Mental health service users' experiences of everyday occupations while attending day centres during the transition into retirement age.

Background: Existing research has shown that those ageing with severe mental illness face significant challenges in daily life. Attendance at community-based day centres (DCs) is offered to support daily structure and break isolation. However, little is known about the experiences of those receiving this type of support while transitioning into retirement age.

'It's like someone is holding your hand, an invisible hand': A grounded theory study of participation and personal recovery in Flexible Assertive Community Treatment.

Background: Participation in everyday life and personal recovery is often adversely affected for individuals with complex mental health needs. Flexible Assertive Community Treatment (FACT) is a recovery-oriented service targeting participation in everyday life and personal recovery and is thus important to understand from the perspectives of service users.

Aim: To explore how service users experience the care and support they receive from FACT as facilitating processes of participation in everyday life and in their personal recovery process.

Experiences of managers and staff working in community-based mental health with people ageing with severe mental health problems.

Background: Existing research shows that older people with severe mental health problems need different forms of support in daily life and in the community to lead an active and meaningful life. A common form of support for people with severe mental health problems in Sweden is attendance at community-based day centres (DCs). However, knowledge of staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs is scarce.

"It's not just the residents who need to be motivated for activity": a qualitative study of the perspectives of staff on providing activity support for people with psychiatric disabilities in supported housing in Sweden.

Background: The goals for staff in Supported Housing for people with psychiatric disabilities include helping to develop the residents' independence and self-confidence in activities. However, staff have expressed frustration about providing this type of support when motivating residents to engage in meaningful activities and also about the difficulty in finding suitable levels of independence within a housing setting with limitations.

Objective: The aim is to explore the views and experiences of housing staff in Supported Housing on how they can stimulate and support engagement in activities for people with psychiatric disabilities.

Experiences of participating in a group-based sensory modulation intervention for mental health service users.

Background: People with mental health issues often experience difficulties with sensory modulation affecting occupational engagement. Research conducted in inpatient units has shown positive effects of individual sensory modulation interventions, however, research on experiences of group-based interventions in outpatient units is limited. Hence, a group-based sensory modulation intervention was adapted and tested within Swedish mental health outpatient units.

Developing sustainable service user involvement practices in mental health services in Sweden: the "Userinvolve" research program protocol.

Background: The purpose of this paper is to outline the protocol for the research program "UserInvolve," with the aim of developing sustainable, service user involvement practices in mental health services in Sweden.

Methods: This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects.

The impact of the BEL intervention on levels of motivation, engagement and recovery in people who attend community mental health services.

Background: Community-based day centres (DC) in Sweden provide support to people with severe mental health problems. The role of DC motivation for outcomes in terms of occupational engagement and personal recovery is yet unknown.

Aims: To compare two groups who received DC services, one of which also received the 16-week Balancing Everyday Life (BEL) intervention.

Opportunities and barriers for occupational engagement among residents in supported housing.

Unlabelled: Opportunities and barriers for occupational engagement among residents in supported housing.

Background: Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations.

Legitimizing user knowledge in mental health services: Epistemic (in)justice and barriers to knowledge integration.

Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden.

Implementing an occupational therapy specific mental health intervention in a multi-professional context - the case of Balancing Everyday Life (BEL).

Background: The occupation-based intervention Balancing Everyday Life (BEL) was found effective under controlled conditions but should also be studied in a natural clinical practice context.

Aim: The aim was to study the implementation process of BEL when provided in a multi-professional mental health team. The focus was particularly on how BEL was received and functioned.

Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data.

Background: Personal recovery is associated with many significant health-related factors, but studies exploring associations between activity factors and personal recovery among service users are scarce. The aims of this study were hence to; 1) investigate if various aspects of activity may mediate change in recovery while also acknowledging clinical, sociodemographic and well-being factors; 2) explore the effects of two activity-based interventions, Balancing Everyday Life (BEL) or standard occupational therapy (SOT), on personal recovery among service users.

Methods: Two-hundred-and-twenty-six service users were included in a cluster RCT, 133 from BEL units and 93 from SOT units.

An integrated mental health and vocational intervention: A longitudinal study on mental health changes among young adults.

Aim: This study aimed to investigate changes in mental health among young adults participating in an integrated mental health and vocational support intervention according to the Södertälje Supported Employment and Education model.

Design: A prospective longitudinal pre-post intervention study of 12 months.

Methods: Instruments on depressive symptoms, quality of life, empowerment, engagement in activities and sociodemographic characteristics were administered to 42 young adults aged 19-28 years with mood disorders.

A day in the life of people with severe mental illness living in supported housing.

Background: People with severe mental illness (SMI) living in supported housing (SH) struggle in everyday life and we currently lack a comprehensive body of knowledge concerning how the residents experience their day. This paper aimed to gain knowledge about how people with SMI describe a day in SH in Sweden, in particular the activities they most frequently engage in and how they experience what they do in or outside their home. Furthermore, it is important to gain knowledge of which activities motivate residents to leave the housing facility and to participate in the community.

Navigating in a Misty Landscape - Perceptions of Supporting a Relative Residing in Supported Housing for People with a Psychiatric Disability.

The aim was to explore informal carers' perceptions of supporting the everyday life of a relative who has a psychiatric disability and resides in supported housing (SH). A qualitative study based on interviews with 12 informal carers was performed, and the data was analyzed with qualitative content analysis. The theme "Navigating in a misty landscape when striving to support a relative with a psychiatric disability" was identified, encompassing four categories pertaining to residents' needs, collaboration, environmental issues and the carer's situation.

Experiences of sensory input in daily occupations for people with serious mental illness.

Background: There is growing evidence that people with serious mental illness have impaired capacity for processing sensory inputs which affects daily occupation. Although this is known, research regarding the target groups experiences of sensory inputs in daily occupations is lacking.

Aim: To investigate the experience of sensory input and strategies used in daily occupations among people with serious mental illness.

Predictors of clinically important improvements in occupational and quality of life outcomes among mental health service users after completion and follow-up of a lifestyle intervention: multiple regression modelling based on longitudinal data.

Background: Balancing Everyday Life (BEL) is a new activity-based lifestyle intervention for mental health service users. An earlier study found BEL to be effective in increasing occupational engagement, occupational balance, activity level, and quality of life scores when compared with a care-as-usual group. However, it is unclear whether care context and socio-demographic, clinical and self-related factors at baseline also influence the results.

Development and Evaluation of a Swedish Short Version of the Questionnaire About the Process of Recovery (QPR).

The aim was to develop a short version of the Swedish Process of Recovery Questionnaire (QPR-Swe) for use with people with severe mental illness and to investigate its internal consistency, construct validity, known-groups validity and any floor or ceiling effects. Two independent samples were used, the first (N = 226) to develop the short version and the second (N = 266) to test its psychometric properties. A seven-item version was developed by selecting items based on item-total correlations.

Breaking a cycle of perceived failure: The process of making changes toward a more balanced lifestyle.

Introduction: Balancing Everyday Life (BEL) is a new lifestyle intervention for mental health services users, developed to support meaningful engagement in daily activities and a balanced lifestyle. This study aimed at exploring the BEL participants' process of making lifestyle changes.

Methods: This constructivist grounded theory study took place in Sweden from 2013-2017 and explored the processes of 19 BEL participants when making lifestyle changes.

Perceived occupational balance and well-being among people with mental illness living in two types of supported housing.

People with psychiatric disabilities often struggle with maintaining a satisfying occupational balance. Knowledge about factors of relevance for occupational balance in this group is therefore vital for improving their support. The aim was to describe perceptions of occupational balance among people with psychiatric disabilities living in supported housing (SH) or in own flat/house with housing support (OHS).

Group leader and participant perceptions of Balancing Everyday Life, a group-based lifestyle intervention for mental health service users.

There exist few recovery and occupation-based interventions for mental health service users. Balancing Everyday Life (BEL) is a new occupation-based lifestyle intervention that was created to fill this need. To gain group leaders' and participants' perspectives of the BEL intervention content and format, including factors that helped, hindered, and could be improved.

Joining, belonging, and re-valuing: A process of meaning-making through group participation in a mental health lifestyle intervention.

Background: Balancing Everyday Life (BEL), a new group-based intervention for mental health service users, was implemented in Sweden. Mental health service users often experience group interventions as meaningful, but knowledge of the process of meaning-making in a group is lacking.

Aim: To explore participants' perceptions of the group in the Balancing Everyday Life (BEL) lifestyle intervention; specifically, personal experiences of what brings meaning when participating in a group.

Effectiveness of Balancing Everyday Life (BEL) versus standard occupational therapy for activity engagement and functioning among people with mental illness - a cluster RCT study.

Background: Many with a mental illness have an impoverished everyday life with few meaningful activities and a sedentary lifestyle. The study aim was to evaluate the effectiveness of the 16-week Balancing Everyday Life (BEL) program, compared to care as usual (CAU), for people with mental illness in specialized and community-based psychiatric services. The main outcomes concerned different aspects of subjectively evaluated everyday activities, in terms of the engagement and satisfaction they bring, balance among activities, and activity level.

Wellbeing, activity and housing satisfaction - comparing residents with psychiatric disabilities in supported housing and ordinary housing with support.

Background: The home is imperative for the possibilities for meaningful everyday activities among people with psychiatric disabilities. Knowledge of whether such possibilities vary with type of housing and housing support might reveal areas for improved support. We aimed to compare people with psychiatric disabilities living in supported housing (SH) and ordinary housing with support (OHS) regarding perceived well-being, engaging and satisfying everyday activities, and perceived meaning of activity in one's accommodation.

Measuring personal recovery - psychometric properties of the Swedish Questionnaire about the Process of Recovery (QPR-Swe).

Background: Personal recovery, defined as an individual process towards meaning, is an important target within mental health services. Measuring recovery hence requires reliable and valid measures. The Process of Recovery Questionnaire (QPR) was developed for that purpose.

Quality of Life Among People with Psychiatric Disabilities: Does Day Centre Attendance Make a Difference?

The purpose was to investigate (i) how people with psychiatric disabilities who attend day centres experience their quality of life (QoL) compared to non-attendees, (ii) differences in QoL between those who attend meeting place-oriented centres and those who attend work-oriented centres, (iii) possible correlates of QoL among day centre attendees. Ninety-three day centre attendees and 82 non-attendees completed questionnaires addressing QoL and selected correlates. No group difference was found regarding QoL.