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Narrative Methods for the Human Sciences

In the first two volumes of this work, Paul Ricoeur examined the relations between time and narrative in historical writing, fiction, and theories of literature. This final volume, a comprehensive reexamination and synthesis of the ideas developed in volumes 1 and 2, stands as Ricoeur's most complete and satisfying presentation of his own philosophy.

Time and Narrative

The Longitudinal Aging Study Amsterdam (LASA) is an ongoing longitudinal study of older adults in the Netherlands, which started in 1992. LASA is focused on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. The study is based on a nationally representative sample of older adults aged 55 years and over. The findings of the LASA study have been reported in over 450 publications so far (see www.lasa-vu.nl
 ). In this article we describe the background and the design of the LASA study, and provide an update of the methods. In addition, we provide a summary of the major findings from the period 2011–2015.

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The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20178

Public mental health: the time is ripe for translation of evidence into practice.

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

Stigma associated with depression is a major public health issue in the EU, with over 20 million people experiencing depression and its associated personal distress each year. While most programmes against stigma related to mental health problems are of a general nature, the knowledge about programmes tackling stigma against people with depression is limited. This study therefore aims to assess the nature and impact of depression-specific programmes in EU countries. Using a web-based tool, 26 programmes were identified across the 18 EU countries taking part in the study. Most were universal and targeted the whole population, while many also targeted specific population groups or settings, such as young people or health professionals. The most common programme aim was improving literacy, although reducing stigmatizing attitudes and discriminatory behaviour and promoting help-seeking were also common. Most programmes originated from professional bodies, or as grassroots initiatives from service user groups/NGOs, rather than as part of national and local policy. The approaches used were primarily different forms of education/information, with some, but very limited, use of positive personal contact. Overall, the quality and extent of impact of the programmes was limited, with few leading to peer-reviewed publications. Specific programmes were identified with evidence of positive impact, and we drew on these examples to develop a framework to be used for future programmes against stigma and discrimination associated with depression. These findings are provided in full in the Anti-Stigma Partnership European Network Toolkit available at www.antistigma.eu.

/pdf/nature-and-impact-of-european-anti-stigma-depression-2dbmodf044.pdf

Nature and impact of European anti-stigma depression programmes

This study describes the ways in which people with psychotic-like experiences without mental health care manage to achieve successful lives. The qualitative study, which used a grounded-theory approach combined with elements of narrative research, draws on interviews with 18 individuals who were recruited through a self-selection strategy via a national advertisement. The frequency of participants’ psychotic-like symptoms was comparable to that of patients who receive mental health treatment for psychosis; however, participants experienced lower levels of distress. The results provide insight into the variety of strategies and interpretative frameworks participants develop to create and to maintain self-defined successful lives while coping with psychotic-like experiences. Experiential knowledge from people outside care settings can be helpful in the development of more sophisticated activities, ideas, and discussions within the international recovery movement.

Coping with psychotic-like experiences without receiving help from mental health care. A qualitative study

Objective: The resource group method for people with severe mental illness might provide a useful framework to facilitate patient's empowerment and systematically engage significant others. However, no research has explored the perspectives and experiences of patients and their significant others. This is crucial for better adjustment to the needs of the people using the method. The aim of this study was to develop a useful framework for a deeper understanding of the resource group method and its outcomes. Method: The study used a longitudinal, qualitative multiple case-study design based on grounded theory methodology. During a period of 2 years, the developments and processes in eight resource groups were explored by conducting a total of 74 interviews (e.g., with patients, significant others, and mental health professionals) and 26 observations of resource group meetings. Results: Analysis showed that a well-functioning resource group set the stage for five processes to unfold: (i) experience of support; (ii) acknowledgment of significant others; (iii) activation; (iv) openness; and (v) integration. These processes facilitated recovery both in terms of an arousing curiosity within the patient as well as increasing reciprocity and equality in their social relations. In addition, the method emphasized the uniqueness of each recovery journey, thereby providing a framework to shape recovery-oriented care. The analysis also revealed three hindering factors: (i) embedding and implementation issues; (ii) predominant network; and (iii) tensions inherent in the resource group setting. Conclusion: Working according to the resource group method involves that the person's recovery work becomes a social process that takes place in relation to the social environment and everyday life in which it is important to acknowledge and integrate the needs of significant others in treatment and care. This study provides a first step toward a multidimensional comprehension of the resource group method, the working mechanisms and its influence on recovery for people with severe mental illness.

/pdf/embracing-the-social-nature-of-recovery-a-qualitative-study-1mvbc2z3v4.pdf

Embracing the Social Nature of Recovery: A Qualitative Study on the Resource Group Method for People With Severe Mental Illness

Met de transitie van de AWBZ naar de Wmo kregen gemeenten meer verantwoordelijkheden voor de maatschappelijke ondersteuning aan mensen met psychische en/of psychosociale kwetsbaarheden. In deze bijdrage geven we een overzicht van ontwikkelingen en benoemen we een aantal aandachtspunten en mogelijkheden voor de realisering van een sluitende ‘gemeentelijke ggz’.

Over geestelijke gezondheidszorg binnen een Wmo-kader

Doel: Na te gaan of een verandering in fysieke, psychische en sociale dimensies van kwaliteit van leven van thuiswonende ouderen geassocieerd is met het ontvangen van formele zorg, in vergelijking met informele zorg en geen zorg. Methode: Er is gebruik gemaakt van data van de waarnemingen uit 1998 en 2001 van de Longitudinal Aging Study Amsterdam (LASA). Ouderen die in 1998 formele thuiszorg ontvingen zijn vergeleken met ouderen die in 1998 informele zorg ontvingen en met ouderen die geen zorg ontvingen. De groepen zijn vergeleken op 3-jaars veranderingen in subjectieve scores van ervaren gezondheid, eenzaamheid, positief affect en tevredenheid met het leven. De data zijn geanalyseerd met lineaire regressieanalyse en ANOVA. Resultaten: In alle groepen vindt tussen 1998 en 2001 een verslechtering plaats in de vier geselecteerde aspecten van kwaliteit van leven. De ervaren gezondheid gaat significant meer achteruit in de groep met formele zorg dan in de groep zonder zorg, maar dit wordt verklaard door een hogere score op functionele beperkingen in 1998. Eenzaamheid neemt significant meer toe in de groep met formele zorg ten opzichte van de groep met geen zorg en de groep met informele zorg, ook na correctie voor confounders. In de groep met formele zorg neemt de tevredenheid met het leven significant meer af dan in de groep zonder zorg en de groep met informele zorg. De interactie met sekse is significant, waardoor na correctie voor de confounders dit verschil bij de vrouwen maar niet bij de mannen significant blijft. Er is geen significant verschil tussen de drie zorggroepen wat betreft veranderingen in positief affect. Conclusie: Oudere mannen en vrouwen die formele thuiszorg ontvangen ervaren na 3 jaar een grotere mate van eenzaamheid, en bovendien ervaren oudere vrouwen die formele zorg ontvangen na 3 jaar minder levenstevredenheid, in vergelijking met vrouwen die informele zorg of geen zorg ontvangen. Vervolgonderzoek zou deze resultaten moeten bevestigen en de mechanismen die hieraan ten grondslag liggen moeten onderzoeken.

Jenny Boumans

Papers

Nature and impact of European anti-stigma depression programmes

Coping with psychotic-like experiences without receiving help from mental health care. A qualitative study

Embracing the Social Nature of Recovery: A Qualitative Study on the Resource Group Method for People With Severe Mental Illness

Over geestelijke gezondheidszorg binnen een Wmo-kader

Veranderingen in de kwaliteit van leven van thuiswonende ouderen: speelt de vorm van zorg een rol?