1 / 36

The Role of Social Networks in Severe Mental Disorders: From Risk Factors to Opportunities and Experience

This study explores the impact of social networks on individuals with severe mental disorders, focusing on factors such as hospitalizations, quality of life, recovery, and the role of natural helpers within the network. The NSN program aims to activate and support existing informal resources within the patient's natural environment.

moeshe
Download Presentation

The Role of Social Networks in Severe Mental Disorders: From Risk Factors to Opportunities and Experience

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. THE ROLE OF SOCIAL NETWORK IN THE SEVERE MENTAL DISORDERS: FROM RISK FACTORS TO OPPORTUNITIES AND EXPERIENCE E.Re, A.Cerri, M.Fontana, A.Maggioni XI W.A.P.R.CongressMilano 10-13/11/12

  2. social network asdeterminant ofprocess the worse the SN is, the more frequent are hospitalizations and the more is the timespentasinpatient ofoutcome qualityof life, wellness, housing and job IPSS 1992, PRISM 1998, IRFMN 2002

  3. NETWORKS ACT AS …..

  4. QUALITY OF LIFE and RECOVERY

  5. schizophrenia and QOL • QOL worse than in the general population and in organic illnesses • young, women, married and not cultured people = better QOL • the longer the illness is , the worse is the QOL • negatives symptoms = worse QOL • no AR = better QOL • drug and psychotherapy combined = better QOL • independent housing and outpatients in ACT = better QOL than inpatient (sense of independence and privacy )

  6. QOL is nottomuchrelatedto socio-demographicsfactors (age,sex,marital status) quiterelated illnesstypology (mostlynegativessymptoms) numberofhospitalizationsepisodes stronglyrelated social abilities and functioning pharmacologicaltreatments illnessduration

  7. SCHIZOPHRENIA AND RECOVERY

  8. WhatisRecovery? Schizophrenia incurable  dangerous  socialexclusion  stigmatisation  coercion researchfindings consumer-user-survivormovement Clinical recovery Personal recovery

  9. Personal Recovery 1Slade 2009

  10. Whyishopeimportant? Scientific evidence for mental health conditions More hopemeans… … better • well-being, QoL(Irving 2004, Landeen 2000) • functioning(Irving 2004, Yanos 2001 • adaptive coping(Irving 1997, Geffken 2006, Hagen 2005, Lysaker 2005) • self-esteem(Marmarosh 2005, McVicker 1997) • immune response(Udelman 1985)

  11. THE NSN PROGRAM

  12. USERS WITH: • SEVERE ILLNESS • DISABILITY • SOCIAL EXCLUSION • PYCHIATRIC SERVICES WITH : • LIMITED REHABILITATIVE • RESOURCES • INTRINSEC • INSTITUTIONAL NATURE SERVICES ALONE CAN’T ANSWER TO COMPLEX NEEDS COMPLEX NEEDS

  13. THE NSN PROGRAM build up or restore the emotional, relational and social tissueofmentallyill people withinterventionsaimedtorecognize, activate and supportinformalhiddenresourcesalreadypresent in the patientnaturalenvironment

  14. THE METHOD a multidisciplinary team inside CMHC providesfor • non residential care of the citizen-usertrough a citizen-naturalhelper • findingwith the patienthisnaturalhelper inside hisnatural SN • personal programestablishedbyallinvolvedsubjects: USER,NATURAL HELPER, PSYCHIATRIC SERVICE • the individualprogramisbased on a formalprogram agreement, issignedbyallthreesubjects, monthlymonitored and renewedeverythreemonths • Possibilityof a financialsupportfor the helper • process and outcomeevaluation

  15. PATIENTS RECRUITMENT • psychiatric diagnosis • social exclusion or low abilities in local resources utilization • low QOL level • minimal ability to understand the sense of the program and not to remain passive in front of the proposal

  16. NATURAL HELPER RECRUITMENT INCLUSIVE CRITERIA • nottobemarginal • tohave a regular income • tobereceptivetocohoperate, tosupport and tobesupportedby CMCH’s professionals • tobereliable EXCLUSIVE CRITERIA • tobe a relative of the patient • tobeprofessional in the psychiatricfield • tobe a volonteerof a formalassociation • tobe a psychiatricpatienthimself

  17. INDIVIDUAL PROGRAMS’ AIMS • letpatientnottobe alone and lieidle(leisureactivities) • practicalsupportsynergicwithresidualabilities (dailyduties – house keeping) • home conditionsmonitoring • psycho-physicalconditionsmonitoring (drugtherapyadministration) • patient-other people interface (neighbours, relatives, colleagues) • SN widening

  18. PERSONAL PROGRAM TYPOLOGIES AND AREAS daily support personal emotional support relational social inclusion social

  19. FEATURES OF THE RELATIONSHIP USER-NATURAL HELPER-SERVICES- NATURAL SOCIAL NETWORK USER LOWERING STIGMA RECIPROCITY RESTRICTED RELATIONSHIP NEGOZIATION, CONTINUITY’ MEDIAtTION NETWORK NATURAL HELPER ONNIPOTENCY, ISOLATION VISIBILITY DERESPONSABILIZATION RECIPROCAL SUPPORT, CLOSENESS SERVICES _____ POSITIVE ASPECTS _____ NEGATIVE ASPECTS

  20. PHASIS OF AN INDIVIDUAL PROGRAM NETWORK EXPLORATION INDIVIDUAL PROGRAMS 3 PEOPLE FORMAL AGREEMENT ON THE PROGRAM MONTLY MONITORING 3-MONTLY EVALUATION OUTCOMEEVALUATION

  21. EVALUATION SCALES • WHO QOL • CAMBERWELL ASSESSMENT OF NEEDS • GAF • TODD’s map • original scales

  22. NATURAL SOCIAL NETWORK PROGRAM 1999-2011 10 differentprogram, withpublic and private financialsupport 13 CMHC, 2 daycenters, 1 residentialfacility ptstreated : 180 ptsevaluatedwith Who-Qol_Bref T0: 117 Tf: 112 ptsevaluatedwith GAF T0: 89 Tf: 88

  23. QUALITY OF LIFE : WORSE BECOMES BETTER BETTER QOL OUTCOME IF THE TO QOL IS LOW Tf– T0 scoresdifference in the WHOQOLbref DSM A.O. Niguarda Ca' Granda

  24. PATIENTS AGE :OLD PTS GO BETTER Tf – T0 scoresdifference in the WHOQOLbref DSM A.O. Niguarda Ca' Granda

  25. psychiatricinterventions and daysspent in hospital/residentialfacilitiesbefore and after the NSN Program( 32 pts ) SN AND COMMUNITY TENURE

  26. SOME FINAL OBSERVATIONS NSN Program, from a quantitative pointofview, could ameliorate the QOL mostly in the elderlypts reduce the service utilization NSN Programcouldfrom a qualitative pointofview reduce the family burden let the service be in contact with the pt for a long time also without spending professionals resources - pt-natural helper relationship go on also after the conclusion of the Program - financial support to the couple is even less important DSM A.O. Niguarda Ca' Granda

  27. QUALIFYING POINTS light intervention active user’s role subjects plurality individual programs flexibility bonds continuity

  28. CRITICAL POINTS natural vs artificialhelperrole resistancestomake the relationshipwith the patientformal evaluationmethodsimmaturity

  29. PERSPECTIVES

  30. mentallyillperson naturalhelper building helper supportingshopkeeper even more social capital and awareness

  31. una sedia in cortile

  32. withoutfriendsnobodycouldchooseto live alsoifhehadallothergoodsAristotele, “Etica nicomachea” , 340 b.d.

More Related