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  • 1.
    Näslund, Hilda
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Sjöström, Stefan
    Umeå universitet, Institutionen för socialt arbete.
    Participatory spaces of mental health service user organizations in the post-deinstitutional era: mapping roles and challenges2017Inngår i: VOLUNTAS - International Journal of Voluntary and Nonprofit Organizations, ISSN 0957-8765, E-ISSN 1573-7888Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    By applying the concept of participatory spaces, this article maps and analyzes current research on mental health service user organizations (MHSUOs). We have analyzed research literature from 2006 to 2016 to examine how the role of and challenges facing MHSUOs are formulated in the post-deinstitutional era. The current situation is marked by MHSUOs parallel presence in invited, claimed and popular spaces for participation. The post-deinstitutional era is characterized by a shift in focus from gaining access to such participatory spaces, to critically examining the political opportunities available in these. We further argue that the dominance of psychiatry-specific spaces could prevent MHSUOs from fully exploring their potential for participation in broader social issues. 

  • 2.
    Sjöström, Stefan
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Zetterberg, Liv
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Why community compulsion became the solution: reforming mental health law in Sweden2011Inngår i: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 34, nr 6, s. 419-428Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aimof this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State. In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, therewas agreement about the (lack of) evidence about its  effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framedwithin an ideology of integrating the disabled. The new legislation allowed for a broad range ofmeasures to control patients at the same time as itwas presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community. The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.

     

  • 3.
    Zetterberg, Liv
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Markstom, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Sjostrom, Stefan
    Umeå universitet, Institutionen för socialt arbete.
    Risk management or improving the life for the patient?: Court rulings concerning compulsory community care in Sweden2011Inngår i: Psychiatrische Praxis, ISSN 0303-4259, E-ISSN 1439-0876, Vol. 38Artikkel i tidsskrift (Fagfellevurdert)
  • 4.
    Zetterberg, Liv
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Sjöström, Stefan
    Umeå universitet, Institutionen för socialt arbete.
    Translating Coercion Policy into Inter-Organisational Collaboration: The Implementation of Compulsory Community Care for People with Mental Illness2016Inngår i: Journal of Social Policy, ISSN 0047-2794, E-ISSN 1469-7823, Vol. 45, nr 4, s. 655-671Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In 2008, compulsory community care (CCC) for people with severe mental illness was introduced in Sweden. CCC requires co-operation between psychiatric and social services, thus further complicating the longstanding difficulties with service coordination in the mental health field.

    This article investigates what happens when a new policy is introduced that assumes complex co-operation of two organisations bestowed with high degrees of discretion. The process of institutionalisation will be analysed in terms of how an idea is translated and materialised on local levels. This has been investigated by interviewing key informants within psychiatric and social services at three different locations.

    The implementation was perceived as relatively successful and occurred without major conflict. The main effect of the new legislation was improvement in the coordination of services, where designing a template form for a coordinated care plan was central. The inter-organisational discussions about service coordination that arose had a spill-over effect on services for other patient groups.

    In essence, respondents describe CCC as a pedagogical reform to promote the coordination of services, rather than a reform to increase coercive powers over patients. This raises concerns about the legitimacy of the reform.

  • 5.
    Zetterberg, Liv
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Sjöström, Stefan
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    The compliant court: Procedural fairness and social control in compulsory community care2014Inngår i: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 37, nr 6, s. 543-550Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Compulsory community care (CCC) was introduced in Sweden in 2008. This article investigates all written court decisions regarding CCC over a 6 month period in 2009 (N = 541). The purpose is to examine how the legal rights of patients are protected and what forms of social control patients are subjected to. 51% of CCC patients are women and 84% are being treated for a psychosis-related disorder. In the court decisions, only 9% of patients are described as dangerous to themselves, while 18% are regarded a danger to others. The most common special provisions that patients are subjected to are medication (79%) and a requirement that they must maintain contact with either community mental health services (51%) or social services (27%). In the decisions, both the courts and court-appointed psychiatrists agree with treating psychiatrists in 99% of cases. Decisions lack transparency and clarity, and it is often impossible to understand the conclusions of the courts. There is considerable variation between regional courts as regards the provisions to which patients are subjected and the delegation of decision-making to psychiatrists. This means that decisions fail to demonstrate clarity, transparency, consistency and impartiality, and thus fail to meet established standards of procedural fairness. Surveillance techniques of social control are more common than techniques based on therapy or sanctions. Because of the unique role of medication, social control is primarily imposed on a physical dimension, as opposed to temporal and spatial forms. The article concludes that patients are at risk of being subjected to new forms of social control of an unclear nature without proper legal protection.

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