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- Homeless adults’ recovery experiences in housing first and traditional services programs in seven european countriesPublication . Greenwood, Ronni Michelle; Manning, M; O' Shaughnessy, Branagh; Moniz, Maria João Vargas; Loubiere, Sandrine; Spinnewijn, Freek; Lenzi, Michela; Wolf, Walter; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Monteiro, Maria Fátima Jorge; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Rivero, Borja; Julián, Martin; Zmaczynska–Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; Van Loenen, Tessa; Raben, Liselotte; Beijer, Ulla; Blid, Mats; Bispo, Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Leon; Tinland, AurelieAcross Europe, as governments turn to housing-led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment-first approach to addressing long-term homelessness. Although there is a large body of research on service users' experiences of Housing First compared to treatment-first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross-sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed.
- Anticipated and experienced stigma and discrimination in the workplace among individuals with major depressive disorder in 35 countries: qualitative framework analysis of a mixed-method cross-sectional studyPublication . Van Bortel, Tine; Wickramasinghe, Nuwan Darshana; Treacy, Samantha; Khan, Nashi; Ouali, Uta; SUMATHIPALA, ATHULA; Svab, Vesna; Nader, Doaa; Kadri, Nadia; Monteiro, Maria Fátima Jorge; Knifton, Lee; Quinn, Neil; Van Audenhove, Chantal; Lasalvia, Antonio; Bonetto, Chiara; Thornicroft, Graham; Van Dissel, Jaap; Brouwers, EvelienABSTRACT: Objectives: Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. Design: Mixed-method cross-sectional survey. Participants, setting and measures: The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. Results: The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. Conclusions: This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
- The role of community integration and empowerment for the transformative change in community mental healthPublication . Ornelas, José; Monteiro, Maria Fátima Jorge; Duarte, Teresa; Moniz, Maria João VargasThe present article first presents a critique about the current status of the community mental health (CMH) field. Second, based on theoretical and empirical literature, it presents a perspective inspired by the inception of community psychology, namely the empowerment and community integration principles to offer a challenging framework to inspire reforms in the CMH field. The article also discusses two promising CMH practices, supported employment and independent housing with support, determinant for the transformation of life conditions for people experiencing mental illness while promoting people’s empowerment and integration in the community. The authors argue that CMH programs and practices focused on integration together with self-representation movements, organisations, or networks aligned with the community psychology acting principles have the potential to inform a renovated partnership within CMH stakeholders and bring about sustainable change focused on the active citizenship for people who experience mental illness.