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ESTUDO COMPARATIVO DE NARRATIVAS DE RECOVERY NUM PROGRAMA DE BASE COMUNITÁRIA E NUM SERVIÇO LOCAL DE SAÚDE MENTAL

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“What’s wrong with the seed?” A comparative examination of an empowering community-centered approach to recovery in community mental health
Publication . Monteiro, Maria Fátima Jorge; Ornelas, José
This 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 disabilities
Publication . Fernandes, Luis Maria Garcia Rolo Sá; Monteiro, Maria Fátima Jorge; Ornelas, José
BACKGROUND: 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.
What transformation? A qualitative study of empowering settings and community mental health organizations
Publication . Monteiro, Maria Fátima Jorge; Aguiar, Rita; Sacchetto, Beatrice; Moniz, Maria João Vargas; Ornelas, José
This 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.
Recovery assessment scale : Testing validity with portuguese community-based mental health organization users
Publication . Monteiro, Maria Fátima Jorge; Ornelas, José
The 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.
Contributos do modelo "Empowerment - Comunidade" para a mudança transformativa na saúde mental comunitária : Análise comparativa
Publication . Monteiro, Maria Fátima Jorge; Ornelas, José H.
A presente Tese designada Contributos do Modelo “Empowerment-Comunidade” para a Mudança Transformativa na Saúde Mental Comunitária: Análise Comparativa é um estudo transversal usando metodologias e técnicas mistas (quantitativas e qualitativas). A investigação assentou no pressuposto de que, adoptando processos organizacionais transformativos, as organizações comunitárias de saúde mental poderão funcionar como contextos relacionais mediadores do empowerment individual e, consequente facilitadores do recovery e da integração comunitária. Com o propósito geral de avaliar os resultados da participação das pessoas com experiência de doença mental em intervenções de saúde mental consideradas transformativas foram estabelecidos três objectivos gerais: 1 - adaptar o modelo conceptual dos contextos comunitários empoderadores para os serviços de saúde mental enquanto recurso para prática da intervenção e da investigação e testar a validade de aplicação através de um estudo de caso; 2 - adaptar para a Língua Portuguesa e validar as medidas de empowerment e de recovery para a utilização no contexto da saúde mental comunitária; 3 - avaliar o impacto do modelo de intervenção: a) nos resultados individuais de empowerment, recovery e integração comunitária dos participantes e b) na implementação e envolvimento de participantes em programas com elevada orientação para o recovery, tais como a habitação independente e o emprego apoiado. O desenho misto da investigação foi aplicado através dos seguintes instrumentos de recolha de dados: Entrevista por Questionário e a Entrevista Qualitativa que podem ser consultados no Anexo 1 e Anexo 2 da Tese. Em termos da recolha de dados, esta decorreu em cinco organizações comunitárias de saúde mental com respostas articuladas dos sectores da saúde e sector social (âmbito do DC nº 407/98), constantes numa lista de organizações filiadas na entidade representativa das organizações não governamentais (Federação Nacional das Entidades de Reabilitação de Doentes Mentais) a prestarem serviços de saúde mental na comunidade à data do estudo. Os resultados permitiram sustentar a proposição teórica de que os programas de saúde mental na comunidade podem e devem encetar mudanças transformativas organizacionais adoptando um funcionamento empoderador e centrado na comunidade (EMP-COM), o qual tem um efeito transformativo na vida das pessoas com experiência de doença mental. As análises confirmaram também a validade das medidas de empowerment (ES-P) e de recovery (RAS-P) para a respectiva utilização no contexto português da saúde mental comunitária. A investigação realizada permitiu extrair conclusões e implicações para a prática da intervenção e da investigação no âmbito do sistema de saúde mental. O relatório de Tese foi composto nas seguintes partes: a Introdução Geral, onde se apresenta a revisão da literatura geral organizada por temáticas dominantes (o empowerment e os contextos comunitários empoderadores, a orientação de recovery na saúde mental, a integração comunitária), os Procedimentos Gerais onde se descreve o desenho geral, os objectivos gerais); a Secção Empírica, organizada em quatro capítulos relativos às análises principais desta investigação em formato de artigo; a Discussão Geral, as Conclusões e Implicações para a Prática, e os Anexos.

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Fundação para a Ciência e a Tecnologia

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Funding Award Number

SFRH/BD/65518/2009

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