The purpose of this study was to explore how persons with severe mental illness (SMI) experience oral health problems (especially dry mouth), and weigh the support they received in this regard from professionals and staff at community-based congregate housing through a controlled intervention programme. Oral health problems and dry mouth are found in association with apathy and indifference, cognitive deficits, and long-term medication with psycho-pharmacological drugs. The present study describes the results from one part of a longitudinal intervention programme, which sought effective ways of mitigating dry mouth through increased support with oral health problems. This part consists of 67 informal interviews with ten participants in two community-based urban housing projects between November 2006 and June 2007, with a follow-up session in December 2007. Content analysis of the results yielded five categories: The shame of having poor dental health, history of dental care, experiences of self-care, handling of oral health problems, and experiences of staff support. Poor oral health caused shame and limited participation in social activities. Participants avoided oral health issues by such circumventions as denial of a tooth ache or dental infections, or postponing oral problems with the hope that they would die away. Offers of support were frequently resisted because of unsatisfactory prior encounters with dental professionals and staff. Our findings suggest that self-care needs to be facilitated in an unobtrusive manner with minimal staff involvement, and clients should be referred to dental care providers experienced in treating people with SMI.

This study highlights experiences of psychiatric care described by patients diagnosed with psychosis. The aim was to investigate how patients, based on earlier experiences, described their wishes and needs regarding the psychiatric care system. Data comprised material from four focus groups; analysis used an inductive thematic approach. Relationships with staff emerged as a recurring theme. During periods of psychosis, patients needed staff to act as “parental figures,” providing care, safety, and help in dealing with overwhelming stimulation from the outside word. In the ensuing struggle to devise a livable life, the need for relationships recurred. In this phase, staff needed to give their time, provide support through information, and mirror the patient's capacity and hope. The patient's trials were described as threatened by a lack of continuity and non-listening professionals. It was important for staff to listen and understand, and to see and respect the patients' viewpoints.

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The Swedish system of disability support is often praised for its comparably well-developed Personal Assistance (PA) scheme. PA is formally prescribed as a social right for disabled people with comprehensive support needs in the <em>Act Concerning Support and Services to Persons with Certain Functional Impairments</em> (LSS). In the decade following the introduction of LSS in 1994, the PA-scheme expanded steadily to accommodate the support needs of more and more disabled people. It is commonly believed that the expansion of PA has substantially boosted the agency of both disabled people and their relatives. This article critically discusses in what direction the Swedish system of disability support has moved in the past decade. Is the common image of a system moving towards an ever increasing <em>defamilialization</em> of disability support still accurate? Or are there signs of stagnation, or even reversal towards refamilialization? What are the possible consequences of the more recent developments for disabled people and their relatives in terms of agency and equality? These questions will be discussed with the help of an analysis of the regulatory framework of disability support, statistical data and findings from public reports.