User involvement in mental health rehabilitation: a struggle for self-determination and recognition

Aim: The study aimed to explore service user involvement in supported housing schemes as experienced by adults with mental illness in interplay with professionals during rehabilitation. Method: The study was designed as a field study in two supported housing schemes, using an ethnographic approach to data collection, including participant observation, informal conversations, and individual and group interview. Twelve participants aged 22 to 45 were included. The data analysis was informed by Ricoeur's theory of textual interpretation, and followed his three levels of interpretation: naive reading, structural analysis, and critical interpretation. Findings: The study showed that user involvement in rehabilitation was experienced by the users as a struggle for self-determination and recognition. Being able to decide and to have influence on daily activities and everyday life, together with having goals to reach during rehabilitation, were viewed as valuable. Situations without influence or involving coercion were reported especially during periods of illness or hospitalization. Conclusions: The results of this study contribute to knowledge about user involvement from service users' perspective, and highlight the difficulties experienced in achieving self-determination and recognition during rehabilitation.