Activity and participation in psychiatric institutional care.

National action plans emphasize the importance of strengthening the role of patients in health and medical care. Patients should feel that they can participate and that they are seen as a resource. In occupational therapy, the client-centred approach has developed, whereby it is key to enable patients to participate in their treatment. The International Classification of Functioning Disability and Health (ICF) has inspired this study, in which concepts such as activity and participation are central. The purpose of the study was to describe how patients in psychiatric institutional care conceive their opportunities to be active, and how they participate in their own treatment. Questionnaires were sent to patients who had received care during a six-month period. Ten patients were then selected for interview. The study shows that younger patients and patients who were treated involuntarily were generally more dissatisfied than other patients. The patients' perceptions of their environment were influenced by the values in the ward. Topics such as atmosphere in the ward, reception, continuity, and support were presented. Important factors related to activity and participation were: agreement concerning the treatment plan, discussions about expectations, creating conditions for engagement in activities, and providing the patients with opportunities to take responsibility for themselves.