Fifty ways to leave your treatment: First-person accounts of factors that helped actualize the choice to disengage from mental health services.

Objective: To investigate which factors and processes facilitated disengagement from mental health services (MHS). Method: The study adapted the narrative approach to the life stories method. We interviewed 13 women and 10 men who were diagnosed with a serious mental illness (SMI) for which they were hospitalized and used medication in the past but disengaged from MHS and were no longer engaged in any mental health treatment for at least a year. Results: Data analysis of the factors and processes that facilitated disengagement revealed three main factors, each overarching several subthemes: (a) Factors Related to Personal Resilience and Motivation; (b) Factors and Processes Related to Interpersonal Relationships; and (c) Using External Resources. Conclusions and Implications for Practice: Disengagement from MHS is not necessarily a problem that needs a solution but rather-in some cases-a legitimate choice that may actually represent healthy reasoning and an important step toward recovery. These findings emphasize the need for a broader and more flexible conceptualization of the potential role of MHS in the recovery process. Such an approach challenges the widespread notion that disengaging from MHS is a negative course of action and suggests that-for some-it is a significant and meaningful life choice that can empower individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

[SOTERIA HOUSE, A NEW SERVICE FOR PREVENTING PSYCHIATRIC HOSPITALIZATION: THREE VIGNETTES AND A DISCUSSION].

INTRODUCTION: Inspired by a model developed in the early 1970s in the USA for the treatment of people in the throes of a mental crisis, often psychotic, the first "Soteria House" was established in Jerusalem in September 2016. The purpose of the house is to prevent psychiatric hospitalization, to offer a supportive therapeutic community and to help the person return to life in the community in the best possible manner. Treatment at the house is characterized by the absence of coercion of any kind, including the use of drugs, a high staff: patient ratio, and the absence of the stigma which too often accompanies psychiatric care. This model was recognized by the Israeli Ministry of Health in September 2017 under the name "Stabilizing House", and since its establishment until today (May 2018) four more houses of its kind have been established. We present three brief case studies of individuals who received care in Soteria.

Retrospective Accounts of the Process of Using and Discontinuing Psychiatric Medication.

Refusal to take psychiatric medication as prescribed is often considered negative, harmful, and even reflective of a sign of one's illness. However, recent research from diverse sources has challenged this axiom. The current study investigated the reasons, processes, experiences, and perceived impacts of medication discontinuation. The study was carried out using the narrative approach to life stories method. Participants were 12 women and 9 men who had discontinued their prescribed medication following psychiatric hospitalization. Four main themes were revealed in the data analysis: (a) the experience with medication, (b) the process of discontinuing medication, (c) elements that helped achieve successful medication discontinuation, and (d) the perceived impact of medication discontinuation. Our findings challenge the widespread notion that discontinuing psychiatric medication is necessarily negative and suggest that, for some, it is a legitimate and meaningful life choice.