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- Psychometric properties of the measure of achieved capabilities in homeless servicesPublication . Greenwood, Ronni; O'Shaughnessy, Branagh R.; Manning, Rachel; Vargas-Moniz, Maria; Sacchetto, Beatrice; Ornelas, José; Jorge-Monteiro, Maria F.; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Lenzi, Michela; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Bernad, Roberto; Rivero, Borja; Julien, Martin; Bokszczanin, Anna; Kalinowska-Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; vanLoenen, Tessa; Raben, Liselotte; Wolf, Judith R.; Beijer, Ulla; Blid, Mats; Källmen, Håkan; Bispo, Maria Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Pascal; Loubière, Sandrine; Tinland, AurélieBackground Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.
- The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH): A consumer‐based measure for the evaluation of community mental health interventionsPublication . Sacchetto, Beatrice; Ornelas, José; Calheiros, Maria ManuelaThe capabilities approach offers a multidimensional, ecological, and agent‐centered framework that may inspire models of intervention and evaluation. Agrowing number of measures grounded on the capabilities approach for outcomemeasurement are appearing. Regarding community mental health, newconsumer‐valued measures—constructed in collaboration with consumers—arehere considered crucial for a transformative shift. Meanwhile, new measurementsneed to provide psychometric evidence to enable proper choice and applica-tion. The Achieved Capabilities Questionnaire for Community Mental Health(ACQ‐CMH) was developed in collaboration with consumers of communitymental health services. It aims to assess consumers' capabilities achieved throughprogram support. The present paper shows advancements in the measurevalidation through a confirmatory factor analysis within a sample of communitymental health consumers (N= 225). Reliability and construct‐related validity werealso observed. A structural solution composed offive factors and 43 itemsrevealed a better modelfit than that obtained in a previous exploratory study.Findings support the reliability, sensibility, and both convergent and discriminantvalidity of using the ACQ‐CMH in the evaluation of community mental healthinterventions. The ACQ‐CMH offers a consumer‐valued framework with specificdimensions and indicators of capabilities for use in a routine service evaluationsetting
- The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH): a consumer‐based measure for the evaluation of community mental health interventionsPublication . Sacchetto, Beatrice; Ornelas, José; Calheiros, Maria ManuelaThe capabilities approach offers a multidimensional, ecological, and agent‐ centered framework that may inspire models of intervention and evaluation. A growing number of measures grounded on the capabilities approach for outcome measurement are appearing. Regarding community mental health, new consumer‐valued measures—constructed in collaboration with consumers—are here considered crucial for a transformative shift. Meanwhile, new measurements need to provide psychometric evidence to enable proper choice and application. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH) was developed in collaboration with consumers of community mental health services. It aims to assess consumers' capabilities achieved through program support. The present paper shows advancements in the measure validation through a confirmatory factor analysis within a sample of community mental health consumers (N = 225). Reliability and construct‐related validity were also observed. A structural solution composed of five factors and 43 items revealed a better model fit than that obtained in a previous exploratory study. Findings support the reliability, sensibility, and both convergent and discriminant validity of using the ACQ‐CMH in the evaluation of community mental health interventions. The ACQ‐CMH offers a consumer‐valued framework with specific dimensions and indicators of capabilities for use in a routine service evaluation setting.
- 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.
- Psychometric properties of the measure of achieved capabilities in homeless servicesPublication . Greenwood, Ronni Michelle; O'Shaughnessy, Branagh R.; Manning, Rachel M.; Vargas-Moniz, Maria; Sacchetto, Beatrice; Ornelas, José; Jorge-Monteiro, Maria Fátima; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Lenzi, Michela; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Bernad, Roberto; Rivero Jiménez, Borja; Julien, Martin; Bokszczanin, Anna; Zmaczynska-Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; vanLoenen, Tessa; Raben, Liselotte; Wolf, Judith; Beijer, Ulla; Blid, Mats; Källmen, Håkan; Bispo, Maria Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Junie M.; Loubière, Sandrine; Tinland, AurélieBackground Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.
- The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH): a consumer‐based measure for the evaluation of community mental health interventionsPublication . Sacchetto, Beatrice; Ornelas, José; Calheiros, Maria ManuelaThe capabilities approach offers a multidimensional, ecological, and agent‐ centered framework that may inspire models of intervention and evaluation. A growing number of measures grounded on the capabilities approach for outcome measurement are appearing. Regarding community mental health, new consumer‐valued measures—constructed in collaboration with consumers—are here considered crucial for a transformative shift. Meanwhile, new measurements need to provide psychometric evidence to enable proper choice and application. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH) was developed in collaboration with consumers of community mental health services. It aims to assess consumers' capabilities achieved through program support. The present paper shows advancements in the measure validation through a confirmatory factor analysis within a sample of community mental health consumers (N = 225). Reliability and construct‐related validity were also observed. A structural solution composed of five factors and 43 items revealed a better model fit than that obtained in a previous exploratory study. Findings support the reliability, sensibility, and both convergent and discriminant validity of using the ACQ‐CMH in the evaluation of community mental health interventions. The ACQ‐CMH offers a consumer‐valued framework with specific dimensions and indicators of capabilities for use in a routine service evaluation setting.
- Putting mental health deinstitutionalisation back on track: A scoping review of what empirically hinders and drives deinstitutionalisation of adults who experience mental illnessPublication . Sá-Fernandes, Luís; Sacchetto, Beatrice; Pires, Johann; Ornelas, José; Vargas-Moniz, MariaMental health deinstitutionalisation continues to be a global human rights priority. After over half a century, the discharge to the community often means the transition to smaller-scale institutions, segregation environments, and limited opportunities for community inclusion. This scoping review aims to identify what hinders and drives the deinstitutionalisation process of adults experiencing mental health challenges. Method: A scoping review was conducted following the Joanna Briggs Institute methodology and reported under the PRISMA extension for scoping reviews (PRISMA-ScR). A systematic search of four electronic databases, PubMed, APA PsycINFO, Web of Science, and Scopus, was undertaken between January and March 2024. Only empirical studies focusing on the deinstitutionalisation process of adults with mental health challenges, published in English, from 1991 to 2024 were eligible for inclusion. A template in Microsoft Excel was created for data extraction. Results were descriptively synthesised and organised into the system change framework’s four fundamental dimensions (norms, resources, regulations, and operations). A total of 57 studies were included. Most of those included studies, 53% were qualitative ( = 30), 60% were published from 2014 to 2024 ( = 34), 26% were from North Americas ( = 15), and 25% were from Europe ( = 14). Factors that hindered mental health deinstitutionalisation included the exclusiveness of the medical model, social discrimination, insufficient community services, transinstitutionalisation, lack of support for community inclusion, most funds allocated to institutionalisation, economic incentives for institutionalisation, institutional policies, inefficient governance, professional control, and limited advocacy. Drivers included a model for community inclusion, an inclusive society, resourcing community alternatives, independent housing, individualised context-oriented support, economic pressures, policy and legal reform, consumer participation in services, and consumer advocacy. The study findings constitute an important basis to inform the ongoing or future deinstitutionalisation processes of adults with mental illness diagnoses.