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Associations of participation domains with personal recovery process and quality of life among service users in Flexible Assertive Community Treatment (FACT)

Borgh, Madeleine LU ; Falkmer, Torbjörn LU ; Argentzell, Elisabeth LU orcid ; Bejerholm, Ulrika LU and Lexén, Annika LU (2026) In Nordic Journal of Psychiatry
Abstract
Purpose: Flexible Assertive Community Treatment (FACT) is being implemented in Swedish general mental health services for persons with complex mental health needs. However, research addressing service users' participation in everyday life and its association to personal recovery is still scarce. The aim of this study was therefore to examine domains of participation and their association with two personal recovery outcomes (the personal recovery process and quality of life) at the 12-month follow-up among persons with complex mental health needs participating in FACT.

Materials and methods: An observational study design with secondary data derived from the FACT intervention arm of the UDiM-FACT trial (83 participants). Measurement... (More)
Purpose: Flexible Assertive Community Treatment (FACT) is being implemented in Swedish general mental health services for persons with complex mental health needs. However, research addressing service users' participation in everyday life and its association to personal recovery is still scarce. The aim of this study was therefore to examine domains of participation and their association with two personal recovery outcomes (the personal recovery process and quality of life) at the 12-month follow-up among persons with complex mental health needs participating in FACT.

Materials and methods: An observational study design with secondary data derived from the FACT intervention arm of the UDiM-FACT trial (83 participants). Measurement was obtained before randomisation (baseline) and at 12 months follow-up. Two multiple linear regression models were conducted. Personal recovery process (QPR-Swe-7) and quality of life (MANSA) at 12 months follow-up were specified as dependent variables. Domains of participation were approximated using objective indicators of social inclusion (SIX), including employment, living situation, partnership/family, friendship at 12 months follow-up and were included as independent variables. Each model was adjusted for the corresponding baseline measure of the outcome variable.

Results: Participants living alone had higher scores on quality of life compared to those living with a partner or family. No other significant associations were found.

Conclusions: The largely non-significant findings may suggest that the FACT model supports personal recovery across a broad range of service users, regardless of differences in participatory domains. However, the results should be interpreted with caution, due to methodological and contextual constraints.

Keywords: Complex healthcare interventions; integrated mental health services; mental health recovery; recovery-oriented services.

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Contribution to journal
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published
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in
Nordic Journal of Psychiatry
publisher
Informa Healthcare
external identifiers
  • scopus:105050658690
ISSN
1502-4725
language
English
LU publication?
yes
id
23ce6f14-8c9d-4fa0-9c04-2acfb1275287
date added to LUP
2026-10-05 10:33:03
date last changed
2026-10-06 04:01:03
@article{23ce6f14-8c9d-4fa0-9c04-2acfb1275287,
  abstract     = {{Purpose: Flexible Assertive Community Treatment (FACT) is being implemented in Swedish general mental health services for persons with complex mental health needs. However, research addressing service users' participation in everyday life and its association to personal recovery is still scarce. The aim of this study was therefore to examine domains of participation and their association with two personal recovery outcomes (the personal recovery process and quality of life) at the 12-month follow-up among persons with complex mental health needs participating in FACT.<br/><br/>Materials and methods: An observational study design with secondary data derived from the FACT intervention arm of the UDiM-FACT trial (83 participants). Measurement was obtained before randomisation (baseline) and at 12 months follow-up. Two multiple linear regression models were conducted. Personal recovery process (QPR-Swe-7) and quality of life (MANSA) at 12 months follow-up were specified as dependent variables. Domains of participation were approximated using objective indicators of social inclusion (SIX), including employment, living situation, partnership/family, friendship at 12 months follow-up and were included as independent variables. Each model was adjusted for the corresponding baseline measure of the outcome variable.<br/><br/>Results: Participants living alone had higher scores on quality of life compared to those living with a partner or family. No other significant associations were found.<br/><br/>Conclusions: The largely non-significant findings may suggest that the FACT model supports personal recovery across a broad range of service users, regardless of differences in participatory domains. However, the results should be interpreted with caution, due to methodological and contextual constraints.<br/><br/>Keywords: Complex healthcare interventions; integrated mental health services; mental health recovery; recovery-oriented services.<br/><br/>}},
  author       = {{Borgh, Madeleine and Falkmer, Torbjörn and Argentzell, Elisabeth and Bejerholm, Ulrika and Lexén, Annika}},
  issn         = {{1502-4725}},
  language     = {{eng}},
  publisher    = {{Informa Healthcare}},
  series       = {{Nordic Journal of Psychiatry}},
  title        = {{Associations of participation domains with personal recovery process and quality of life among service users in Flexible Assertive Community Treatment (FACT)}},
  year         = {{2026}},
}