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Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 17303

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Special Issue Editors

Dr. Kim Jørgensen

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Guest Editor

Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet University, Pilestredet 32, 0166 Oslo, Norway
Interests: mental healthcare; recovery-oriented practice; patient participation; cross-sectorial collaboration; qualitative research; interviews; observational study; action research; grounded theory
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Bengt Karlsson

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Guest Editor

Department of Health-, Social- and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, USN Postboks 235, 3603 Kongsberg, Norway
Interests: mental health; substance abuse; philosophy of science; family- and network therapy; recovery and recovery-oriented facilities
Special Issues, Collections and Topics in MDPI journals

Dr. Emma Watson

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Guest Editor

Nottinghamshire Healthcare NHS Foundation Trust, Nottingham NG3 6AA, UK
Interests: peer support; lived experience; recovery; survivor research

Special Issue Information

Dear Colleagues,

We would like to invite papers to this Special Issue of the International Journal of Environmental Research and Public Health that will explore recovery in mental health—perspectives and experiences of providers and service users.

In Western countries, treatment and rehabilitation in psychiatric hospitals and municipalities must be based on a recovery-oriented approach, but we have little research on what “recovery-oriented” means in practice or how service users experience providers’ support in their recovery process. In addition, we have inconclusive research on service users’ experiences of recovery without the support of mental health providers. As a result, we need empirical research about promoting recovery in mental health from the perspectives and experiences of providers and service users.

This Special Edition welcomes papers examining recovery in an institutional context and service users’ experiences of recovery in their everyday lives.

For this Special Issue, we invite you to submit articles on high-quality original research or reviews that provide new and robust discoveries that broaden current knowledge.

All manuscripts will be reviewed by experts in the field and must be submitted no later than 30 April 2023.

Dr. Kim Jørgensen
Prof. Dr. Bengt Karlsson
Dr. Emma Watson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

mental health
intersectionality
non-medical perspective
community
minorities
social and environmental determinants of health
substance abuse
philosophy of science
family- and network therapy
recovery and recovery-oriented practices

Related Special Issue

Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users in International Journal of Environmental Research and Public Health (13 articles)

Published Papers (10 papers)

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Research

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11 pages, 314 KiB

Open AccessArticle

Mental Health Clinician Attitudes about Service User and Family Agency and Involvement in Recovery-Oriented Practice

by Janice Chisholm, Judy Hope, Ellie Fossey and Melissa Petrakis

Int. J. Environ. Res. Public Health 2023, 20(18), 6787; https://doi.org/10.3390/ijerph20186787 - 20 Sep 2023

Cited by 2 | Viewed by 1272

Abstract

Background: Recovery-oriented practice (ROP) is a framework focusing on recovery through hope, choice, and meaning, to live with or without enduring symptoms and challenges. Aims: To examine clinicians’ attitudes about the involvement of service users and family or supporters in ROP. Methods: A bespoke Qualtrics survey obtained views of mental health clinicians working in an Australian public mental health service about service user and family involvement in ROP, using a five-point Likert scale of agreement and free-text responses. Data were analysed with descriptive statistics and content analysis methods. Results: Two hundred and three clinicians completed the survey. Most (79%) clinicians agreed with the statement that service users want clinicians to use ROP principles, and the majority (63%) also ‘strongly believed’ that ROP made a difference to service users’ mental health outcomes. Only 15% ‘strongly agreed’ and 57% somewhat agreed with the statement that service users know what treatment is best for them, and only 20% of clinicians ‘strongly agreed’ that supporters of service users believed in and wanted ROP for their family member or friend. Future directions: This study adds to the literature on clinicians’ views about ROP and shows that although clinicians are supportive of ROP, they also express substantial ambivalence about whether service users and families know what treatment is best. For ROP implementation to be successful, workforce training needs to support clinicians to reflect on these views with service users and families, and to encourage supported decision making. Future studies should focus on changes in clinicians’ views and practice post ROP training. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

12 pages, 718 KiB

Open AccessArticle

Toward an Experience-Based Model of Recovery and Recovery-Oriented Practice in Mental Health and Substance Use Care: An Integration of the Findings from a Set of Meta-Syntheses

by Trude Klevan, Mona Sommer, Marit Borg, Bengt Karlsson, Rolf Sundet and Hesook Suzie Kim

Int. J. Environ. Res. Public Health 2023, 20(16), 6607; https://doi.org/10.3390/ijerph20166607 - 18 Aug 2023

Cited by 1 | Viewed by 1525

Abstract

A model of recovery and recovery-oriented practice has been developed based on three previously published meta-syntheses of experiences and processes of mental health and substance use recovery. The model integrates the findings of these three meta-syntheses into three components: experiences of recovery, processes of recovery-oriented practice, and social and material capital. The experiences of recovery involve being, doing, and accessing and are viewed as embedded in the processes of recovery. The processes of recovery-oriented practice aim to mobilize and apply various forms of capital to support the recovery journey. Social and material capital, in turn, constitute the context in which recovery occurs and requires mobilization for the individual and the service system. The model is grounded in the principles of well-being, person-centeredness, embedding, self-determination, and the interdependency of human living. The model is both descriptive and explanatory, as it depicts the experiential and processual aspects of recovery and recovery-oriented practice and their interrelationships. The model as a framework needs to be elaborated further through application in practice and research, especially for understanding how experiences, processes and practices interact over time, and how they are affected by access to material and social capital. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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15 pages, 519 KiB

Open AccessArticle

“It’s Not Important”—The Social Constructing of Poor Physical Health as ‘Normal’ among People with Schizophrenia: Integrated Findings from an Ethnographic Study

by Birgitte Lerbæk, Rikke Jørgensen and Andrea McCloughen

Int. J. Environ. Res. Public Health 2023, 20(12), 6133; https://doi.org/10.3390/ijerph20126133 - 15 Jun 2023

Viewed by 1377

Abstract

People with schizophrenia have shortened life expectancy partly due to physical ill health. Management of coexisting mental and physical health issues is complex, and knowledge in the field is lacking. This study investigated how physical health was managed among people with schizophrenia, by integrating findings from three separate analyses conducted in an ethnographic study. Qualitative data generation methods were used; 505 h of field work were undertaken among nine participants with schizophrenia and 27 mental healthcare professionals were interviewed using a semi-structured interview approach. Three separate analyses were conducted using thematic and discourse analysis. Progressive focusing was used to integrate findings. Across the mental health care contexts that were part of this research, managing physical health was characterised by a lack of recognition of the seriousness of physical health issues as part of everyday life among people with schizophrenia. Poor physical health was accounted for as being “not of importance” by both mental health care professionals and the participants experiencing physical health issues. The integrated findings offer new insights about the social co-construction of poor physical health as something normal. At the individual level, this shared understanding by people with schizophrenia and healthcare professionals contributed to sustaining inexpedient management strategies of “modifying” behaviour or “retreating” from everyday life when physical health issues were experienced. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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12 pages, 308 KiB

Open AccessArticle

Consumer Views and Experiences of Secondary-Care Services Following REFOCUS-PULSAR Staff Recovery-Oriented Practices Training

by Michelle Kehoe, Ellie Fossey, Vrinda Edan, Lisa Chaffey, Lisa Brophy, Penelope June Weller, Frances Shawyer and Graham Meadows

Int. J. Environ. Res. Public Health 2023, 20(10), 5894; https://doi.org/10.3390/ijerph20105894 - 20 May 2023

Viewed by 1277

Abstract

Background: The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP training. Methods: Using a qualitative participatory methodology, 21 consumers (aged 18–63 years) participated in one-on-one interviews. A thematic analysis was applied. Results: Four main themes were extracted: (1) connection, (2) supportive relationships, (3) a better life, and (4) barriers. Connections to community and professional staff were important to support consumers in their recovery journey. Many consumers were seeking and striving towards a better life that was personal and individual to each of them, and how they made meaning around the idea of a better life. Barriers to recovery primarily focused on a lack of choice. A minor theme of ‘uncertainty’ suggested that consumers struggled to identify what their recovered future might entail. Conclusion: Despite staff undertaking the ROP training, all participants struggled to identify language and aspects of recovery in their interaction with the service, suggesting a need for staff to promote open, collaborative conversations around recovery. A specifically targeted recovery resource might facilitate such conversation. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

14 pages, 509 KiB

Open AccessArticle

Operationalising a Recovery-Oriented Support and Information Programme Online: The EOLAS Programme

by Karin O’Sullivan, Carmel Downes, Mark Monahan, Jean Morrissey, Gobnait Byrne, Gerard Farrell, Patrick Gibbons and Agnes Higgins

Int. J. Environ. Res. Public Health 2023, 20(5), 4417; https://doi.org/10.3390/ijerph20054417 - 01 Mar 2023

Cited by 1 | Viewed by 1737

Abstract

Evidence demonstrates that psychoeducation interventions have clinical and recovery-related benefits for people experiencing psychosis and their family members. The EOLAS programmes are one example of recovery-oriented psychoeducation programmes for psychosis. They differ from other programmes in that they are co-designed and co-facilitated (peer and clinician) group programmes. Due to the COVID-19 pandemic, EOLAS went online using a videoconferencing platform. The study examined the feasibility, acceptability and usefulness of EOLAS-Online and explored whether some of the positive recovery outcomes reported by attendees regarding the in-person programmes were replicated online. Data were collected through an online survey and semi-structured interviews. Quantitative data were analysed using descriptive statistics. Thematic analysis was used for qualitative data. Fifteen attendees (40% of attendees) completed the surveys and eight participated in interviews. A total of 80% were satisfied/very satisfied with the programme. The programme was rated highly for increased knowledge of mental health, coping strategies, and engaging with peers. The use of technology was mostly unproblematic, although some audio and video-related challenges were identified. Engaging with the online programme was experienced positively, including facilitator support to engage. The overall findings indicate that EOLAS-Online is feasible, acceptable and useful in supporting attendees’ recovery journeys. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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9 pages, 489 KiB

Open AccessArticle

Analysis of Attempted Suicide in a Pediatric Setting: Extracted Notes for Clinical Practice and Complexity of Help

by Sigita Lesinskienė, Odeta Kinčinienė, Rokas Šambaras and Emilijus Žilinskas

Int. J. Environ. Res. Public Health 2022, 19(14), 8604; https://doi.org/10.3390/ijerph19148604 - 14 Jul 2022

Cited by 2 | Viewed by 1473

Abstract

Background and Objectives: Suicidality among adolescents is a global mental health issue. However, the post-suicidal care of minors is insufficient and lacks complexity, as repeated attempts occur. Further, little is known about the social (i.e., family setting) and psychological (for example, exposure to bullying, suicidality, or addiction within a close environment) backgrounds of minors who engage in suicidal behavior in Lithuania. Thus, the aim of our study was to evaluate and compare psychosocial factors that may influence minors’ decisions to attempt suicide for the first time and then repeatedly and to extract notes for future clinical practice. Materials and Methods: Data from 187 cases of suicide attempts by minors treated at the Children’s Hospital of Vilnius University Santara Clinics from January 2011 to January 2018 was obtained and analyzed. Results: The data showed that 48.7% of minors hospitalized because of a suicide attempt had a history of previous suicide attempts. Minors who attempted suicide repeatedly were more often engaged in non-suicidal self-injurious behavior (p = 0.033). Further, a small number had experienced suicide within their close surroundings (p = 0.045). The comparative analysis did not reveal any significant differences in psychosocial backgrounds between first-time attempters and those who attempted suicide for at least a second time. Conclusions: Social and psychological support after a suicide attempt in a pediatric setting is lacking efficiency, as minors who repeatedly attempt suicide suffer from similar psychosocial burdens. Complex and targeted follow-up care is needed. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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12 pages, 703 KiB

Open AccessArticle

The Pathways to Participation (P2P) Program: A Pilot Outcomes Study

by Danielle Hitch, Lindsay Vernon, Rachel Collins, Carolyn Dun, Sarah Palexas and Kate Lhuede

Int. J. Environ. Res. Public Health 2022, 19(10), 6088; https://doi.org/10.3390/ijerph19106088 - 17 May 2022

Cited by 2 | Viewed by 1827

Abstract

Research has consistently found that people with mental illness (known as consumers) experience lower levels of participation in meaningful activities, which can limit their opportunities for recovery support. The aim of this study was to describe the outcomes of participation in a group program designed to address all stages of activity participation, known as Pathways to Participation (P2P). A descriptive longitudinal design was utilized, collecting data at three time points. Outcomes were measured by the Camberwell Assessment of Need Short Appraisal (CANSAS), Recovery Assessment Scale—Domains and Stages (RAS-DS), Behavior and Symptom Identification Scale (BASIS-24), Living in the Community Questionnaire (LCQ), and time-use diaries. All data were analyzed using descriptive statistics and Chi-square analyses. A total of 17 consumers completed baseline data, 11 contributed post-program data, and 8 provided follow-up data. Most were female (63.64%) and had been living with mental illness for 11.50 (±7.74) years on average. Reductions in unmet needs and improvements in self-rated recovery scores were reported, but no changes were identified in either time use or psychosocial health. The findings indicate that the P2P program may enable consumers to achieve positive activity and participation outcomes as part of their personal recovery. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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14 pages, 323 KiB

Open AccessArticle

Recovery-Oriented Cross-Sectoral Network Meetings between Mental Health Hospital Professionals and Community Mental Health Professionals: A Critical Discourse Analysis

by Kim Jørgensen, Kate Andreasson, Tonie Rasmussen, Morten Hansen and Bengt Karlsson

Int. J. Environ. Res. Public Health 2022, 19(6), 3217; https://doi.org/10.3390/ijerph19063217 - 09 Mar 2022

Cited by 1 | Viewed by 1751

Abstract

Aims and objectives: In the medical field, we lack knowledge on how interprofessional collaboration across sectors is carried out. This paper explores how healthcare professionals and users perceive recovery-oriented cross-sectoral discharge network meetings between mental health hospital professionals and community mental health professionals and which discourses manifest themselves within the field of mental healthcare. Method: Ten professionals from a mental health hospital and eight community mental health professionals participated. In addition, five users with experience in mental health services in both sectors participated. Fairclough’s discourse analysis framework was used to explore their experiences. The study was designed following the ethical principles of the Helsinki Declaration and Danish law. Each study participant in the two intersectoral sectors gave their informed consent after verbal and written information was provided. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study). Results: The healthcare professionals in both sectors are governed by steering tools, legislation and a strong biomedical tradition to solve illness-related problems, such that users must be offered treatment and support to achieve self-care as soon as possible. This can be seen as a reflection of, and a driving force in, a change in the wider social practice that Fairclough terms the ‘marketisation of discourse’—a social development in late modernity, whereby market discourse colonises the discursive practices of public institutions. The user of psychiatric and social services experiences a structured system that does not offer the necessary time for deep conversations. Users do not consider recovery as something that is only seen in relation to the efforts of the professionals, as recovery largely takes place independently of professionals. Recovery depends on users’ internal resources and a strong network that can support them on the journey. Conclusion: Healthcare professionals perceive recovery-oriented cross-sectoral discharge network meetings to reflect paternalistic and biomedical discourses. Users want to be seen more as whole persons and did not experience sufficient involvement in the intersectoral care. Relevance to clinical practice: Healthcare professionals need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

Review

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24 pages, 1491 KiB

Open AccessReview

Social Processes of Young Adults’ Recovery and Identity Formation during Life-Disruptive Mental Distress—A Meta-Ethnography

by Ida Marie Skou Storm, Anne Kathrine Kousgaard Mikkelsen, Mari Holen, Lisbeth Hybholt, Stephen Fitzgerald Austin and Lene Lauge Berring

Int. J. Environ. Res. Public Health 2023, 20(17), 6653; https://doi.org/10.3390/ijerph20176653 - 25 Aug 2023

Viewed by 1462

Abstract

Young people’s mental health recovery is well-explored in empirical research, yet there is a lack of meta-studies synthesizing the characteristics of young people’s recovery. This meta-ethnography explores young adults’ recovery during life-disruptive experiences of early psychosis or schizophrenia. Based on a systematic literature review search, 11 empirical qualitative studies were included for synthesis. Inspired by young people’s prominent experience of social isolation in the included studies, we applied an interpretive lens of belonging deriving from the sociology of youth. The synthesis presents five themes: (1) expectations of progression in youth in contrast with stagnation during psychosis, (2) feeling isolated, lost and left behind, (3) young adults’ recovery involves belonging with other young people, (4) forming identity positions of growth and disability during psychosis, and the summarizing line of argument, (5) navigating relational complexities in the process of recovery. While suffering from social isolation, young people’s recovery is conceived as getting on with life, like any other young person involving connecting and synchronizing life rhythms with their age peers. Socializing primarily with caring adults entails being stuck in the position of a child, while connecting with young people enables the identity positions of young people. This synthesis can inspire support for young people’s recovery through social inclusion in youth environments. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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9 pages, 305 KiB

Open AccessReview

Mental Health Recovery in Social Psychiatric Policies: A Reflexive Thematic Analysis

by Jacob M. Nielsen, Niels Buus and Lene L. Berring

Int. J. Environ. Res. Public Health 2023, 20(12), 6094; https://doi.org/10.3390/ijerph20126094 - 09 Jun 2023

Cited by 1 | Viewed by 1451

Abstract

The realisation of recovery as an overarching goal of mental health care services has proven difficult to achieve in practice. At present, concepts of recovery are contested and unclear, which affects their implementation in psychiatric practices. We examined social psychiatric policies about recovery with the aim to explore their underlying assumptions about recovery. Relevant texts from the policies’ knowledge bases were subjected to reflexive thematic analysis. We developed a central theme: “A clinical standardisation of the concept of recovery”. The theme involved meaning clusters that encompassed conflicting and commonly shared assumptions about recovery across the text corpus. We discussed the findings from discourse analytical and governmentality perspectives. In conclusion, the policies’ aim of providing clarity about recovery was circumvented by the very knowledge bases used to support their endeavours. Full article

(This article belongs to the Special Issue Promoting Recovery in Mental Health—Perspectives and Experiences of Professionals and Service Users: 2nd Edition)

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