Moving toward a recovery-oriented approach in the Swedish mental health system—an interview study of Personligt Ombud in Sweden

Abstract

Introduction: Personligt Ombud (PO) is a Swedish version of case management (CM) which was established with the Swedish Mental Health Reform in 1995. The main purpose of POs is to ensure that people with psychiatric disabilities receive the services needed to live an independent life in the community and to coordinate these services. Studies have shown that POs provide more support than this and it was interesting to investigate this further. Aim: The aim of the study was to explore what supportive strategies Personligt Ombuds (POs) use in their work with the clients who have PO support. Method: To obtain extensive descriptions of strategies that POs use in work, POs from different parts of Sweden were chosen and asked to participate in the study and 22 POs agreed to participate. The interviews were conducted over the telephone. The interviews were transcribed and analyzed using qualitative content analysis. Findings: The findings of the study were reflected in a main category where PO could be described as a facilitator of an active changing process, where the clients make their personal changes in life, based on personal active choices. POs used several strategies, such as defining goals, acting to push the client forward, acting as mentors, strengthening the client and mobilizing external resources. Conclusion: Many of the strategies POs used are similar to strategies in recovery-oriented services and, in particular, in Strengths Model Case Management. However, there are strategies that POs could develop to be even more recovery-oriented. There is a lack of systematic review of the strengths of a client, and this could be solved by using an already existing assessment instrument like the one in the Strengths Model Case Management.

Enhancing active citizenship for persons with psychosocial disabilities

“…Sweden has developed its own model of case management called 'personligtombud' (English translation: private representative). The case worker has a variety of tasks such as helping the person to obtain welfare benefits and services, supporting the person to solve long-standing problems (Jesperson 2007) and giving advice (Klockmo, Marnetoft, and Nordenmark 2012). However, case managers usually have a large leeway to design their work and tend to act as 'welfare entrepreneurs' and are consequently at risk of being poorly integrated in the generic welfare system (Markström, Lindqvist, and Sandlund 2009).…”