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- 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.
- 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.
- 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.
- Properties of the portuguese version of the empowerment scale with mental health organization usersPublication . Monteiro, Maria Fátima Jorge; Ornelas, JoséBackground: This study examines the reliability and validity of the Portuguese version of the Empowerment Scale (ES) to be used in the community/psychosocial mental health field. Authors also reviewed the properties of the development and cross-cultural adaptation of the ES. Because mental health services are required to encourage empowerment and recovery-oriented interventions, adequate empowerment-oriented outcome measures are needed to evaluate services and study interventions across countries. Methods: The current research was part of a larger research project with 213 participants. A confirmatory factor analysis (CFA) was conducted to observe the ES’s construct-related validity, and a reliability analysis for internal consistency. The ES concurrent validity with the recovery and psychiatric symptoms measures was also assessed using the Pearson’s correlation coefficient. Results: The CFA supported the five-factor configuration for the refined model of measure as satisfactory. The Portuguese version of the ES presented an overall satisfactory reliability (α = .79) and was positively correlated with personal recovery (r = .71) and inversely with psychiatric symptoms (r = −.22). Conclusions: The overall scale was considered reliable and valid to be used by Portuguese researchers and practitioners to evaluate empowering interventions in mental health services. Furthermore, in the effort to increase ES construct-related validity, this article suggests further improvements to enhance the empowerment measure.
- 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.
- 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.
- Community-based participatory research: a collaborative study to measure capabilities towards recovery in mental health community organizationsPublication . Ornelas, José; Aguiar, Rita; Sacchetto, Beatrice; Monteiro, Maria Fátima JorgeThe purpose of this article is to offer a theoretical review on community based research, namely about collaborative processes and qualitative participatory methodologies, and to present an application of this framework to the research design. Method: It is provided a review on community-based research methodology, university-community partnerships, and is described the qualitative participatory methodology used in one collaborative study. Conclusion: following the partnership guidelines for collaborative community-university research, we highlight the participatory and qualitative process that intended to develop a measure of user’s capability gains fostered by mental health community based organizations.
- “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.
- Empowerment promotion through competitive employment for people with psychiatric disabilitiesPublication . Fernandes, Luis Maria Garcia Rolo Sá; Monteiro, Maria Fátima Jorge; Ornelas, JoséBACKGROUND: Despite ample research about empowerment or supported employment in the mental health field, research about people with psychiatric disabilities in competitive employment and its impact on personal empowerment using standardized measurements needs to be expanded. OBJECTIVE: This study examined if competitive employment contributes to a positive impact on personal empowerment among 55 people with psychiatric disabilities who participate in community based mental health organizations. METHODS: The current sample was created from a larger study with the purpose of obtaining a homogenous set of participants based on the employment status criteria. Participants filled out the Portuguese version of the empowerment scale and hierarchical regression analysis was used to study if participants’ employment status was a predictor of personal empowerment. RESULTS: The conducted analyses demonstrated that competitive employmentwas related to higher levels of empowerment, and that the empowerment dimension of power-based interpersonal relationships was significantly associated with being at work. CONCLUSIONS: Our results suggest that addressing consumers’ working needs through supported employment services has the potential to enhance consumers’ personal empowerment and improve community life.