Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-11-2015 | Original Paper

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

Authors: Mona Eklund, Urban Markström

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 6/2015

Abstract

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.

Andersson, M., Eklund, M., Sandlund, M., & Markström, U. (in press). Freedom of choice or cost efficiency? The implementation of a free-choice market system in community mental health services in Sweden. Scandinavian Journal of Disability Research.

Argentzell, E., Leufstadius, C., & Eklund, M. (2012). Factors influencing subjective perceptions of everyday occupations: comparing day centre attendees with non-attendees. Scandinavian Journal of Occupational Therapy, 19, 68–77.CrossRefPubMed

Argentzell, E., Leufstadius, C., & Eklund, M. (2014). Social interaction among people with psychiatric disabilities—Does attending a day centre matter? International Journal of Social Psychiatry, 60, 519–527.

Bejerholm, U., & Eklund, M. (2004). Time-use and occupational performance among persons with schizophrenia. Occupational Therapy in Mental Health, 20(1), 27–47.CrossRef

Bengtsson-Tops, A. (2004). Mastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. Journal of Psychiatric and Mental Health Nursing, 11, 298–304.CrossRefPubMed

Bredgaard, T., & Larsen, F. (2008). Quasi markets in employment policy: Do they deliver on promises? Social Policy and Society, 7, 341–352.CrossRef

Catty, J., Burns, T., Comas, A., & Poole, Z. (2007). Day centers for severe mental illness. Cochrane Database of Systematic Reviews 2007, Issue 1, Art. No.: CD001710. DOI: 10.1002/14651858.CD001710.pub2.

Eklund, M. (1997). Therapeutic factors in occupational group therapy identified by patients discharged from a psychiatric day center and their significant others. Occupational Therapy International, 4, 198–212.CrossRef

Eklund, M., Bengtsson-Tops, A., & Lindstedt, H. (2007). Construct and discriminant validity and dimensionality of the Interview Schedule for Social Interaction (ISSI) in three psychiatric samples. Nordic Journal of Psychiatry, 61, 182–188.CrossRefPubMed

Eklund, M., & Erlandsson, L. K. (2013). Quality of life and client satisfaction as outcomes of the Redesigning Daily Occupations (ReDO) programme for women with stress-related disorders: A comparative study. Work, 46, 51–58.PubMed

Eklund, M., & Sandlund, M. (2012). The life situation of people with persistent mental illness visiting day centers: A comparative study. Community Mental Health Journal, 48, 592–597.CrossRefPubMed

Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.CrossRefPubMed

Finn, D. (2009). The “welfare market” and the flexible new deal: Lessons from other countries. Local Economy, 24, 38–45.CrossRef

Friedman, M., & Friedman, R.D. (1990). Free to choose : A personal statement (1st Harvest/HBJ ed.). San Diego: Harcourt Brace Jovanovich.

Hansson, L., & Bjorkman, T. (2005). Empowerment in people with a mental illness: reliability and validity of the Swedish version of an empowerment scale. Scandinavian Journal of Caring Sciences, 19, 32–38.CrossRefPubMed

Henderson, S., Duncan-Jones, P., Byrne, D. G., & Scott, R. (1980). Measuring social relationships. The Interview Schedule for Social Interaction. Psychological Medicine, 10, 723–734.CrossRefPubMed

Jolley, G., Freeman, T., Baum, F., Hurley, C., Lawless, A., Bentley, M., et al. (2014). Health policy in South Australia 2003–10: primary health care workforce perceptions of the impact of policy change on health promotion. Health Promotion Journal of Australia, 25, 116–124.CrossRefPubMed

Krippendorff, K. (2013). Content analysis: An introduction to its methodology (3rd ed.). Los Angeles: SAGE.

Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979). Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2, 197–207.CrossRefPubMed

Leufstadius, C., Eklund, M., & Erlandsson, L. K. (2009). Meaningfulness in work – Experiences among employed individuals with persistent mental illness. Work, 34, 21–32.PubMed

Lindqvist, R., Markström, U., & Rosenberg, D. (2010). Psykiska funktionshinder i samhället. Aktörer, insatser, reformer [Psychiatric disabilities in society. Actors, interventions, reforms]. Malmö: Gleerups.

Markström, U. (2003). Den svenska psykiatrireformen. Bland brukare, eldsjälar och byråkrater [The Swedish mental health reform. Among users, enthusiasts and bureaucrats]. Umeå: Boréa förlag.

National Board of Health and Welfare. (2011). Nationella riktlinjer för psykosociala insatser vid schizofreni och schizofreniliknande tillstånd —stöd för styrning och lednin. [National guidelines for psychosocial interventions for schizophrenia and related disorder —support for management and leadership]. Stockholm: National Board of Health and Welfare.

Perri 6. (2003). Giving consumers of British public services more choice: What can be learned from recent history? Journal of Social Policy, 32, 239–270.

Rebeiro, K. L., & Cook, J. V. (1999). Opportunity, not prescription: an exploratory study of the experience of occupational engagement. Canadian Journal of Occupational Therapy, 66, 176–187.CrossRef

Rogers, E. S., Chamberlin, J., Ellison, M. L., & Crean, T. (1997). A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services, 48, 1042–1047.CrossRefPubMed

Rogers, E. S., Ralph, R. O., & Salzer, M. S. (2010). Validating the empowerment scale with a multisite sample of consumers of mental health services. Psychiatric Services, 61, 933–936.CrossRefPubMed

Spall, P., McDonald, C., & Zetlin, D. (2005). Fixing the system? The experience of service users of the quasi-market in disability services in Australia. Health and Social Care in the Community, 13, 56–63.CrossRefPubMed

Struyven, L., & Steurs, G. (2005). Design and redesign of a quasi-market for the reintegration of jobseekers: Empirical evidence from Australia and the Netherlands. Journal of European Social Policy, 15, 211–229.CrossRef

Swedish Governmental Reports. (2008). Lag (2008:962) om valfrihetssystem [Law (2008:962) about freedom of choice systems]. Stockholm: Swedish Governmental Reports.

Tjörnstrand, C., Bejerholm, U., & Eklund, M. (2011). Participation in day centres for people with psychiatric disabilities: Characteristics of occupations. Scandinavian Journal of Occupational Therapy, 18, 243–253.CrossRefPubMed

Tjörnstrand, C., Bejerholm, U., & Eklund, M. (2013a). Participation in day centres for people with psychiatric disabilities – A focus on occupational engagement. British Journal of Occupational Therapy, 73, 144–150.CrossRef

Tjörnstrand, C., Bejerholm, U., & Eklund, M. (2013b). Psychometric testing of a self-report measure of engagement in productive occupations. Canadian Journal of Occupational Therapy, 80, 101–110.

Tjörnstrand, C., Bejerholm, U., & Eklund, M. (2014). Factors influencing occupational engagement in day centres for people with psychiatric disabilities. Community Mental Health Journal. doi:10.1007/s10597-014-9765-0.

Undén, A. L., & Orth-Gomer, K. (1989). Development of a social support instrument for use in population surveys. Social Science and Medicine, 29, 1387–1392.CrossRefPubMed

WHO. (1993). The ICD-10 classification of mental and behavioural disorders. Geneva: World Health Organization.

Title: Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services
Authors: Mona Eklund
Urban Markström
Publication date: 01-11-2015
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 6/2015
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-014-0601-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2015

Defining Episodes of Care in Children’s Mental Health Using Administrative Data

Obstacles in Managing Mental Health Problems for Primary Care Physicians in Hong Kong

Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls

Whom to Ask for Professional Help in Case of Major Depression? Help-Seeking Recommendations of the Sardinian Public

The Design and Development of Staff Wellbeing Initiatives: Staff Stressors, Burnout and Emotional Exhaustion at Children and Young People’s Mental Health in Australia

Building Resilience After School for Early Adolescents in Urban Poverty: Open Trial of Leaders @ Play