliance between the professional and the user as well as a broad methodical competence. Our mission as a community mental health resource center is among other factors to strengthen the contextual perspective locally both regarding knowledge and models. It is thus important to stimulate arenas for the exchange of experience, knowledge and competence, where both research and examples of good practice are included.
The article gives an understanding of the day to day good help provided by employees and users of two assertive outreach teams. The policy of Norwegian Health authorities is to develop holistic, cohesive services for people with substance abuse and severe mental problems. Few studies describe the everyday activities between helpers and service users. Data for the study was gathered through participant observation and semi structured in-depth interviews. Findings: Everyday activities are diverse and vast. The core element of good help is that it is provided in the service users’ everyday arenas. The study shows that help, whether it is provided at IKEA or in the car (going from one place to the other), provides a «cooperative room» in everyday and practical settings which services users pinpoint as important. Central to this is that service users can access their helpers via text messages or telephone. Summarized: Practice that can be characterized as holistic, cohesive services has a focus on collaborative approaches, is person-centered and provided on the service users everyday arena.