Alain Topor

University of Agder | UIA · Department of Psychosocial Health

Background Mental health problems and financial difficulties each increase the risk of social exclusion. However, few large studies representing a broad age range have investigated the combined social effect of having both difficulties. The purpose of this cross-sectional study was to examine associations of mental health problems, financial diffic...

The deinstitutionalization of mental health institutions has enabled service users to live in the community and search for what Duff coins ‘enabling places.’ These places were explored through walking interviews, in which service-users led the way. This analysis revealed features which made places promote liveable lives: places help people explore,...

Background Mental health problems and low economic capability increase the risk of social marginalization. However, few larger studies with a broad age group have investigated how the cumulative effect of having both these difficulties may affect social life. The purpose of this study was to examine the associations between having mental health pro...

Background: The lack of social and material perspectives in descriptions of recovery processes is almost common in recovery research. Aim: Consequently, we investigated recovery stories and how people with mental health and/or addiction challenges included social and material aspects in these stories. Method: We conducted focus group and individual...

From being a concept questioning the core of psychiatric knowledge and practice, recovery has been adopted as a guiding vison for mental health policy and practice by different local, national, and international organizations. The aim of this article is to contextualize the different understandings of recovery and its psychiatrization through the e...

This paper points out some problematic aspects of qualitative research based on interviews and uses examples from mental health. The narrative approach is explored while inquiring if the reality of life here is forced into the formula of a chronological story. The hermeneutic approach, in general, is also examined, and we ask if the reality of life...

Since the 1970s, psychiatric care in the western world has undergone fundamental changes known as de-institutionalisation. This has changed the living conditions for people with severe mental illness. The purpose of this study was to investigate the living conditions and utilisation of care and social services for a group of people in Sweden with d...

Objective: Recently, the position of persons with mental health and drug problems has evolved from victim of an illness to holder of an experience-based knowledge (EBK). Studies about recovery are often based on recovery narratives. However, focusing on components of the recovery process-parts of this EBK concerned with the causes, onset, and journ...

In conjunction with the dismantling of psychiatric hospitals, social workers have been commissioned to help service users in their daily living in their homes and in the community. The consequences of these changes for experience-based knowledge and practices in their contexts remain relatively unknown. In this study, eighteen service users and the...

Service users often mention the importance of trivial actions by professionals for the construction of trust and working alliances facilitating their recovery process. These micro-affirmations being connected to the experience of being seen, heard, and respected. However, we lack knowledge about how these relationships are developed in daily practi...

Purpose The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Methods Eight...

People with severe mental illness face a different ‘interventional’ landscape compared to some decades ago, when mental hospitals were dominant, in Sweden as well as in the rest of the Western world. The aim of the research reported in this article was to follow men and women diagnosed with psychosis for the first time over a 10-year period, and to...

Our daily lives and sense of self are partly formed by material surroundings that are often taken for granted. This materiality is also important for people with mental health problems living in supported housing with surroundings consisting of different healthcare services, neighbourhoods, buildings or furniture. In this study, we explored how und...

Introduction In the aftermath of the deinstitutionalisation in western countries, new community‐based mental health services have been established. An essential object of studies in this new institutional landscape has been helpful professional relationships, but we still lack knowledge about helpful relationships in community‐based institutional s...

In Sweden, the mental hospitals were closed by the end of the 1990s. Basaglia influenced the Swedish reality not through his and his colleagues’ words, but through their practical transformation of these words into reality. Sweden is a pragmatic and social ‘engineering’ country. In Italy, Swedish mental health workers and administrators found a cle...

Italian Law 180 of 1978 is probably the most radical Mental Health Act ever passed. It forbade the admission of any new patients to mental hospitals forthwith and called for the rapid closure of such institutions. The Law crowned the work of the charismatic Italian psychiatrist Franco Basaglia and his ‘Democratic Psychiatry’ movement. The Italian r...

Purpose The aim of this study is to explore how material things might become involved in the recovery process of people with mental health difficulties. Method Empirical material from three different studies on various aspects concerning mental health issues that each of the authors had conducted was reanalysed through a phenomenological item anal...

In der ambulanten Begleitung von Menschen mit psychischen Erkrankungen ist eine reflektierte und strukturell unterstützte Beziehungsarbeit zentral. Die AutorInnen beleuchten, wie eine hilfreiche professionelle Beziehung in der Arbeit mit psychisch Erkrankten handlungspraktisch und konzeptionell umgesetzt werden kann, und sie zeigen auf, welche orga...

Background User involvement, based on respect and carried out through dialogue, has been shown to lead to increased self-respect, self-confidence and positive identity. In Sweden, the Social Service Act requires that interventions be designed and implemented together with the individual concerned. The basic criterion for social support is prolonged...

Purpose: The aim of this study is to explore the ways in which “small things” may be of importance for people with mental health difficulties. Method: Empirical material from three different studies was reanalysed through a phenomenological, dialogical, approach. Results: We discovered some paradoxical aspects of small things: i.e., they could be a...

This article explores how professional relationships may be helpful from the perspective of residents in staffed supportive housing for individuals with severe mental health and/or drug problems. Using in-dept interviews, residents were individually asked to describe a helpful relationship with a self-chosen staff member, the content of the help pr...

Purpose Persons with severe mental health problems (SMHP) point out financial strain as one of their main problems. De-institutionalisation in welfare countries has aimed at normalisation of their living conditions. The aim of the study was to follow the changes in income and source of income during a 10-year period for persons with a first-time ps...

The living conditions for persons with severe mental illness have undergone substantial change in Sweden as well as in the rest of the Western world due to the downsizing of inpatient care and the development of community-based interventions. However, there is a lack of knowledge concerning the “trajectories of interventions” in this new, fragmente...

Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their...

Over the last few decades, various housing types for people with mental health problems have been developed for use in the community. These housing types differ in their objectives, staff support and design. In this study, we focus on how fire safety influences the lives of tenants in supported housing. The qualitative study was designed with a mul...

The aim of this study is to present concrete descriptions of the content in the construction of helpful relationships with staff, according to users. Starting with the re-occurring concept of the meaning of “little things” in recovery studies, a literature review was done. A thematic analysis shows that small things play an important role in improv...

The study focus on how clients with co-occurring problems describe the importance of treatment factors for the recovery process and how these descriptions relates to professional descriptions. 40 client interviews and 15 interviews with professionals were conducted. Three major themes emerge in the results: medication, methods and the professionals...

Background: Despite repeated attempts, it has not been possible to reach a consensus on the definition of recovery. In this paper, we use the term “institutional recovery” and focus on the persons’ use of services. Aim: What type of services were used by men and women who were diagnosed for the first time with psychosis? How did different cut-offs...

Purpose The purpose of this paper is to investigate the internal and social factors that persons with experience from severe mental illness and alcohol and other drugs problems, and who have received treatment for these problems, describe as important for initiating and maintaining a recovery process. Design/methodology/approach In total, 40 per...

Purpose The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals’ perceptions of their contribution to improvement. Desig...

Living conditions for persons with severe mental illness (SMI) in Sweden have changed dramatically in recent decades, mainly due to the closure of mental hospitals in the 1990s and the subsequent development of community-based interventions. Thereby, people with SMI have experienced care interventions in various forms, which vary according to how t...

During a 9-month period, 100 persons with SMI were given approx. 73 USD per month above their normal income. Sixteen of the subjects were interviewed. The interviews were analysed according to the methods of thematic analysis. The money was used for personal pleasure and to re-establish reciprocal relations to others. The ways in which different in...

Background: Although being personal in relationships with service users is commonly described as an important aspect of the way that professionals help people with severe mental problems, this has also been described to bring with it a need to keep a distance and set boundaries. Aims: This study aims to explore how professionals working in psych...

Purpose – The importance of collaboration in the mental health field is a well established theoretical principle, but there has so far been less attention to its practical implications from a parents’ perspective. The purpose of this paper is to describe parents’ experiences of collaboration with mental health practitioners. Design/methodology/app...

Psychotropic drugs, particularly antipsychotic types, are a cornerstone of the treatment of people with psychosis. Despite numerous studies showing that drug treatment with psychotropic drugs initially alleviates psychiatric symptoms, the proportion of people with mental health problems and symptoms that do not follow doctors' prescriptions, thus e...

The relationship with professionals is an important factor in relation to the outcome of interventions directed to persons with severe mental problems. However, the current knowledge regarding the development of helpful relationships within Individual Placement and Support (IPS) services is limited. The aim of the study was to investigate how parti...

Background: The relationship between severe mental illness, poverty and social isolation has been explored in a number of studies.Aim: The purpose of the study was to explore the relationship between financial strain and social isolation.Methods: Sixteen persons with severe mental illness were interviewed about their experience of having a severe m...

Tecknen på en medikalisering av det psykosociala fältet har ökat under senare tid. Denna artikel undersöker denna medikaliseringsprocess utifrån Socialstyrelsens kunskapssammanställning »Effekter av psykosociala insatser för personer med schizofreni och bipolär sjukdom«, som ska resultera i riktlinjer för socialtjänsten.

Kraven på ett evidensbaserat socialt arbete har ofta hänvisat till det medicinska fältet, något som gör det intressant att undersöka hur Socialstyrelsen och svensk psykiatri tillämpar de egna kraven på evidens. En granskning av Socialstyrelsens kunskapsöversikt av »schizofrenin« visar att dessa krav används på ett subjektivt sätt, vilket förstärker...

Objectives: Several studies have pointed at a co-occurrence between severe mental problems and relative poverty. Also users refer to their strained financial situation as one of their main problems. We lack knowledge about how persons ‒ still characterised in diagnostic manuals as having difficulty with their sense of reality and their ability to c...

ABSTRACT Caring through discipline? Analyzing house rules in community mental health services in Norway In Scandinavian countries, public housing and recreation programs for people suffering from mental health or substance abuse problems emphasize normalization of life and participation in a normal social life. The theoretical approach taken by co...

Background: The relationship with professionals has proved to be important with regard to outcome for persons with severe mental illness (SMI). The understanding of non-helpful relationships is important complementary knowledge to that regarding helpful relationships. Aim: To review the available qualitative research providing knowledge of non-hel...

Method: a financial contribution per month was granted to 100 individuals with severe mental illnesses for a 9-month period. Assessments of the subjects were made before the start of the intervention and after 7 months' duration. A comparison group including treatment as usual only was followed using the same instruments. Significant improvements...

During the last decades services to people with severe mental health problems have gone through important changes. Terms as de-, trans-, reinstitutionalisation and dehospitalisation has been used. The objective of the study was to collected data about the changes in a welfare society about the new institutional landscape after the mental hospital a...

Relationships with professionals have been shown to be helpful to persons with severe mental illness (SMI) in relation to a variety of services. In this article, we aimed to synthesize the available qualitative research to acquire a deepened understanding of what helpful relationships with professionals consists of, from the perspective of persons...

People with severe mental illness (SMI) are often described as lonely and socially incapable – an inability resulting from the mental illness. The aim of this article is to explore experiences of being alone among persons with SMI. The article is based on interviews with 19 persons diagnosed with psychosis who were interviewed between four and nine...

Background: Establishing a working alliance has been found to be of great importance for the outcome of professional interventions for people diagnosed with severe mental illnesses. Aim: The aim of the present study was to analyse the concrete actions of helpful professionals in establishing a working alliance. Method: Interviews with 58 persons di...

In psychiatry, it is assumed that the social conditions of everyday life do not in themselves affect the severity of an individual’s mental ill health. Rather, the illness is the cause of problems that the individual meets in daily life. However, recent studies indicate that social factors can explain behavior that has ordinarily been regarded as s...

Summary Money and mental health, the social reason(s) for loneliness An individual’s financial situation, and poverty touching a great number of people with severe mental illness, are not actualized in most psychiatric literature, research and practice. The users themselves point to economic strain as one of their most important problems, and an am...

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Being in recovery from bipolar disorder involves work-related concerns. The specific aims of this study are to: 1) understand the role of work in recovery from bipolar disorders, and 2) understand how people with such disorders deal with work-related challenges. These topics are examined from the stance of the recovery process, in which work-relate...

Mennesker som strever med livene sine bør selv være med å vurdere hva som er den beste hjelpen. Fleksibilitet er stikkordet, skriver medlemmer av forskernettverket for sosiokulturelle perspektiver på psykisk helse.

Research has shown the importance of the relationship between professionals and users for the outcome of interventions in psychiatry. The aim of this study is to analyze time as one factor in the development of working alliances. Fifty-eight persons in recovery from diagnosis of severe mental illness were interviewed about helping factors in their...

Research has shown the importance of the relationship between professionals and users for the outcome of interventions in psychiatry. The aim of this study is to analyze time as one factor in the development of working alliances. Fifty-eight persons in recovery from diagnosis of severe mental illness were interviewed about helping factors in their...

Background: The quality of the relationship between professional and user is one of the important factors in the recovery process. However, more knowledge is needed concerning the components of helping relationships and characteristics of the helping professional. The aim of this study was to explore users’ experiences of helping relationships with...

The quality of the relationship between professional and user is one of the important factors in the recovery process. However, more knowledge is needed concerning the components of helping relationships and characteristics of the helping professional. The aim of this study was to explore users' experiences of helping relationships with professiona...

Recent literature on recovery describes the process as deeply personal and unique to each individual. While there are aspects of recovery that are unique to each individual, this article argues that focusing solely on these overlooks the fact that recovery unfolds within a social and interpersonal context. Drawing from qualitative data, this articl...

the de-, re- and trans-institutionalization of psychiatric care has resulted in a number of changes in the interventions available to persons with severe mental disorders.AimsThis article describes the design of a naturalistic follow-up study of persons with a psychosis diagnosis, the characteristics of the study population, and the interventions t...

The Practice and Body of Knowledge of Psychiatry as Opposed to Those of the User An increasing number of policy documents are recommending that the recovery perspective be used as a guiding principle in the development of psychiatric care. The recovery perspective also implies a formalized user involvement in the planning and managing of treatment...

Background: The de-, re- and trans-institutionalization of psychiatric care has resulted in a number of changes in the interventions available to persons with severe mental disorders. Aims: This article describes the design of a naturalistic follow-up study of persons with a psychosis diagnosis, the characteristics of the study population, and the...

People who have been diagnosed with schizophrenia are regarded as being no longer capable of making rational choices. Fifteen users with psychosis diagnosis participated to 10 focus group sessions about different aspects of everyday life. The discussions were tape recorded and the transcript analyzed using a grounded theory inspired methodology. A...

Background: Recent literature on recovery describes the process as deeply personal and unique to each individual. While there are aspects of recovery that are unique to each individual, this article argues that focusing solely on these overlooks the fact that recovery unfolds within a social and interpersonal context. Materials: Drawing from qualit...

Recovery research often describes recovery from mental illness as a complex individual process. In this article a social perspective on recovery is developed. To ascertain which factors people regard as decisive to their own recovery and what makes them beneficial. In-depth interviews were conducted with 58 persons in Sweden who had recovered from...

Despite much effort to positively affect long-term outcome in psychosis and schizophrenia many patients are still facing a poor outcome with persistent psychotic symptoms and decline in social functioning. The aim of this study was to examine the relationship between financial strain and social network and five-year outcome of first episode psychos...

This article offers examples of the ways in which qualitative methods have informed, and may inform, mental health policy in Canada and beyond. Three initial uses of these methods are identified: to generate hypotheses to be tested by other means; to explore the subjective experiences and everyday lives of people with mental illnesses; and to inves...

Relationships with professionals have been shown to be helpful to persons with severe mental illness (SMI) in relation to a variety of services. In this article, we aimed to synthesize the available qualitative research to acquire a deepened understanding of what helpful relationships with professionals consists of, from the perspective of persons...

Relationships have a tremendous impact on how people recover from schizophrenia. Previous research has focused on the role of clinicians in these supportive relationships, but the current study finds that these relationships can occur within the mental health system, the family, or out in the community. Regardless, it is very important for people i...

We analyzed informant narratives in terms of the benefits of spending time within various community arenas, including service user organizations, advocacy agencies, the bowling alley, and universities. Themes contributing to recovery from severe mental illness included the understanding and acceptance infromants both gave and received from others,...

This article analyzes the role of social factors in recovery from psychosis, which can be helpful as well as hinder the process of recovery. Informants found their roles as psychiatric patients constituted a major barrier to social adaptation. They experienced stigma both within their natural social networks and mental health services, which often...

This article provides an interpretation of the key issues that emerged from the research, attempting a possible synthesis of the different themes described in the other papers and beginning a map of recovery as an ongoing interpersonal and social process. From a subjective point of view, there is a dimension of ‘social experience’, which implies th...

Expanding on the introduction to the multinational study described in the first article, this article briefly reviews informants’ contexts of treatment across Italy, Norway, Sweden, and the United States, and provides a cursory description of each informant, organized according to her or his respective country. The informant descriptions are follow...

Informants in the present study identified poverty, unemployment, substandard living conditions and homelessness as being among the major struggles they faced within their recoveries from psychosis and depression. In considering the benefits of material resources, many informants discussed the notion of having a home, referring to it as a place for...

As part of a growing literature describing processes of recovery in psychotic disorders, this report presents findings of an intensive, international study. Open-ended qualitivite interviews were conducted in Italy, Norway, Sweden, and the United States with a total of twelve individuals who have experience of recovery in psychosis. All interviews...

As they began the journey of recovery from psychosis, informants described the importance of making their own initial decision to get well and maintain their physical and mental health. Developing a sense of self-control in their lives by managing their symptoms, determining how they spend their time, developing their own ways of defending themselv...

The purpose of this paper was to provide an example from phenomenological research of moving from rich descriptive interview data to coherent revelatory descriptions employing empathic bridges within the narrative structure of storytelling. We used transcribed data from two interviews concerning recovery from severe mental illness: one with an Amer...