Valuing whole complex lives: Young adults' experiences of recovery-related principles in mental healthcare in the United States

"I don't believe I'm going to recover from anything." Understanding recovery amongst people with severe mental illness attending community health services in Spain

PURPOSE

The concept of recovery has become the backbone of mental health services and professional practices. However, research aimed at analysing the conceptualisation of recovery of people diagnosed with severe mental illness (SMI) has an obvious Anglo-Saxon bias. Our objective was to analyse what a sample of 51 users of mental health services diagnosed with SMI in Spain understand by recovery.

METHOD

The participants were interviewed in depth about their concept of recovery, and their responses were thematically analysed by three observers.

RESULTS

Four categories of definitions of the concept of recovery were found in the analysis: Socio-Behavioural, Biomedical, Resistance, and Wellbeing-Growth. Inter-rater reliability scores ranged from 0.7 to 0.84 according to Krippendorff's alpha. While the Biomedical category essentially corresponded to the idea of clinical recovery, the Wellbeing-Growth category reproduced the concept of personal recovery (PR) that is dominant in the literature. The most frequent categories were Socio-Behavioural and Biomedical. Assimilation of the PR concept by participants was quite limited. The markedly relational character of the most frequent categories challenges the individualistic core of the classic definition of PR.

CONCLUSIONS

We advocate the need to make alternative recovery concepts and narratives visible to the mental health services' users and practitioners.IMPLICATIONS FOR REHABILITATIONThe concept of personal recovery is not common amongst mental health services' users as recovery is mainly understood in social and biomedical terms.Different conceptualizations of recovery can coexist in participants.Mental health services should consider alternative narratives to personal recovery.Mental health services should provide resources for creating community and sense of belonging as first strategies for promoting recovery.

A Holistic Self-learning Approach for Young Adult Depression and Anxiety Compared to Medication-Based Treatment-As-Usual

A package of biopsychosocial services for young adults experiencing psychological distress was evaluated and compared to usual outpatient psychiatric care. Young adults (18-25) with moderate-to-severe symptoms of depression and/or anxiety (n = 26) were enrolled in a 13-week intervention consisting of nutritional coaching and multi-vitamin supplements, weekly educational and peer support groups, and a modest financial stipend to engage with physical or expressive activities. A comparison group (n = 13) continued with their usual medication-based outpatient care. Program participants reported significantly improved depression, anxiety, severity of distress, overall quality of life, and empowerment over 4 months, with progress maintained or further improved at 2-month follow-up. No evidence of change on any outcome was observed for comparison group participants. Although long-term impacts on mental health trajectories and reliance on psychotropic medications remain unknown, a holistic self-learning approach is a viable alternative to standard outpatient psychiatric care for young adults.