PCOM - Artigos em revistas internacionais
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- Distal supports, capabilities, and growth‐focused recovery: A comparison of Housing First and the staircase continuum of carePublication . Greenwood, Ronni Michelle; O'Shaughnessy, Branagh R.; Manning, Rachel; Hogan, Niamh; Vargas-Moniz, Maria; Ornelas, JoséAdults who have substantial histories of homelessness and complex support needs may feel ambivalent about integrating into their communities and find it difficult to do so. Being familiar to and recognized by others as a resident in a neighborhood or community are sources of “distal support” that provide individuals with feelings of belonging to their community and are important to recovery from homelessness. We hypothesized that individuals engaged with Housing First (HF) programs would report more distal support than individuals engaged with traditional homeless services (treatment as usual, TAU), and that distal support would predict more community integration, growth‐related recovery, and achieved capabilities. We analyzed data collected from homeless services users (n = 445) engaged with either HF or TAU in eight European countries. Measures included achieved capabilities, growth‐focused recovery, distal supports, and community integration. Serial mediation analyses confirmed our hypothesis that the effects of HF on growth‐related recovery and achieved capabilities are indirect, mediated by distal supports and community integration. Findings are discussed in relation to the importance of modeling the effects of HF on social and psychological outcomes as indirect and identifying important mediators that translate the effects of HF components on social and psychological outcomes. We also note the importance of case management activities that encourage clients to develop and sustain distal supports with others who live and work in their neighborhoods.
- European public perceptions of homelessness: A knowledge, attitudes and practices surveyPublication . Petit, Junie; Loubiere, Sandrine; Tinland, Aurlie; João Vargas Moniz, Maria; Spinnewijn, Freek; Manning, Rachel; Santinello, Massimo; Wolf, Judith; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Auquier, PascalAddressing Citizen's perspectives on homelessness is crucial for the design of effective and durable policy responses, and available research in Europe is not yet substantive. We aim to explore citizens' opinions about homelessness and to explain the differences in attitudes within the general population of eight European countries: France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden.
- Adaptation of nussbaum's capabilities framework to community mental health: A consumer-based capabilities measurePublication . Sacchetto, Beatrice; Ornelas, José; Calheiros, Maria Manuela; Shinn, MarybethThe capabilities approach provides a rich evaluative framework to guide transformative change in the community mental health system. This study reports the content and construct validity and psychometric properties of a contextualized measure of the extent to which mental health programs foster achieved capabilities. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH), adapted from Nussbaum's capabilities framework, was developed previously with consumer collaboration. Content validity was assessed through a collaborative process, involving a panel of eight consumers, staff members, and senior researchers. The resulting shorter version (ACQ-CMH-98) was completed by 332 community mental health consumers sampled throughout Portugal. Factor (PCA) analysis, internal consistency reliability, and test-retest reliability over 2 weeks (N = 33) showed good psychometric properties. The resulting six-factor structure with 48 items explains 48.88% of the total variance (KMO = 0.89; Bartlett p = .00). Internal consistency of the obtained dimensions ranges from .91 to .76. Associations of the measure with recovery, quality of life, and psychological distress scales add further evidence of construct validity. The adaptation of Nussbaum's framework stressed specific components that may enhance understanding and change within the community mental health system.
- Defining psychological empowerment construct: analysis of three empowerment scalesPublication . Miguel, Marta Cristina Trindade; Ornelas, José; Maroco, JoãoThis study aimed to contribute to the validation of psychological empowerment, which is a combination of sense of control (intrapersonal component), critical awareness of the sociopolitical environment (interactional component), and community involvement (behavioral component). Three scales of empowerment used to evaluate the 3 components were translated into Portuguese, adapted for the Portuguese population, and applied in person, by phone and by e-mail. Participants were enrolled in or had completed a program of recognition of prior learning. We tested reflective and formative measurement models and the results suggested that a reflective model fits the data better than a formative one. Confirmatory factor analysis confirmed psychological empowerment as a hierarchical third-order factor. Second-order factors correspond to the intrapersonal, interactional, and behavioral empowerment components, reflected in first-order factors: leadership competence, policy control, source of power, nature of power, instruments of power, and participation behaviors.
- The role of perceived housing quality and perceived choice to recovery: An ecological perspective on a housing first program in LisbonPublication . Martins, Paulo Daniel Fernandes; Ornelas, José; Silva, Ana CristinaThis study explores, from an ecological perspective, the relationship between perceived housing quality and the perception of choice, and between perceived choice and recovery of 45 Housing First Lisbon participants. For this purpose, we used a quantitative method and applied three instruments that report perceived housing quality, perceived choice and severe mental illness recovery. The findings reveal a significant and positive association between perceived housing quality and perceived choice, and between perceived choice and recovery, with choice being predicted by housing quality and recovery predicted by choice. These results reinforce the scientific evidence regarding the success of housing first models as a consumer choice-driven intervention, addressing pertinent environmental factors that contribute to housing stability. The study demonstrates that recovery processes can be maximized through services that empower their consumers by allowing them to choose and control the priority and order of the support services received.
- “What’s wrong with the seed?” A comparative examination of an empowering community-centered approach to recovery in community mental healthPublication . Monteiro, Maria Fátima Jorge; Ornelas, JoséThis cross-sectional group comparison aimed to examine whether personal empowerment, recovery and community integration were associated with the individual's participation in an empowering community-centered model of intervention. Ninety-three participants from an empowering community-centered community mental health organization were compared with a matched group of individuals from standard interventions of four equivalent organizations. Results showed that participants taking advantage of the empowering community-centered approach were more involved in high recovery-oriented programs; and attained higher levels of personal goals and hope, empowerment, and of community integration. An involvement in high recovery-oriented programs (supported employment or independent housing) revealed improved outcomes for the individual. In conclusion, the findings suggested a transformative impact of the empowering community-centered model both at the individual and the program level by altering the resource accessibility and social conditions for people who experience mental illness. The implications of findings for transforming community mental health practice are discussed in detail.
- The Capabilities Questionnaire for the Community Mental Health context (CQ-CMH) : A measure inspired by the capabilities approach and constructed through consumer–researcher collaborationPublication . Sacchetto, Beatrice; Aguiar, Rita; Monteiro, Maria Fátima Jorge; Neves, Maria João; Cruz, Maria Adelaide; Coimbra, José António; Ornelas, JoséThe involvement of people with psychiatric disabilities in research and service evaluation has traditionally been rare, especially in the construction of outcome measures. This study documents a collaborative process with consumers from 2 Portuguese community mental health services in the construction of the Capabilities Questionnaire for the Community Mental Health context (CQ-CMH). The measure is inspired by Nussbaum's capabilities approach and aims to measure consumers' capabilities when supported by the community mental health services.
- Recovery assessment scale : Testing validity with portuguese community-based mental health organization usersPublication . Monteiro, Maria Fátima Jorge; Ornelas, JoséThe aim of the present study was to develop the Portuguese version of the Recovery Assessment Scale (RAS-P), and to assess the validity of the findings using the revised test, with 213 users from 5 nonprofit community-based mental health organizations. Participants in the assessment completed a self-reported survey investigating their sense of personal recovery, personal empowerment, capabilities achievement, psychiatric symptoms’ frequency, and demographic data. Evidence from exploratory and confirmatory factor analyses using the 24-item version of the test, validated a 4-factor structure for the RAS-P model based on the dimensions of Personal Goals and Hope, Managing Help Needs, Supportive Interpersonal Relationships, and Life Beyond Symptoms, consistent with components of the recovery process. Convergent and discriminant validity was also achieved using bivariate correlation coefficients among the 4 subscales’ scores, between the overall scale and the subscales, and in relation to external variables. Findings allowed for the interpretation that the RAS-P is measuring a particular psychological construct, which is different from symptoms of the mental illness. A hypothesized significant association with personal empowerment and with capabilities achievement was demonstrated. Positive association was also found between participants’ use of recovery-oriented services such as independent housing or supported employment programs. The RAS-P scores also revealed excellent internal consistency for the overall scale ( .90), and good consistency for the subscales ( .75), which attest to its precision in measurement. In conclusion, the study proved the RAS-P a reliable and useful tool in the context of the community mental health practice.
- Migration-related detention centers : The challenges of an ecological perspective with a focus on justicePublication . Esposito, Francesca; Ornelas, José; Arcidiacono, CaterinaBackground: In recent years, border control and migration-related detention have become increasingly widespread practices affecting the lives of undocumented migrants, their families, and communities at large. In spite of the concern within academia, few studies have directly witnessed the life and experiences of people confined to migration-related detention centers. In the medical and psychological fields, a considerable body of research has demonstrated the pathogenic nature of detention in terms of mental health, showing an association between length of detention and severity of distress. Nevertheless, it was limited to the assessment of individuals’ clinical consequences, mainly focusing on asylum seekers. There currently exists a need to adopt an ecological perspective from which to study detained migrants’ experiences as context-dependent, and influenced by power inequalities. This paper addresses this gap. Discussion: Drawing upon advances in community psychology, we illustrate an ecological framework for the study of migration-related detention contexts, and their effects on the lives of detained migrants and all people exposed to them. Making use of existing literature, Kelly’s four principles (interdependence, cycling of resources, adaptation, succession) are analyzed at multiple ecological levels (personal, interpersonal, organizational, communal), highlighting implications for future research in this field. A focus on justice, as a key-dimension of analysis, is also discussed. Wellbeing is acknowledged as a multilevel, dynamic, and value-dependent phenomenon. Summary: In presenting this alternative framework, the potential for studying migration-related detention through an ecological lens is highlighted, pointing the way for future fields of study. We argue that ecological multilevel analyses, conceptualized in terms of interdependent systems and with a focus on justice, can enhance the comprehension of the dynamics at play in migration-related detention centers, providing an effective tool to address the multi-level challenges of doing research within them. Furthermore, they can contribute to the development of policies and practices concerned with health, equality, and human rights of all people exposed to migration-related detention. Consistent with these assumptions, empirical studies adopting such a framework are strongly encouraged. These studies should use mixed and multi-method culturally situated designs, based on the development of collaborative and empowering relationships with participants. Ethnographic approaches are recommended.
- What transformation? A qualitative study of empowering settings and community mental health organizationsPublication . Monteiro, Maria Fátima Jorge; Aguiar, Rita; Sacchetto, Beatrice; Moniz, Maria João Vargas; Ornelas, JoséThis article is based on empowering settings research and has a two-fold objective: to propose an adaptation of the empowering community settings framework to community mental health organizations practice to foster recovery and community integration; and to discuss how the adapted framework is a relevant tool to challenge community mental health transformation at multiple levels of analysis. The current study was anchored in a larger qualitative research project. It used a case study approach, with 8 in-depth interviews with diverse participants from one community mental health organization. The adapted model proved useful to guide transformational practice in community mental health programs and for evaluation of organizational empowerment and multilevel community-oriented interventions. Suggestions and implications for future research are also presented.