Factors, process and outcomes of recovery from psychiatric disability: the unity model.

BACKGROUND: Despite the fruitful findings on related issues of recovery in the West, some researchers have called for more studies on the factors that facilitate recovery and international literature on recovery to be made available. Moreover, to date, a united model that integrates outcome, component process and contextual factors of recovery has not yet been developed. Thus, this study explored the recovery experiences of persons with psychiatric disabilities (hereinafter called consumers) in Taiwan and extracted the key facilitators for developing a preliminary unity theory of recovery. MATERIAL: In-depth qualitative interviews of 15 consumers in recovery and their caregivers were held. Over a research period of two years, consumers were interviewed twice. The dialogue of each interview was transcribed into text and a narrative summary of the storyline for each participant was also prepared. DISCUSSION: For most consumers, the journey of recovery was an incremental process of progress, yet few of them mentioned a turning point and its significant change on their life. Regaining social roles seemed to be a necessary but not sufficient outcome indicator for recovery. While symptom remission, mental strength and parental support were the cornerstones for recovery, the treatment model and professionals got the credit for it too. CONCLUSION: The recovery process occurs within a complex context of various stages and multi-facilitators. The forces of three cornerstones, essential components and contextual facilitators all influx into the river of recovery and emerge as one united mechanism that supports the consumer's spiral progress through the journey of striving for autonomy.

Measuring social capital of persons residing in a long-term psychiatric institution.

BACKGROUND: Most studies support the association between social capital and health. However, none of the studies to date has focused on persons with psychiatric disability, and these past studies have drawbacks in conceptual development and the use of operational variables of social capital. AIMS: This study develops measures and examines patterns of social capital for persons with psychiatric disability. METHODS: Subjects (n = 273) were selected from a long-term psychiatric institution in Taiwan, based on their level of functioning. The measures of social capital were designed at the individual level, and included social networks, reciprocal help (engagement) and level of seeking help (trust and mobilization). Data were collected through face-to-face interviews. RESULTS: Factor analyses revealed a three-factor structure of social capital with 14 measures: bonding and reciprocity in the hospital, bonding and reciprocity within the ward, and network resources. Through cluster analyses, five patterns of social capital emerged among the consumers: large network and strong bonding, strong network and high bonding, ward network and bonding, ward network and low bonding, and low social capital. Based on the profile of each cluster, younger age, a history of drug abuse, shorter hospitalization and better social functioning seem to correlate with higher social capital. CONCLUSION: The results support the idea that social capital is a metaconstruct, and reveal that consumers have the ability to establish social capital. The measurement and level of social capital as well as its implications for the rehabilitation of consumers into community living are discussed.

Community attitudes towards the mentally ill: the results of a national survey of the Taiwanese population.

BACKGROUND: In Taiwan, to strengthen the psychiatric rehabilitation system has been one of the primary goals of the Department of Health since 1985. Unfortunately, this endeavor has not been successful and it is believed that one of the barriers is social stigma towards the mentally ill. However, to date no national survey has been conducted for Chinese population on the focal topic using a random sample. AIMS: In this study we explored the attitudes of the general population towards the mentally ill in Taiwan. Specifically, we examined the effect of contact on one's attitudes after controlling for demographic variables. METHODS: A national survey was conducted on 1,203 subjects drawn through a stratified proportional random sampling. Data were collected using the Computer-Assisted Telephone Interview System. We conducted MANOVA and multiple regression analyses to explore the correlates of the attitudes. RESULTS: The results revealed that the general population held relatively higher levels of benevolence, tolerance on rehabilitation in the community, and nonsocial restrictiveness. However, they held relatively less positive attitudes on non-authoritarianism and normalization. Overall, direct contact and age were the two most important correlates of community attitudes. Education and occupation were also significant. CONCLUSIONS: Benevolent thoughts do not necessarily guarantee the acceptance of rehabilitation in the community or treating the mentally ill as a person like anyone else. However, the benevolent thought could be transformed into compassion and acceptance of another human being if people are given the opportunity to have direct contact with mentally ill persons. The results also indicated that community education should specifically target laborers of all age groups.