Contributos do modelo "Empowerment - Comunidade" para a mudança transformativa na saúde mental comunitária : Análise comparativa

The Thesis under consideration, given the title Contributions of the “EmpowermentCommunity” Model to Transformative Change in Commun ity Mental Health: A Comparative Examination is a cross-sectional study using a number of metho dologies and procedures (both quantitative and qualitative). The research is foun ded on the assumption that, whenever adopting transformative organisational procedures, community mental health organisations can function as mediating relational contexts for i ndividual empowerment and consequently, facilitators of recovery and community integration. With the general aim of evaluating the results of p articipants with a history of mental illness in so-called transformative mental health i nterventions, three general objectives were established: 1 – to adapt the conceptual model of e mpowering community contexts for mental health services as a resource for intervention prac tice and investigation and to test the validity of its application through a case study; 2 – to ada pt into the Portuguese language and to test the validity of the empowerment and recovery measur es for their use in the context of community mental health; 3 – evaluate the impact of the intervention model; a) as regards the individual results of levels of empowerment, recove ry and community integration among participants and b) the implementation and involvem ent of participants in programmes with particular emphasis on recovery, as well as indepen dent housing and supported employment. The mixed nature of the study was implemented using the following data collection instruments: Interview conducted by Questionnaire a nd Qualitative Interview – which may be consulted in Annexes 1 and 2 of this Thesis. As for the collection of data, this took place in five similar mental health community organisations that carry out their functions for an articulated response to questions of health in the social sector (DC no 407/98), belonging to a register of organisations affiliated with the entit y representing non-governmental organisations (National Federation of Institutions for the Rehabilitation of Mental Patients) that were providing mental health services in the c ommunity, at the date of the study. The results sustained the theoretical proposition t hat mental health programmes in the community can and should instigate transformative o rganisational change by adopting an empowering process centred on the community (EMP-CO M), which would have a transformative effect on the life of people with a history of mental illness. Analyses also confirmed the validity of the empowerment (ES-P) an d recovery (RAS-P) measures for their respective implementation in the Portuguese communi ty mental health context. The extent of the investigation undertaken was sufficient to form ulate certain conclusions and implications regarding the practises of intervention and investi gation in the domain of the mental health system. The main body of the Thesis was organised according to the following sections: a General Introduction, where the revision of general literature is presented, organised by theme (empowering community contexts, recovery-orientatio n in mental health, community integration), the procedures in which the general s tructure and objectives are described; an Empirical Section, organised into four chapters acc ording to the main analyses conducted for this investigation; a General Discussion, Conclusio n and Implications for Practice, and the Appendices.