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Deinstitutionalisation , social inclusion & personal recovery

This presentation discusses the deinstitutionalisation process in the Netherlands, focusing on the MOVE-project and its impact on social inclusion, personal recovery, and self-sustainability in mental health care. It highlights the challenges faced in residential care for people with severe mental illness and the need for recovery-oriented care.

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Deinstitutionalisation , social inclusion & personal recovery

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  1. Deinstitutionalisation, socialinclusion & personal recovery Charlotte de Heer-Wunderink, Ingrid van der Zee & Sandra Vos Hanze University of Applied Sciences Groningen, The Netherlands

  2. Content • Deinstitutionalisation in the Netherlands • The MOVE-project • Social inclusion, recovery and self sustainability

  3. Transitions in mental health care • Financial: large budget cuts • Ideological: fromcaringfortosupporting/promoting • Personal recovery • Selfefficacy • Autonomy

  4. Challenges Residential care for people with severe mental illness • Insufficient implementation of recovery oriented care • Crises and‘dailyhassles’ tendto take over • Lack of training of professionals in evidence based practices: skills, knowledge and attitude • Hospitalisation of staff as well as service users • Misconceptionsabout rehabilitation and recovery

  5. The MOVE-project • Longitudinal follow-up study • 2 years • 129 service users + keyworkers • 6 RegionaIInstitutesforResidential Care • Monitoringdeinstitutionalisation • Fromcommunityresidential care to independent living

  6. Thispresentation • 1 year follow up • Who has made the transitionto independent living? • What is key to thattransition? • Socialinclusion • Personal recovery • Self sustainability

  7. Methods Survey (interview): socialinclusion: vocationalparticipation social relations: numberandnature leisureactivities personal recovery: Mental Health Recovery Measure (MHRM; official Dutch translation) self sustainability checklist

  8. Analysis • SPSS 20 and Statistica • Descriptives, Chi square, logisticregression, ANOVA and feature selection analysis • Aims: • establishdifferencesbetween service user groups • identifypredictorsfor independent living

  9. MOVE: service user participants

  10. Participants: wishfor independent living at T1 living situation at T3 T1 n=129 T3 59 % (n=76) 41 % (n= 53) n=11 n=3 n=3 48 % (n=62) 19 % (n =25) 33 % (n=42)

  11. Socio-demographic & clinicalcharacteristics *RC=residential care, IL = independent living

  12. SocialInclusion • Predictorsfor living situation

  13. Socialinclusion • Vocationalparticipation: • No significant differencesbetweengroupsafter 1 year • Social relations • Residentsno wishfor independent living < residentswith a wishandindependently living services users at T1 and T3 (F (2,126)= 4.5, p<.05) • Leisure activities • Residents no wish: more activitieswithotherresidentsandstaffcomparedtoother service users (χ2=12.3 and 13.3, df=2, p<.01) • The number of social relations is a predictor for independent living at T1 andthrough time (feature selection: χ2=17.9, p<.05; χ2=52.6, p<.001)

  14. Personal recovery • Mental Health Recovery Measure(Young & Bullock, 2003; Dutch version: Moradi, Brouwers, Van den Boogaard & Van Nieuwenhuizen, 2007) • Reliability: Cronbachsα: 0.86-0.94 • Acceptable construct validity • 30 statements • Likertscale: stronglydisagree (1) - stronglyagree (5) ‘I’mworthwhile, despitemypsychologicalproblems’ ‘My way of thinking, helps me toachievemy goals’

  15. MHRM: Personal recovery • Independently living service users • Residentswhowishto live independently Developmentsbetween T1 - T3 Service users • Residentswhowishtostay in the supportedhousing facility

  16. MHRM: Personal recovery Developmentsbetween T1 - T3 Independently living service users • Socialcontacts • Way of thinking • Understanding oneself

  17. Personal recovery Residential service users without a wish = laggardsconcerning: • belief in a betterfuture (χ2=40, p<.001) • working hard onpsychologicalrecovery (χ2=25, p<.001) • takingrisksforpersonalrecovery (χ2=32, p<.001) • belief in oneself (χ2=19, p<.05) • postivegrowth and changes (χ2=22, p<.01) • socialcontacts/friends (χ2=18, p<.05) • understandingoneself (χ2=18, p<.05)

  18. Selfsustainability • Residential service users without a wish have/experienceless • socialskills • wellbeing • (knowledge of possible) support • motivation

  19. Summary • Residential service users without a wish are lagging • motivation/wish = important fortransition • social relations: the more the better • personalrecovery does matter • recoveryoriented care canmake a difference!

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