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Gunasekaran S, Tan GTH, Shahwan S, Goh CMJ, Ong WJ, Subramaniam M. The perspectives of healthcare professionals in mental health settings on stigma and recovery - A qualitative inquiry. BMC Health Serv Res 2022; 22:888. [PMID: 35804378 PMCID: PMC9270770 DOI: 10.1186/s12913-022-08248-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health stigma is one of the most prominent barriers to recovery, and it is widely known that stigma may manifest differentially in different cultures. Healthcare professionals working closely with persons with mental illnesses (PMI) may provide important insights towards stigma that are otherwise unattainable from caregivers and consumers. However, there is a dearth of literature on healthcare professionals' perspectives on this topic. Thus, this study uses a multilevel approach to explore how stigma affects recovery from the perspectives of healthcare professionals that work closely with PMI in Singapore. METHODS Semi-structured interviews were conducted with a total of 17 healthcare professionals who were working in mental health settings in Singapore. Participants were recruited via direct email invitation or through snowball sampling. Data collected was analysed with the inductive thematic analysis method. All coding and inter-rater analyses were performed with NVivo. RESULTS The current study themes identified stigma-related factors that influence PMI's recovery from the perspectives of healthcare professionals working closely with PMI. These factors were organised into three overarching themes in a multilevel structure. The three themes were classified as Micro Factors (e.g., internalised stigma), Meso Factors (e.g., discrimination of people associated with the stigmatised group), and Macro Factors (e.g., structural stigma and stigma within healthcare settings). CONCLUSIONS The findings of this study gave us a greater understanding of how stigma influences recovery in Singapore, which could be used to guide the development and implementation of future policies and strategies to promote recovery. Importantly, our results suggest that improving mental health literacy, addressing cultural misgivings towards mental illness, implementing recovery-oriented practices, and making insurance more accessible for PMI could mitigate the deleterious impact that stigma has on recovery.
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Affiliation(s)
- Savita Gunasekaran
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore.
| | - Gregory Tee Hng Tan
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Chong Min Janrius Goh
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Wei Jie Ong
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
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Duncan A, Stergiopoulos V, Wodchis WP, Kirst M, Dainty KN. Client Experiences With a Short-Term Case Management Mental Health Service. J Patient Exp 2022; 9:23743735221113059. [PMID: 35860791 PMCID: PMC9289903 DOI: 10.1177/23743735221113059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Short Term Case Management (STCM) was introduced in 2016 in Toronto, Ontario, as a brief intervention to address long wait-lists for case management services. STCM provides individuals with mental illness, living in the community, case management services on a weekly basis over 3 months to identify personal goals and work toward an improved state of health and well-being. Despite the small but growing body of evidence on short-term case management, there is limited research on clients’ reported experiences of these services. This study used a phenomenological approach to answer the question “What are the experiences with services of individuals who received short-term case management services?” Eight qualitative semistructured interviews were conducted between November 2019 and January 2020 to collect the perspectives and experiences of clients who had received STCM. Most participants valued engaging in a brief therapeutic relationship. Additionally, participants described that the intervention helped them connect with other agencies for ongoing support and begin achieving their own long-term goals. Some participants voiced concerns about the brief duration of the intervention. Future research should explore the role of briefcase management in the continuum of services and the typology of clients who may benefit from longer therapeutic relationship to achieve their goals.
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Affiliation(s)
- Andrea Duncan
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | | | - Walter P Wodchis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Implementation and Evaluation Science, Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Maritt Kirst
- Department of Psychology, Community Psychology Program, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Katie N Dainty
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Patient-Centred Outcomes, North York General Hospital, Toronto, Ontario, Canada
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3
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Gyamfi N, Bhullar N, Islam MS, Usher K. A systematic review of measures assessing mental health professionals' perspectives of recovery. Int J Ment Health Nurs 2021; 30:847-874. [PMID: 34129745 DOI: 10.1111/inm.12895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
Recovery is internationally recognized as a concept to improve the well-being of consumers. Compared with the numerous measures assessing consumer perspectives of recovery, only a few measures have been developed to assess Mental Health Professionals' (MHPs) perspectives of recovery to inform practice. The present study aims to systematically review the literature to identify existing measures designed to assess MHPs' perspectives of recovery and evaluate their psychometric properties, and the methodological considerations of the design and use of these measures. We searched literature across eight electronic databases: MEDLINE, Web of Science, PsycINFO, PsyArticles, CINAHL, Scopus, EMBASE, and Google scholar. We identified 2631 articles across all databases. Of these, 40 articles met the inclusion criteria, which comprised 14 original measures assessing mental health recovery and 26 articles reassessing the psychometric properties of the original 14 measures. Our results suggested that while there are existing measures for assessing MHPs' perspectives of recovery, only a few of these measures met standard evaluation criteria for psychometric properties. Specifically, the validation of the identified measures is still in its infancy. For example, the easiness of applying the measures differs among the studies, and only a few of the measures fully involved consumers in the scale development phase. The implication of the findings for future use and development of recovery measures in mental health practice and research are discussed and recommended.
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Affiliation(s)
- Naomi Gyamfi
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Navjot Bhullar
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Hurtado MM, Villena A, Vega A, Amor G, Gómez C, Morales-Asencio JM. 'I have anxiety, but I have values and preferences' Experiences of users with generalized anxiety disorder: A qualitative study. Int J Ment Health Nurs 2020; 29:521-530. [PMID: 31908140 DOI: 10.1111/inm.12690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2019] [Indexed: 12/12/2022]
Abstract
To understand the experience and perceptions of people diagnosed with generalized anxiety disorder, along the whole process and their role through the decision-making process for their treatment. A qualitative study through focus groups composed of people diagnosed with generalized anxiety disorder was carried out. Content analysis was carried out to explore the most representative issues. Five thematic categories were identified: onset of the disorder, symptoms and course; daily life with the disorder; coping with the disorder; demand of healthcare for anxiety, and treatment options and decision-making. Most of the patients reported physical symptoms of anxiety. The majority of participants perceived little social support from their environment and occupational interferences. Coping seems to differ among participant that have recovered or not recovered. The involvement of users with generalized anxiety disorder was scarce, and pharmacological treatment was always the first option offered. There is scarce orientation to elicit preferences and values of patients across the process of care for people with generalized anxiety disorder. The consequence is a biased predisposition of the healthcare system to provide pharmacological treatment as the first option and ignore the perspective of patients on how to cope with their illness.
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Affiliation(s)
- María M Hurtado
- Mental Health Unit, Regional University Hospital, Málaga, Spain
| | - Amelia Villena
- Mental Health Unit, Valle de los Pedroches Hospital, Pozoblanco, Spain
| | - Amanda Vega
- Mental Health Unit, Regional University Hospital, Málaga, Spain
| | - Gisela Amor
- Mental Health Unit, Regional University Hospital, Málaga, Spain
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Ngo H, Ennals P, Turut S, Geelhoed E, Celenza A, Wolstencroft K. Step-up, step-down mental health care service: evidence from Western Australia's first - a mixed-method cohort study. BMC Psychiatry 2020; 20:214. [PMID: 32393203 PMCID: PMC7216384 DOI: 10.1186/s12888-020-02609-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/19/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mental health Step-up, Step-down services (SUSD), also known as subacute services or Prevention and Recovery Services, have emerged to fill an identified gap between hospital-based inpatient care and clinical community-based mental health support. Evidence for the effectiveness of the SUSD service model is limited but growing. Accordingly, this study looked to add to the extant body of knowledge, by (i) assessing change outcomes in mental health and wellbeing, and predictors of these changes, for patients who accessed Western Australia's first SUSD service; and (ii) evaluating patients' satisfaction with service, and what patients value from their stay. METHODS This was a mixed-method retrospective cohort study. Participants comprised 382 patients who accessed a 22-bed Mental Health SUSD facility and incurred 551 episodes of care during the 01/07/2014-30/06/2016 period. Patients' change outcomes in psychological distress, general self-efficacy, and work and social adjustment from service entry to service exit were analyzed using generalized linear modeling. Simple Pearson's correlation coefficients were calculated for preliminary assessment of the associations between patients' service satisfaction and their change outcomes. Qualitative outcomes that patients valued from their stay were analyzed thematically according to a semi-grounded theoretical approach. RESULTS Significant improvements were observed in patients' self-reported psychological distress, self-efficacy, and work and social adjustment (all p < 0.0001). A strong and persistent baseline effect existed across the three measures. Older age, female gender, and having a dependent child in the same household were protective/enhancing factors for the patients' recovery. Satisfaction with service was high. Patients valued having the time and space to recuperate, gain insight, focus, and create changes in their lives. CONCLUSION The encouraging findings, regarding both patients' change outcomes and satisfaction with service, support the value of the SUSD service model for patients with mental illnesses. Strengths and limitations were discussed; ensued recommendations were offered to both service providers and researchers to enhance the robustness of future research findings, to help inform more effective policy and funding decisions related to mental health care.
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Affiliation(s)
- Hanh Ngo
- Division of Emergency Medicine, School of Medicine, The University of Western Australia (Internal Mail Code M516), 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | | | - Serhat Turut
- grid.477634.5Neami National, Melbourne, VIC Australia
| | - Elizabeth Geelhoed
- grid.1012.20000 0004 1936 7910School of Allied Health, The University of Western Australia, Perth, WA Australia
| | - Antonio Celenza
- grid.1012.20000 0004 1936 7910Division of Emergency Medicine, School of Medicine, The University of Western Australia (Internal Mail Code M516), 35 Stirling Highway, Crawley, WA 6009 Australia
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A Place to Call Home: Hearing the Perspectives of People Living with Homelessness and Mental Illness Through Service Evaluation. Community Ment Health J 2019; 55:1218-1225. [PMID: 31098765 DOI: 10.1007/s10597-019-00406-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
There is an ongoing need to incorporate the perspectives of people in supported community housing to improve the provision of integrated mental health services. This study aimed to explore the satisfaction and experiences of people who have received supported housing and mental health services. We conducted a retrospective, mixed methods study using a data mining approach, analyzing consumer satisfaction survey responses collected on discharge from the service over a 7-year period. Responses from 178 consumers aged between 20 and 62 years were included. Quantitative results indicated that consumers rated the quality of services as relatively high. Analysis of qualitative responses identified seven themes describing people's views on how they had benefitted from the service. Consumers reported benefits in terms of practical and emotional supports, responsiveness of the team to their needs, socialization and community integration, personal growth and recovery, and finding 'my place'. Themes of learning and skills development were also important. These results suggest that practical support, together with emotional expressions of care and compassion are most valued by people who participated in this service. This research has implications for service evaluation and for future research, which may include focusing on the key role of connectedness, 'my place' and hope for recovery.
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7
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Ellison ML, Belanger LK, Niles BL, Evans LC, Bauer MS. Explication and Definition of Mental Health Recovery: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:91-102. [PMID: 27709376 DOI: 10.1007/s10488-016-0767-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This review assessed the concordance of the literature on recovery with the definition and components of recovery developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Each SAMHSA identified recovery component was first explicated with synonyms and keywords and made mutually exclusive by authors. Inter-rater reliability was established on the coding of the presence of 17 recovery components and dimensions in 67 literature reviews on the recovery concept in mental health. The review indicated that concordance varied across SAMHSA components. The components of recovery with greatest concordance were: individualized/person centered, empowerment, purpose, and hope.
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Affiliation(s)
- Marsha Langer Ellison
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, 200 Springs Rd, Bedford, MA, 01730-0012, USA. .,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Lindsay K Belanger
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Barbara L Niles
- National Center for PTSD Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Leigh C Evans
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,School of Public Health, Boston University, Boston, MA, USA
| | - Mark S Bauer
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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9
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Fernando GA, Wilkins A. Barriers to recovery in communities exposed to disasters: Sri Lankan voices speak. Int Rev Psychiatry 2016; 27:218-32. [PMID: 26087041 DOI: 10.3109/09540261.2015.1040375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Disasters experienced by a community place all members at risk for physical and psychological harm. While natural resilience may help many to recover, there may be barriers that hinder the recovery process. This qualitative study was conducted to examine barriers to recovery in a community impacted by both war and the tsunami. A group of 43 ethnically diverse Sri Lankans (F = 63%) participated in six focus groups and provided their perspectives on barriers they perceived to impede their recovery from traumatic events. Grounded-theory-based data analysis revealed culture-general and culture-specific socio-economic, environmental, sociocultural, and individual barriers that participants identified as impeding their recovery. Interventions and health policies targeting these groups could focus on helping communities to overcome these barriers as a means of facilitating recovery in these beleaguered communities.
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10
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Petersen KS, Friis VS, Haxholm BL, Nielsen CV, Wind G. Recovery from mental illness: a service user perspective on facilitators and barriers. Community Ment Health J 2015; 51:1-13. [PMID: 25344345 DOI: 10.1007/s10597-014-9779-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
Mental health services strive to implement a recovery-oriented approach to rehabilitation. Little is known about service users' perception of the recovery approach. The aim is to explore the service user's perspectives on facilitators and barriers associated with recovery. Twelve residents living in supported housing services are interviewed. The analysis is guided by a phenomenological-hermeneutic approach and the interpretation involves theories from critical theory, sociology, and learning. Learning, social relations, and willpower are identified as having an impact on recovery. Stigmatization and social barriers occurred. Social relations to peer residents and staff were reported as potentially having a positive and negative impact on recovery. Studies have explored the user's perspectives on recovery but this study contributes with knowledge on how recovery-oriented services have an impact on recovery.
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Affiliation(s)
- Kirsten Schultz Petersen
- Department of Public Health, Section of Clinical Social Medicine and Rehabilitation, Aarhus University, P.P. Oerumsgade 9-11 Building 1B, 8000, Aarhus C, Denmark,
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11
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Kidd S, Kenny A, McKinstry C. The meaning of recovery in a regional mental health service: an action research study. J Adv Nurs 2014; 71:181-92. [DOI: 10.1111/jan.12472] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Susan Kidd
- Bendigo Health Care Group; La Trobe Rural Health School; Bendigo Victoria Australia
| | - Amanda Kenny
- La Trobe Rural Health School; La Trobe University; Bendigo Victoria Australia
| | - Carol McKinstry
- La Trobe Rural Health School; La Trobe University; Bendigo Victoria Australia
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12
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Green CA, Estroff SE, Yarborough BJH, Spofford M, Solloway MR, Kitson RS, Perrin NA. Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. Schizophr Bull 2014; 40 Suppl 1:S1-S94. [PMID: 24489078 PMCID: PMC3911266 DOI: 10.1093/schbul/sbt170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Percy ML, Bullimore P, Baker JA. Voice hearer's perceptions of recovery: findings from a focus group at the Second World Hearing Voices Festival and Congress. J Psychiatr Ment Health Nurs 2013; 20:564-8. [PMID: 23230997 DOI: 10.1111/jpm.12030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M L Percy
- School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK
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14
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Cleary M, Horsfall J, O'Hara-Aarons M, Hunt GE. Mental health nurses' views of recovery within an acute setting. Int J Ment Health Nurs 2013; 22:205-12. [PMID: 22882297 DOI: 10.1111/j.1447-0349.2012.00867.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
How the principles of a recovery-oriented mental health service are incorporated in the day-to-day nursing practice of mental health nurses in inpatient settings is unclear. In this study, we interviewed 21 mental health nurses working in acute inpatient mental health units about a range of recovery-focused topics. Three overlapping themes were identified: (i) the perception of recovery; (ii) congruent humanistic approaches; and (iii) practical realities. Only four interviewees had some formal training about recovery. Most respondents recognize that positive attitudes, person-centred care, hope, education about mental illness, medication and side-effects, and the acknowledgement of individual recovery pathways are necessary to prevent readmission, and are central to a better life for people who live with a mental illness. This research supports the view that ideas and practices associated with the recovery movement have been adopted to some degree by nurses working at the acute end of the services continuum. However, most saw the recovery orientation as rhetoric rather than as an appropriately resourced, coordinated, and integrated program. These nurses, however, speak of much more detailed aspects of working with patients and being required to prepare them for the exigencies of living in the community post-discharge.
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Affiliation(s)
- Michelle Cleary
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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15
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Williams J, Leamy M, Bird V, Harding C, Larsen J, Le Boutillier C, Oades L, Slade M. Measures of the recovery orientation of mental health services: systematic review. Soc Psychiatry Psychiatr Epidemiol 2012; 47:1827-35. [PMID: 22322983 DOI: 10.1007/s00127-012-0484-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 01/28/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE The review aimed to (1) identify measures that assess the recovery orientation of services; (2) discuss how these measures have conceptualised recovery, and (3) characterise their psychometric properties. METHODS A systematic review was undertaken using seven sources. The conceptualisation of recovery within each measure was investigated by rating items against a conceptual framework of recovery comprising five recovery processes: connectedness; hope and optimism; identity; meaning and purpose; and empowerment. Psychometric properties of measures were evaluated using quality criteria. RESULTS Thirteen recovery orientation measures were identified, of which six met eligibility criteria. No measure was a good fit with the conceptual framework. No measure had undergone extensive psychometric testing and none had data on test-retest reliability or sensitivity to change. CONCLUSIONS Many measures have been developed to assess the recovery orientation of services. Comparisons between the measures were hampered by the different conceptualisations of recovery used and by the lack of uniformity on the level of organisation at which services were assessed. This situation makes it a challenge for services and researchers to make an informed choice on which measure to use. Further work is needed to produce measures with a transparent conceptual underpinning and demonstrated psychometric properties.
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Affiliation(s)
- J Williams
- Section for Recovery, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, Box PO29, SE5 8AF, UK.
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McCaffrey T, Edwards J, Fannon D. Is there a role for music therapy in the recovery approach in mental health? ARTS IN PSYCHOTHERAPY 2011. [DOI: 10.1016/j.aip.2011.04.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Happell B, Palmer C, Tennent R. The Mental Health Nurse Incentive Program: desirable knowledge, skills and attitudes from the perspective of nurses. J Clin Nurs 2011; 20:901-10. [DOI: 10.1111/j.1365-2702.2010.03510.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the "right" consumer, including: finding a consumer without an axe to grind; ensuring the consumer is representative of broader views; health professionals as consumer representatives. While these concerns are common they have not yet been extensively debated and discussed in the broader Literature. Strategies necessary to support consumers in participatory roles are also considered and the controversial subject of financial remuneration for consumers is also explored.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, Institute for Health and Social Science Research, CQUniversity Australia, Bruce Highway, Rockhampton 4702, Queensland, Australia.
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19
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Happell B, Moxham L, Platania-Phung C. A psychometric analysis of the Mental Health Consumer Participation Questionnaire. Int J Ment Health Nurs 2010; 19:377-84. [PMID: 21054723 DOI: 10.1111/j.1447-0349.2010.00692.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
If consumer participation is to be translated from rhetoric into reality, the attitudes of health professionals need to be addressed. Educational strategies can play an important role, but measures of attitudes are needed to determine the effectiveness of these strategies. This paper seeks to establish the Mental Health Consumer Participation Questionnaire (MHCPQ) on psychometric grounds, and explore attitude levels. Overall, the 150 nursing students who participated saw consumer participation in a favourable light, although this varied with the nature and extent of involvement. Psychometric properties, attitude structure, and attitude differences are reported. The MHCPQ displays good face validity and can be further developed and used in mental health-care settings.
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Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia.
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Happell B. Moving in circles: a brief history of reports and inquiries relating to mental health content in undergraduate nursing curricula. NURSE EDUCATION TODAY 2010; 30:643-648. [PMID: 20138410 DOI: 10.1016/j.nedt.2009.12.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 12/13/2009] [Accepted: 12/21/2009] [Indexed: 05/28/2023]
Abstract
Since the abolition of specialist, undergraduate education in mental health nursing, serious concerns have been raised about the inadequate amount of theory and clinical experience devoted to this specialty in most pre-registration nursing programs in Australia. A number of government initiated reports and inquiries have been undertaken to scope the problem and provide recommendations with the aim of overcoming the identified deficits. Most inquiries have agreed that mental health nursing is under-represented in undergraduate programs and this has serious consequences for establishing a sustainable mental health nursing workforce and for providing optimal care for people experiencing a mental illness. The recommendations tend to support the continuation of comprehensive nursing education, but emphasise the need for increased mental health content. Terms like significant and substantial are often used which are not easily quantifiable. The repetitive nature of the recommendations and findings of the reports suggests that real change is not likely to occur unless specific minimum standards for the mental health content of undergraduate nursing programs are set.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, Institute for Health and Social Science Research, CQUniversity Australia, Bruce Highway, Rockhampton, 4702 Queensland, Australia.
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Abstract
This review begins with an outline of outcome measurement in the country where it has been most thoroughly implemented, namely Australia. There follows a consideration of what constitutes an outcome in mental illness generally, and chronic mental illness in particular. Some instruments, such as the Health of the Nation Outcome Scales (HoNOS), focus primarily on illness severity, and examples of their use in the area of chronic mental illness are presented. Other instruments, such as the Life Skills Profile (LSP), assess personal functioning or disability, and that literature is reviewed. One major area of attention in the chronically mentally ill is quality of life. Another fruitful approach to assessing outcome is to look at needs, especially unmet needs, for which the leading instrument is the Camberwell Assessment of Need; relevant findings are reviewed. The most recent area of interest is recovery. While several scales have been developed, there are as yet relatively few reports of their application with patients with chronic mental illness. The concluding section considers the benefits and weaknesses of using the same standard instruments with all consumers within a service, and shows the utility of outcome results in groups and individuals with generally small overall changes.
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Affiliation(s)
- Tom Trauer
- Department of Psychiatry, The University of Melbourne, School of Psychology and Psychiatry, Monash University, St Vincent's Hospital Mental Health Service, Fitzroy, Victoria, Australia.
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22
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Elstad TA, Hellzén O. Community mental health centres: a qualitative study of professionals' experiences. Int J Ment Health Nurs 2010; 19:110-8. [PMID: 20367648 DOI: 10.1111/j.1447-0349.2009.00643.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article presents findings from a qualitative study of mental health work in community mental health centres with a multiprofessional workforce and aims of active user participation in the service. User participation implies collaborative relationships and different roles than that of expert professionals and dependent patients. How do professionals working in these services experience their work and professional role? This question was explored in order to highlight important aspects of community mental health work. A group of six experienced professionals from three community mental health centres in a Norwegian city were interviewed twice. The informants highlighted the complexity of community mental health work and the need to be flexible when working to support people with mental health problems in their everyday life situation. To see the service users as people and to facilitate social interaction was important. Their work was described as 'liberating' compared to working in institutions. However, although in their experience they found that professional knowledge and skills were important in their work situation, all had experienced that this was not always acknowledged by professionals in other services.
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Affiliation(s)
- Toril Anne Elstad
- Faculty of Nursing, Sør-Trøndelag University College, 7004 Trondheim, Norway.
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23
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Abstract
This paper questions the current mental health discourse that offers new definitions of the concept of 'recovery' and offers a different perspective that aims to clarify its meaning. Confusion is caused when medical language continues to be used in discussions that aim to challenge traditional medical understanding of the term 'recovery' (meaning cure). Medical and non-medical concepts of recovery are referred to interchangeably in many narratives and the common references to and acceptance of the Harding et al. papers and similar that report on how people can 'get better' from schizophrenia perpetuates this confusion. In this paper, it is suggested that 'recovery' should not be viewed as having new meaning, but that two different concepts have been confused, with the same word having been used to describe two completely different things altogether. This means that what is referred to in this paper as 'medical' recovery (traditional definitions of recovery that aims for cure), becomes subordinate to 'life' recovery (personal development and change) in which psychiatric classification might have no part in a person's understanding of their experience and where improving 'symptoms' could be irrelevant in the personal process of growth and discovery.
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Affiliation(s)
- Elizabeth Collier
- School of Nursing, University of Salford, Salford, Greater Manchester, UK.
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24
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Kartalova-O'Doherty Y, Tedstone Doherty D. Recovering from recurrent mental health problems: giving up and fighting to get better. Int J Ment Health Nurs 2010; 19:3-15. [PMID: 20074198 PMCID: PMC2839479 DOI: 10.1111/j.1447-0349.2009.00636.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this paper is to present selected findings of a grounded theory study that aims to explore individual processes and desired outcomes of recovery from recurrent health problems in order to build up a theoretical framework of recovery in an Irish context. Volunteers included mental health service users or participants of peer support groups who have experienced recurrent mental health problems for two or more years, consider themselves in improvement, and are willing to participate in individual interviews. The current paper is based on the analysis of 15 audiorecorded and transcribed interviews. We identified two open codes of 'giving up' and 'fighting to get better'. Giving up was associated with accepting a passive identity of a patient with a chronic mental illness and a lack of intrinsic motivation to get better. Fighting had both positive (fighting for) and negative (fighting against) dimensions, as well as internal and external ones. The fight for recovery entailed substantial and sometimes risky effort. Starting such a fight required strong, self-sustained motivation. Service providers might need to discuss internal and external motivators of fighting for recovery with service users, with a view to including such motivators in the care plans.
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25
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Jormfeldt H. Attitudes towards health among patients and staff in mental health services: a comparison of ratings of importance of different items of health. Soc Psychiatry Psychiatr Epidemiol 2010; 45:225-31. [PMID: 19396575 DOI: 10.1007/s00127-009-0059-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 04/14/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND In mental health services, the concept of health is often perceived, from a biomedical perspective, as the absence of disease, involving several negative consequences together with a lack of systematic health-promoting activities. The subjective experiences of health among patients in mental health services are crucial to reinforce the experience of health throughout different phases of life. Positive dimensions of health include interaction between the individual and the environment, subjective experience of individual power as well as possibilities to influence important aspects of the life situation. The aim of the study was to describe and compare attitudes to health among patients and staff in mental health services in terms of the importance of health as measured by the attitude version of the Health Questionnaire. METHODS A cross-sectional study including a randomly selected sample of 141 outpatients in contact with the mental health services and 140 mental health staff was performed. RESULTS Patients and staff share most attitudes towards health, which indicates that health is a concept that applies to human beings irrespective of mental disease in the context of mental health services. CONCLUSIONS The possibility to be able to define, measure, and compare positive dimensions of health may be important in the attempts to divert the focus towards one that promotes health and resources in mental health services and away from one on illness and deficits.
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Hewitt J. Redressing the balance in mental health nursing education: arguments for a values-based approach. Int J Ment Health Nurs 2009; 18:368-79. [PMID: 19740146 DOI: 10.1111/j.1447-0349.2009.00633.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Evidence-based practice (EBP) has become a dominant epistemology in nursing education, and has devalued the complex interpersonal components of mental health nursing. A curriculum for mental health nursing, which values the personhood of service users, should focus on those processes that promote recovery within a therapeutic relationship committed to collaboration and respect for diversity. These relationships become possible where the preparation of mental health nurses for practice includes an examination of self in terms of beliefs and values and their consequences on others. The combination of action and reflection in praxis provides a means by which self-examination and professional obligation can be examined in order to construct a moral identity, which is responsive to the needs of people with mental health problems. Praxis is more than a means of reflecting on practice: it draws together skill, practice knowledge, attitudinal style, and moral reasoning. For this reason, ethical values have a vital role to play in the development of contemporary nursing praxis.
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Affiliation(s)
- Jeanette Hewitt
- Centre for Philosophy, Swansea University, Swansea, South Wales, UK.
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27
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Usher K, Baker JA, Holmes C, Stocks B. Clinical decision-making for ‘as needed’ medications in mental health care. J Adv Nurs 2009; 65:981-91. [DOI: 10.1111/j.1365-2648.2008.04957.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Sommerseth R, Dysvik E. Health professionals' experiences of person-centered collaboration in mental health care. Patient Prefer Adherence 2008; 2:259-69. [PMID: 19920972 PMCID: PMC2770397 DOI: 10.2147/ppa.s3988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The basic aim in this paper is to discuss health care professionals' experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation. METHOD The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semi-structured in-depth interview to judge validity. RESULTS Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care. CONCLUSION Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.
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Affiliation(s)
- Rita Sommerseth
- Correspondence: Rita Sommerseth, University of Stavanger, Faculty of Social Sciences, Department of Health Studies, N-4036 Stavanger, Norway, Email
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