This dissertation deals with people with mental illness that currently live in their own accommodation in the community. Common to all mentally ill people is their serious difficulties in carrying out activities and meeting needs in important areas of life. Terms such as "normalisation" and "integration" into the community of this group were important words full of promise at the time the psychiatric reform was carried out. However, there is some strong evidence that the psychiatric reform has not been completely successful. Despite the knowledge that loneliness and social isolation commonly occur among people with mental illness, there is little research that describes how mentally ill people themselves experience their life situation. The overall aim of the dissertation was to gain deeper understanding of the life situation of peop with mental illness via their own narratives on how their day-to-day life appears to them, ar through this gain knowledge of the type of support needed for them to live a satisfactory life. Various data acquisition methods were applied. Study I involved in-depth interview of two men and two women on their daily life. Data acquisition in Study II was via participant observations, an activity unit for people with mental illness. Photographs were used for Studies III and IV Eight informants were issued with disposable cameras and asked to take approximately 10 pictures of objects, situations and/or individuals. These photographs were then used as a basis for follow-up interviews. Results from Study I showed that informants were aware both of their illness and their psychosocial disadvantages, and that they had insight into what was required of them to influence their situation, while simultaneously having insight into their poor ability to tak initiatives. Informants in Study II experienced themselves as unwelcome, vulnerable and marginalised individuals with little hope of a change in existence, resulting in anxiety over the future. They felt trust was lacking in relation to other people and experienced themselves as not accepted in the company of others or by society. Study III provided description of informants occupied with themselves and their existence. The informants tell of a form of spirituality giving them a sense of peace and tranquillity, but which only exists for them at the beginning and end ol life.

 Animals are more loyal than people and make no demands, but are however, according to the informants, in a position of dependence on humans. Possessions are of significance to the informants, meaning they see their possessions as part of themselves. In Study IV informants related how they would like their future to appear. They also told what having an identity meant to them, how identity is formed in individuals, what having a mental illness and feeling good means. The informants showed a longing to be seen, but at the same time not wanting to be seen. Finding a meaning with life was important since it could end at any moment.

In summary, the findings point to an existential loneliness that consists of a life pattern consisting of an interaction between the impact of the mental illness and the identity as a mentally ill person feelings of marginalisation and abandonment. Experiencing that life has a meaning, possibility o social exchange and a sense of control seem to be important for the persons with mental illness in this study. Consequently, it can be inferred that if the care of people with mental illness pays attention to the dimensions of existential loneliness persons with mental illness may be helped to experience that life has a meaning despite their disability.

The purpose of this study was to explore views of life among people with long-term mental illnesses. The participants' possible cognitive inability to express such views dictated a research design that was both fit for purpose and respectful of their integrity. The study, based on an ethnographic framework, involved photographs and interviews with five women and three men. The participants were the photographers, as well as the authors of their own narratives, and the photographs served as a starting point for the interviews. The interview material was analysed in terms of the phases of interpretation. Four main themes were identified: 'thoughts about God and the meaning of life and death', 'the meaning of relationships with others', 'how animals give meaning to life without demands' and 'the symbolic bearing of objects on life'. These four themes represent key existential issues among people with long-term mental illnesses, but they lack confidants to share or discuss these matters with.

The aim of the study was to describe psychiatric caregivers’ perceptions of self-esteem and activities for patients with long-term mental illness. The study design used a qualitative approach, based on an open lifeworld perspective. A total of 13 caregivers at four psychiatric hospital units in a large Swedish city were interviewed about their views on patients’ physical activity and/or other pastimes, as well as their self-esteem and its bearing on the patients’ well-being. According to the caregivers, it is up to the patients themselves to decide what they wish to occupy themselves with. In the same time the caregivers’ opinions are that patients have difficulties to occupy themselves.The caregivers believe that patients’ disability is based in a lack of self-esteem, commitment and capacity to realize their wishes. The caregivers in this study argue that activities are valuable for self-esteem and physical health of people with long-term mental illness. The caregivers consider that it is the patient’s responsibility to initiate their needs of activities. This means that the caregivers do not use their knowledge about the importance of activities for the patient’s health.Search terms: activity, caregivers, mental illness.

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PURPOSE: The purpose of this article is to describe a method to help patients with long-term mental illness describe their life situations--their "life worlds"--through photography.

CONCLUSIONS: Photographs and interviews are useful for data collection. The positive effect of this method is allowing informants who have long-term mental illnesses to express their perceptions.

PRACTICE IMPLICATIONS: Nurses can use photography in conjunction with interviews to ascertain the life worlds of their patients.

It is well known that people with severe mental illness often suffer from constant fatigue, insomnia, and somatic complaints that are too often overlooked. In addition, these persons die earlier in life than others in the population. The purpose of this study was to investigate patients' descriptions of activities and the importance of these activities for their health. Eight persons living in their own home were interviewed about both their views about exercise and their exercising activities. Two themes emerged: Getting Control over One's Life and The Need for Contact with Family & Friends. All of the informants were aware of the importance of physical activity to feel good. The informants described three different forms of activities: daily activities in the home, activities in a rehabilitation centre, and various forms of jogging. These different forms of activity were important to the informants since they reduced their anxiety and stress.

Previous research has shown that persons with long-term mental illness who require prolonged treatment and social support wish to, yet find it difficult to, find meaning or quality in life. A descriptive qualitative design using self-photography and in-depth interviews was used for data collection. The aim of this study was to explore basic attitudes to life as expressed by nine persons with long-term mental illness living in the community. The findings provide insight into the values of relationships, work, and the home for persons with long-term mental illness and indicate that they are cognizant of social norms yet have difficulty integrating these in their daily lives. The study also illuminates the informants' difficulties in creating satisfying and supporting relationships with others.

The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being ‘odd’ is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.

The aim of this study was to gain in-depth knowledge of how persons with long-term mental illness experience their everyday situation, in order to identify potential psychosocial obstacles to a meaningful existence. The focus was on psychosocial aspects, such as contact with others and the quality of these contacts. An ethnographic design was used, in order to provide an inside perspective. Four persons with long-term mental illness participated in the study. Three open-ended interviews, at 1-week intervals, were conducted with each informant. Analysis of transcribed material consisted of naive reading and content analysis guided by the investigators' understanding of the psychiatric context. Three themes were generated: feeling lonely but being unable to establish friendships; knowledge of what to do but lacking initiative; and awareness of the need for support but not wanting to be subject to control. These themes reflect contradictions between thoughts, feelings and actions, which seem to contribute to a psychosocial disadvantage in the life of persons with long-term mental illness.

To a large extent today, caring for people with mental illness takes place outside of institutional care. Sometimes, assistance from a special police group may be required to commit the patient to a hospital for continued psychiatric treatment. The aim of this study was to describe a group of police officers and their experiences of committing individuals with mental illness to the hospital for treatment. Two specialised commitment groups within the police were interviewed. A qualitative content analysis was used to identify topics of greater significance in the data. The interviews show that the informants desire greater cooperation with psychiatric care personnel and want to know more about mental illness and how to approach those with mental illness.

PURPOSE: To illuminate user experiences of schizophrenia, reasons for receiving antipsychotic medication, and encounters with mental health services.

DESIGN AND METHODS: 24 semistructured qualitative research interviews with schizophrenia patients treated with 3-monthly paliperidone palmitate across Scandinavia were synthesized in qualitative content analysis.

FINDINGS: Participants describe considerable challenges in everyday functioning. Simultaneously, they rate their current mental and physical well-being high and seem satisfied with their lives. These pathways indicate personal recovery.

PRACTICE IMPLICATIONS: The participants emphasize the importance of trustful relations with healthcare professionals, therapeutic conversations, antipsychotic medication in a 3-monthly formulation, and support from relatives.

INTRODUCTION: Three-monthly dosage of paliperidone palmitate entails longer time to relapse after discontinuation, is similarly tolerable and safe compared to monthly injections of paliperidone palmitate and is beneficial for the caregivers. However, few studies have so far explored in depth the patients' experiences with paliperidone palmitate medication every three months, or with switching from monthly to three-monthly injections of paliperidone palmitate.

MATERIAL AND METHODS: A qualitative study based on individual interviews with persons with schizophrenia who receive three-monthly paliperidone palmitate in Norway, Sweden and Denmark. Data was analysed according to qualitative content analysis.

RESULTS: Twenty-four patients, 16 men and 8 women, took part in individual interviews. The patients' mental health care professionals mainly recommended the switch to three-monthly paliperidone palmitate, and few or no disadvantages were described. According to the patients, three-monthly paliperidone palmitate had several advantages, such as less frequent injections, less administration and planning and less focus on the illness. In addition, the participants described feeling more stability, being more physically and socially active, and that improvement processes were supported. For some, the use involved practical and economic challenges, and some worried whether the medicine 'wore off' before the next injection. According to the patients, switching to three-monthly paliperidone palmitate did not influence the frequency or content of patients' interaction with health care professionals.

CONCLUSION: Switching from monthly to three-monthly injections with paliperidone palmitate seems to be experienced as advantageous for patients with schizophrenia.

The objective of this study was to describe the current situation of patients with epilepsy after rehabilitation with emphasis on employment and education and to investigate if clinical factors at admission were associated with increase in employment or education. All patients that participated in a comprehensive rehabilitation were eligible. Data were collected from medical records at admission, during rehabilitation, at discharge and from a structured telephone interview at follow-up 1-17 years after admission. In total, 124 patients participated in the follow-up. Participation in employment or education improved from admission to follow-up in 38 patients. In univariable analysis, active epilepsy with tonic-clonic seizures at admission was significantly associated with increased participation in employment or education at follow-up, so was decreased frequency of tonic-clonic seizures from admission to follow-up. The significance of the associations disappeared in adjusted multivariable analysis. Participation in employment or education was improved for many patients at follow-up.

This study aimed to identify the issues experienced as essential in rehabilitation for persons with epilepsy. Six focus group interviews were conducted, five groups with patients that had completed comprehensive rehabilitation for persons with epilepsy, in a day-care setting, at the Neurological Rehabilitation Clinic at Stora Sköndal Hospital, between 2006 and 2009 (total n=17) and one group with staff members (n=5). Using content analysis, two themes emerged: life with epilepsy and rehabilitation experiences. The result emphasizes that rehabilitation for persons with epilepsy should be designed individually, in structure and in content. Encounters between patients were important, as well as the team's attitude in meeting with the patients. Therapeutic working alliance is essential between patients and staff for creating an individual rehabilitation.