Implementation of individual placement and support in a first‐episode psychosis unit: A new way of working

The aim of this study is to explore the IPS implementation process in a first‐episode psychosis (FEP) mental health service team in Sweden. More specifically, the study explores how integration processes and critical situations are perceived over time by team members who originated from two diverse welfare organizations. A serial interview design was used (initially, at 6 and 12 months) to describe experiences of 16 team members. Material was analyzed using a constant comparison grounded theory approach. Team members dealt with the ambivalence of sharing mental health information, and whether the new way of working was a risk or benefit for users. They gradually learned new perspectives and knowledge, built trust and shared common views. After a year, the team workload perceived reduced and became person‐centred. Some members described remaining unclear roles and requested further support. Negotiated goals for integration and early knowledge transfer are critical. Organizational change and trusting team relationships have to be facilitated. Anticipated gains of integration should be clearly described and discussed early on, and continuous support for sustainability should be considered. This study confirmed the importance and potential of integrating IPS into FEP teams.     

Traits of a representative welfare state: the Swedish example

Järkestig Berggren U, Blomberg S, Petersson J. Traits of a representative welfare state: the Swedish example Int J Soc Welfare 2010: 19: 402–411 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The care manager reform and the case manager reform are new reforms in the social care services in Sweden, which are evolving during the 2000s. Together they shape the social care services introducing a new way of decision‐making where representatives for the organisation (care manager) and the users (case manager) negotiate. The reforms have been analysed in two studies with results presented in this article. Using the concepts of role, orientation, function and assignments, it is argued that the managers come to the negotiations on rights from different positions that are both conflicting and complementary. They further mediate the development towards a welfare mix, where the market, social networks and users interact to obtain the public welfare provision. Through this negotiated rights model, it is argued that traits of a representative welfare state emerge, with the distinction of moving the focus to the administrative practices and their differences away from political ideologies.     

Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years

The deinstitutionalization of mental health care has changed the responsibilities of involved authorities and has led to a continuous need for new treatment forms and interventions. This article describes this development in Europe, and in particular how these new conditions have been handled in Sweden over the past 20 years at the level of governmental policy‐making. Three major policy documents from 1994, 2009 and 2012 were included in this study. To increase our understanding of the policies' contents, we have used theoretical concepts concerning governance, implementation and political risk management. Although our main interest was to find out how the government handles interventions for users of the mental health care system, we found that the policy work is progressing stepwise. The first document, from the deinstitutionalization era, did not discuss interventions clearly. Instead, it was mainly concerned with both practical and economical areas of responsibility. The second document, from the post‐deinstitutionalization era, was more focused on what services should be delivered to the users, while the most recently published document to a greater extent addressed the question of how the support is supposed to be designed. The trend in European community mental health policy has been to advocate services in open forms that are integrated into the society's other care systems. This is also the case in Sweden, and continuous work is being done by the government to find strategies to support the development, and to meet the needs at both political and local levels.     

New ways of organizing product introductions

The aim of this paper is to describe and reflect on an interactive research approach used to address the challenges on how to improve product introductions, the part of the product realization process associated with the transfer of a product from product development to serial production. In the interactive research approach, research results as well as improvement of practice are given equal importance. The collaboration between researchers and practitioners therefore addresses both the focus and the process of the change. The approach includes four main iterative steps: 1) mapping/diagnosis, 2) feedback of results, 3) participation in development activities, and 4) follow-up/evaluation. The paper reports findings from interactive research in one company within office product industry and one company group, consisting of three company units within the engine industry. Preliminary findings indicate that the participating companies afterwards work in a more structured way with product introductions and that the employees have gained deeper knowledge about product introductions as well as experienced the advantages of working across functional boundaries. Furthermore, the interactive research approach is suitable to run projects from an ergonomics perspective as it focuses on developing both practice and theory, it is human-centered, and it emphasizes broad participation from practitioners.     

Young carers in Sweden—A pilot study of care activities,view of caring,and psychological well‐being

Children who have parents with any kind of illness may become young carers who take a responsibility not expected of children for household tasks, or personal or emotional care for parents and siblings. So far, little is known about children in Sweden who are at risk of becoming young carers. The aim of this article is therefore to explore the extent and impact of children's caring activities as reported in a pilot study by a sample of children in Sweden. A number of international questionnaires measuring the amount of caring activities, impact of caring, quality of life, and psychological well‐being were translated and combined into a survey. The pilot survey was completed by 30 children 10–18 years of age. Also, when completing the survey, the children were interviewed concerning their experiences of caregiving. The participants report on a group level emotional symptoms such as fear and nervousness above the clinical cut‐off value. They also rate a lower level of caring compared with findings from the United Kingdom, but they report a higher degree of negative impact of caring than young carers in the United Kingdom.     

Implementation of evidence-based interventions: analyzing critical components for sustainability in community mental health services

This study analyses the implementation and sustainability of evidence-based community mental health services in the form of publicly financed Individual Placement and Support programs. Critical implementation components and program fidelity were assessed after one year. After two years, program fidelity was assessed once again. After three years, the programs’ sustainability was assessed and semi-structured interviews performed, in order to deepen the understanding of implementation. Interviews and documents provided the quantitative and qualitative data, which were analyzed by the use of the Supported Employment Fidelity Scale, the Sustainable Implementation Scale (which was developed in a connecting study), and qualitative content analysis. Despite promising fidelity results after one year, eight out of 14 programs were terminated within three years. Implementation of integrated evidence-based programs in community-based settings is a delicate undertaking. Implementing agencies can benefit from rigorous preparation before program start, especially concerning the circumstances at the organizational level, such as making plans for collaboration, financing and assessments of program fidelity.     

User‐oriented mental health reform in Sweden: featuring ‘professional friendship’

In developing new forms for society‐based support for mental health service users, authorities implemented a service in Sweden, called Personligt ombud (PO), with the assignment to support service users exercising their rights. The aim of this article is to describe what service users find to be significant features of their working relationships with their PO. Using a phenomenological approach, 23 users were interviewed sharing their experiences of their PO. The results show that service users describe their relationships with the PO as a ‘professional friendship’. The friendship‐like feature refers to reciprocity in sharing life experiences and forming a trustful relationship in which professional assistance can be offered, promoting well‐being and recovery. Conclusions are that the PO provides a service that calls for re‐interpretation of professional and user roles, where both give and receive.     

Pride, empowerment, and return to work: on the significance of promoting positive social emotions among sickness absentees

Sickness absence is a great public health problem and there is a lack of knowledge concerning the hows and whys of success or failure in promoting return to work of sick-listed persons. Discussions of and research into social and psychological aspects of this problem area are in need of theoretical contextualisation. In this paper it is suggested that theories of social emotions may be useful, and that the concept of empowerment can be applied provided that it is reasonably well defined. The notions of pride/shame and empowerment are elucidated and discussed, and it is shown that they can be related in the context of research into emotional dimensions of sickness absentees' experiences of the rehabilitation process in a way that may help to guide empirical studies. A simple model of hypothetical relations between pride/shame, empowerment/disempowerment, work ability, health, and return to work is sketched.     

Disabled students’ experiences of higher education in Sweden,the Czech Republic,and the United States – a comparative institutional analysis

Students with disabilities face obstacles in their encounters with higher education. The aim of this study is to investigate how the institutional context shapes students’ experiences of unequal opportunities in higher education. In comparing disabled students’ experiences from universities in Sweden, the Czech Republic, and the United States, the study makes visible the kind of experiences that students share and how experiences differ between these countries within the global context of higher education. The study has shown that students’ possibilities for equal participation are shaped by the institutional context that is based on medical diagnosis and compensation for an inaccessible education.