Dilemmas in recovery-oriented practice to support people with co-occurring mental health and substance use disorders: a qualitative study of staff experiences in Norway

Brekke, Eva; Lien, Lars; Nysveen, Kari; Biong, Stian

doi:10.1186/s13033-018-0211-5

Cited by 24 publications

(38 citation statements)

References 43 publications

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“…Tensions between recovery-oriented models of care and addiction treatment have been documented (60). The tension described by staff between addressing tobacco and recovery-oriented models of care deserves further discussion.…”

Section: Discussionmentioning

confidence: 99%

‘They’re Going to Smoke Anyway’: A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation

Twyman

Cowles²,

Walsberger

et al. 2019

Front. Psychiatry

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Background: Addressing the high prevalence of tobacco use experienced by people with severe mental illness (SMI) requires consideration of the influence of wider cultural, socioeconomic and environmental factors. This qualitative study aimed to examine the impact of social and living environments on tobacco use and cessation by people with SMI accessing community managed mental health services. The perspectives of both staff and consumers with SMI were explored. Methods: Semi-structured focus groups were undertaken with a purposive sample of community mental health staff and consumers from three sites in three major cities in NSW, Australia. Two sites provided outreach support, and one site provided residential support. Data were collected (2017–2018) until saturation was reached. Focus groups were audio-recorded and transcribed, and thematic analysis was conducted. Results: Thirty-one staff and 17 consumers participated separately in six focus groups. Themes identified by staff included a degree of fatalism, conceptualising tobacco use as choice rather than addiction and tensions between cessation support and broader models of care. Staff viewed smoke-free home and mental health service policies as effective at promoting quitting but contradictory to recovery-oriented models of care. Consumers identified smoking as an integral part of life and social networks, as a way of maintaining control and lack of social support to quit as key themes. While many consumers reported smoking inside the home, others described enforcing smoke-free rules. Conclusion: Social and living environments played an integral role in tobacco use and cessation for both staff and consumers. The role of community managed mental health organisations in addressing tobacco use within social and living environments was not strongly supported by staff and sometimes seen as antithetical to recovery-oriented models of care. Potential ways to address this include education and training for prospective and current community mental health organisation staff highlighting the synergy between the recovery-oriented model and provision of preventive health support.

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Section: Discussionmentioning

confidence: 99%

‘They’re Going to Smoke Anyway’: A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation

Twyman

Cowles²,

Walsberger

et al. 2019

Front. Psychiatry

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“…Based on Evan's narrative, the role of professionals is first and foremost to help young adults to have a realistic understanding of themselves in relation to how society works and to have realistic expectations of life in line with this understanding. However, one can ask whether such a strategy involves letting young people expect too little from their lives [51,52].…”

Section: Negotiating Future Opportunities In Light Of Past Experiencesmentioning

confidence: 99%

Resist or Adapt? A Narrative Analysis of Endeavors for Belonging Among Young Adults with Co-Occurring Substance Use and Mental Health Problems

Semb

Sælør

Borg

2021

J. Psychosoc. Rehabil. Ment. Health

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The article explores how young adults with co-occurring substance use and mental health problems experience and describe their own and others’ contributions to their sense of community belonging. This article is part of a larger qualitative interview study of young adults. The data for this report were the individual interviews with two study participants. These participants were chosen because they offered in-depth understandings relating to various aspects of community belonging. A thematic narrative analysis of the interview data was carried out. Central to this model of analysis is to transform unstructured qualitative interview data into a unified narrative for each participant, structured around a thematic plot. The analysis revealed two plots: ‘Having to go against yourself to be an insider', and ‘You have to realize that you have problems and try to do something about them'. We interpreted the first narrative as an expression of marginalized people feeling they deserve recognition from society, while the second narrative reflected the idea that each person has a personal responsibility for being valued. We conclude that the narratives expressed the importance of helping young adults to place their lived experiences in a larger social context.

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“…Recovery, social inclusion and human rights are increasingly recommended in national and international guidelines for mental health and substance abuse services [9,24,51]. Although recovery in western health and welfare services is evolving, the individualized and clinical understandings are still dominating [34].…”

Section: Introductionmentioning

confidence: 99%

Recovery on the Pitch: Street Football as a Means of Social Inclusion

Ogundipe

Borg

Thompson

et al. 2020

J. Psychosoc. Rehabil. Ment. Health

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The study contributes to the existing literature on the value of street football teams in recovery, by exploring how persons with mental health and/or substance abuse problems experience participation in street football teams. In total, 51 persons experiencing mental health and/or substance abuse challenges who played in street football teams, in Norway, participated in focus group interviews. The interviews were recorded and transcribed verbatim. Data were analyzed using thematic content analysis, and resulted in three major themes: (1) The spirit of the football team, (2) More than just a pitch, and (3) The country's best follow-up system. Overall, our findings highlighted the importance of community and communal efforts through acts of citizenship, in facilitating and promoting social inclusion for persons in challenging life situations. Street football is one measure than can be helpful in this context. Communities, policy makers and funders need to acknowledge and gain more insight and understanding of the value that street football teams represent. There is also a need for further studies exploring what contributes to community in our highly individualistic society.

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Dilemmas in recovery-oriented practice to support people with co-occurring mental health and substance use disorders: a qualitative study of staff experiences in Norway

Cited by 24 publications

References 43 publications

‘They’re Going to Smoke Anyway’: A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation

‘They’re Going to Smoke Anyway’: A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation

Resist or Adapt? A Narrative Analysis of Endeavors for Belonging Among Young Adults with Co-Occurring Substance Use and Mental Health Problems

Recovery on the Pitch: Street Football as a Means of Social Inclusion

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