BackgroundPeople who struggle with mental health problems can provide valuable insight into understanding and improving the coordination of mental health and welfare services. The aims of the study were to explore service users’ experiences and perceptions of continuity of care within and across services relevant to personal recovery, to elicit which dimensions of continuity of care are most essential to service users, and to generate ideas for improving service users’ experiences of continuity of care.MethodsIn the context of a hermeneutic-phenomenological approach, ten service users at a community mental health centre were interviewed about their experiences of continuity of care in and across services. Eight of these were re-interviewed two years later. A collaborative research approach was adopted. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis.ResultsFollowing the analysis five themes representing experiences of continuity of care were developed. Each theme ranged from poor to good experiences of continuity of care: Relationship – from experiencing frequent setbacks and anxiety due to breaks in relationships, to feeling safe in an ongoing personal relationship; Timeliness – from experiencing frustrating waiting times with worsening of problems, to getting help when needed; Mutuality – from having a one-sided struggle, to a situation in which both professionals and service users take initiatives; Choice – from not having the opportunity to make practical arrangements within the context of one’s everyday life, to having an array of support options to choose from; Knowledge – from feeling confused and insecure because one does not know what is happening, to feeling safe because one is informed about what is going to happen. Participants provided a range of suggestions for improving experiences of continuity of care.ConclusionsA discrepancy between aspects of continuity that are essential for service users and their experiences of actual practice was revealed. The valid evidence generated in the present collaborative study therefore offers knowledge to policy makers, professionals and service users that may be of help in their future efforts in orienting primary care, mental health, addiction and welfare services towards recovery.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2719-9) contains supplementary material, which is available to authorized users.

A previous analysis showed that mental health service users experienced profound loneliness, struggled to relate to other people, and were careful in considering what to share with health-care professionals. Being recognized by professionals in relationships may contribute to recovery processes characterized by 'connectedness', 'hope and optimism', 'identity', 'meaning', and 'empowerment'. This paper regards people as mainly seeking contact and meaning (relational perspective) and aims to describe service users' understanding of being in relationships with professionals, and how these relationships may limit or enhance recovery. Interpretative phenomenological analysis was used to analyze data from in-depth interviews. Participants described three levels of connectedness with professionals: (i) being detached; (ii) being cautious; and (iii) being open and trusting. Level of connectedness seemed to be associated with opportunities for promoted recovery. Trusting relationships may strengthen identity, provide opportunities for meaning and hope, and contribute to opening new perspectives, and lessen significance of internal voices. Adopting a relational perspective may assist professionals in recognizing the service user as a person involved in making sense of life experiences and in the process of connecting to other people.

Sammendrag:Artikkelen tar for seg sårbarhet i relasjoner mellom psykiatriske tjenester og fagfolk som arbeider i kommunebaserte psykiske helsetjenester. Hensikten var å utforske hvordan brukerne av disse tjenestene beskrev og ga mening til sine møter med andre mennesker. Forskningen er et samarbeidsprosjekt mellom forskere og personer med erfaringsbasert kunnskap. Dataene er hentet fra 19 intervjuer med 11 personer som er avhengige av psykiske helsetjenester minst tre ganger i uken. Resultatene bekrefter at gjensidighet er grunnleggende for relasjoner. Det er viktig å anerkjenne den enkelte brukeren, og dette innebaerer et personlig engasjement hos den profesjonelle omsorgsyteren.Omsorgsbiblioteket har ikke tilgang til å publisere dette dokumentet i fulltekst. Kanskje ditt lokale bibliotek kan hjelpe deg, eller kanskje du kommer videre med lenken nedenfor.Relevant lenke: https://doi

Stable, trusting relationships are at the core of Norwegian community-based mental health services. Being acknowledged and respected may promote a client's recovery. The aim of this study was to explore mental health workers' experiences of relating to clients. The design involved multi-stage focus groups based on a participatory approach and using interpretative phenomenological analysis. Acknowledging the personhood of a client appears to offer opportunities for growth and development in the client as well as in the health worker, based on reciprocal processes of each person affecting the other and the health workers' openness to understanding the other person.

BackgroundRecovery can be understood as a subjective process guided by personal expectations, goals and hopes. The aim of the study was to explore how persons using a Community Mental Health Centre (CMHC) experienced that their expectations for treatment, and goals and hopes for recovery were supported by the health professionals during treatment.MethodsEmploying a hermeneutic–phenomenological approach, eight service users were interviewed about their expectations for treatment and their goals and hopes for recovery at the start of their contact with health professionals at a CMHC. Two years later, they were re-interviewed about their experiences of treatment and support from the health professionals in their work towards these goals and hopes. A collaborative approach was adopted. A co-researcher with lived experience took part in all stages of the study. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis.ResultsFive themes reflecting how participants experienced support from health professionals at the CMHC in their work towards their recovery goals were elicited, as follows: developing an understanding of oneself and one’s mental health problems; learning how to change feelings and behaviours; being ‘pushed’ into social arenas; finding helpful medication; and counselling in family, practical and financial issues. The participants’ expectations about counselling with regard to longer-term family, practical, and financial challenges were insufficiently met by the CMHC. In the experience of the service users, recovery occurred within the context of their everyday life with or without the support of their professional helpers.ConclusionsTo facilitate recovery, health professionals should acknowledge the service user’s personal goals and hopes and take a more comprehensive and longer-term approach to his or her needs and desires. Acknowledging and facilitating recovery goals by offering counselling with regard to family, practical and financial issues seems particularly important.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1133-x) contains supplementary material, which is available to authorized users.