Empowerment, self and engagement in day center occupations: a longitudinal study among people with long-term mental illness.

BACKGROUND: Day centers are a common form of mental health service internationally. They are aimed at enhancing occupational engagement and social relations, but there is a need to clarify the outcomes of day center programs, including the impact on important aspects of recovery such as empowerment.

AIMS: The aim of this study was to explore whether perceived empowerment changed over time among Swedish day center users and whether self-esteem, quality of life, socio-demographic data and self-reported diagnosis, type of program and level of engagement in day center occupations could predict future empowerment.

METHOD: The study involved a re-analysis of longitudinal data from 14 day centers, where measures of perceived empowerment and other individual factors were collected over a 15-month period. Non-parametric statistics were used, including Wilcoxon's signed-rank test and logistic regression analysis.

RESULTS: There were no significant changes in day center attendee empowerment scores. Self-esteem and level of engagement in day center occupations were found to be predictors of empowerment, together explaining 34% of the variation.

CONCLUSIONS: Developing empowerment in the day center context involves a complex interaction of individual, social and material factors. Potential barriers to empowerment are discussed along with considerations related to measuring empowerment as an outcome of day center programs.