Abstract
Objectives. It is unclear whether and to what extent purportedly empowering practices in mental health care, like rehabilitation programs, recovery-supporting mental health care environments and peer-run services, contribute to the process of empowerment. Several American empowerment questionnaires have been developed in recent years, facilitating the measurement of empowerment outcomes. Given likely major transatlantic cultural differences in a value-sensitive concept such as empowerment, this article describes the development of the Netherlands Empowerment List (NEL) and its psychometric properties. Methods. Patients in Dutch mental health services provided meaning to the empowerment concept from which the NEL was derived. Based on 531 completed questionnaires, analyses in agreement with COSMIN criteria examined aspects of internal consistency, content validity, structural validity, convergent validity, discriminant validity, reproducibility and responsiveness of the NEL. Results. The NEL is a 40-item self-report questionnaire with six subscales: Social support, Professional help, Connectedness, Confidence and purpose, Self-management and Caring community. Internal consistency (Cronbach’s alpha = 0.94), aspects of validity, reproducibility (intraclass correlation = 0.79) and responsiveness were good. Correlation with existing scales was the highest for the Mental Health Confidence Scale (r = 0.78) and the lowest for the Boston Empowerment Scale (r = 0.61). Conclusion. The NEL appears to be a suitable instrument to capture the dimension of empowerment in European mental health settings.
Highlights
Empowerment is a concept that is used in many sectors, including mental health care [1] [2]
Given likely major transatlantic cultural differences in a value-sensitive concept such as empowerment, this article describes the development of the Netherlands Empowerment List (NEL) and its psychometric properties
We examined which aspects people with severe mental illness related to the concept of empowerment [13]
Summary
Empowerment is a concept that is used in many sectors, including mental health care [1] [2]. Rappaport describes empowerment as a process in which people, organisations or communities are able to influence events and situations that are important for them [3]. Empowerment is about processes in which the person rediscovers his identity and self-esteem and “takes his life in his own hands”. It is about the contribution by people with lived experience to the organisation and practice of mental health care and society. The concept of empowerment and the activities it embraces have been receiving growing attention in mental health care in several European countries in recent years, including the Netherlands. The focus is on the development of so-called best practice, those that are co-set up and/or co-controlled by people with lived experience [7]
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