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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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Cockburn L, Trentham B, Kirsh B. Educating Tomorrow’s Practitioners: Influences on Community Mental Health Occupational Therapy Education. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2014. [DOI: 10.1179/otb.2005.52.1.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Eriksson NT, Wiklund-Gustin L. Blessed alienation: the Christian monastery as a caring and restorative environment. QUALITATIVE HEALTH RESEARCH 2014; 24:172-82. [PMID: 24463632 DOI: 10.1177/1049732313519708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Being mentally ill is often associated with experiencing alienation from society because sensations are not easily shared with others. Modern health care leads us to pose many questions. Some sufferers search and find their way to monasteries as they did centuries ago. We interviewed six persons staying in a monastery to understand the meaning of health and care in a monastic environment in contemporary Sweden. We analyzed the transcripts by means of a hermeneutic approach and discovered that the helping effect of the monastery was based on its contradictory/paradoxical structure that corresponded to the lifeworld of a person suffering from mental illness. The monastery was a place where one could be different but equal, and simultaneously provided freedom within boundaries, calmness and intensity, privacy and relations, demands and confirmation. This facilitated experiences of health and wholeness, necessary to manage the challenges of recovery.
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Sklar M, Groessl EJ, O'Connell M, Davidson L, Aarons GA. Instruments for measuring mental health recovery: a systematic review. Clin Psychol Rev 2013; 33:1082-95. [PMID: 24080285 DOI: 10.1016/j.cpr.2013.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/27/2013] [Accepted: 08/05/2013] [Indexed: 11/29/2022]
Abstract
Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide.
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Affiliation(s)
- Marisa Sklar
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 9500 Gilman Drive, San Diego, CA 92093-0994, United States.
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Rasmussen P, Muir-Cochrane E, Henderson A. Document analysis using an aggregative and iterative process. INT J EVID-BASED HEA 2012; 10:142-5. [DOI: 10.1111/j.1744-1609.2012.00262.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Basiletti M, Townsend E. Group Decision Making in an Intersectoral Mental Health Community Partnership. Br J Occup Ther 2012. [DOI: 10.4276/030802212x13361458480289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: In a major Canadian jurisdiction that includes several regions, an intersectoral working group with community partners was formed to enable change in systems and policies for individuals with serious and persistent mental illness. The top priority of the working group was housing. Purpose: The study explored how the working group members experienced decision-making power in their efforts to enable change in housing policies. Method: The research used a qualitative single-case design to study the decision-making processes as experienced by the group members. Data were collected through individual semi-structured interviews, two focus groups and review of key public documents. The data were analysed using the constant comparative method, with critical reflection on group decision making and the contextual influences of system-level policies. Group members contributed to the analysis. Findings: Amid positive experiences of working together, group members experienced challenges related to power differentials between service providers, government personnel and consumers, and the impact of the systemic environment on the group processes. Implications: Implications are raised for occupational therapy education and practice, and for studying group decision making as an occupation.
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Affiliation(s)
- Mari Basiletti
- Academic Adjunct Faculty, School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elizabeth Townsend
- Professor Emerita, School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, and Director, Centre for Education Research, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Piat M, Sabetti J, Bloom D. The transformation of mental health services to a recovery-orientated system of care: Canadian decision maker perspectives. Int J Soc Psychiatry 2010; 56:168-77. [PMID: 20207679 PMCID: PMC4835229 DOI: 10.1177/0020764008100801] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recovery is emerging as a worldwide paradigm in mental health. There is increasing recognition that the transformation of mental health systems to a recovery perspective requires collaboration among all stakeholders. Research to date has focused on the perspectives of service users and providers. The role and influence of organizational decision makers in the transformation process has been less studied. MATERIALS This study reports findings from semi-structured interviews with decision makers on the implementation of recovery in Canada. DISCUSSION Decision makers view community-based services as most open to recovery-based approaches, and front-line providers as pivotal in implementing system change. Decision makers described their own role as limited to providing overall orientation and funding. CONCLUSIONS The shift to recovery must include active leadership from decision makers as a catalyst to change.
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Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, McGill University, Montreal, Canada.
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Abstract
In the last 10 years the concept of recovery has entered the discussion on mental health. Since then it has been surrounded in debate - from advocates who suggest that there is a need to build mental health services on recovery principles, to people who suggest that there is insufficient 'empirical' evidence to support a reorientation of services. The focus of this article is on exploring the concept of recovery as both a process and an approach to care.
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Affiliation(s)
- Agnes Higgins
- School of Nursing and Midwifery, Trinity College, Dublin
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Jacobson N. [Recovery in mental health policy and practice: an implementation primer]. SANTE MENTALE AU QUEBEC 2007; 32:245-264. [PMID: 18253671 DOI: 10.7202/016519ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
With the publication of Quebec's Plan d'Action en Santé Mentale 2005-2010 the province announced an intent to develop a recovery-oriented mental health system. This article provides planners in Quebec, and elsewhere, with an overview of issues pertinent to recovery implementation. It reviews examples of system-level guidelines, program models, practitioner competencies, and measurement tools designed to promote a recovery orientation and suggests how these tools might be used by those charged with implementing recovery in their own jurisdictions. Finally, it raises some of the hard questions about meaning and power that must be addressed during the implementation process.
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Affiliation(s)
- Nora Jacobson
- Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario
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Andresen R, Caputi P, Oades L. Stages of recovery instrument: development of a measure of recovery from serious mental illness. Aust N Z J Psychiatry 2006; 40:972-80. [PMID: 17054565 DOI: 10.1080/j.1440-1614.2006.01921.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In order to realize the vision of recovery-orientated mental health services, there is a need for a model and a method of measuring recovery as the concept is described by mental health consumers. A preliminary five-stage model based on consumer accounts was developed in an earlier study by the authors. This next stage of the research program describes the development and initial testing of a stage measure which, when validated, can be used in testing that model. METHOD Existing measures of recovery were reviewed to assess their concordance with the model, and a new measure, the Stages of Recovery Instrument (STORI) was subsequently developed. A postal survey was conducted of 94 volunteers from the NISAD Schizophrenia Research Register. Participants completed the STORI and measures of mental health, psychological wellbeing, hope, resilience and recovery. RESULTS The STORI correlated with all of the psychological health variables, and the five stage subscales were found to be internally consistent. An ordinal relationship between the stage subscales was demonstrated by the intercorrelations of the subscale scores and the pattern of correlations between the subscales and the other measures. However, a cluster analysis of items revealed an overlap in measurement of adjacent stages, with only three clear clusters emerging. CONCLUSIONS The results provide preliminary empirical validation of the STORI as a measure of the consumer definition of recovery. However, refinement of the measure is needed to improve its capacity to discriminate between the stages of the model. The model could then be comprehensively tested using longitudinal methods and the inclusion of objective measures.
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Affiliation(s)
- Retta Andresen
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
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Kirsh B, Krupa T, Horgan S, Kelly D, Carr S. Making it better: building evaluation capacity in community mental health. Psychiatr Rehabil J 2005; 28:234-41. [PMID: 15690736 DOI: 10.2975/28.2005.234.241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper describes a province-wide initiative aimed at building the capacity of community mental health programs to participate in program evaluation and development by transferring knowledge, promoting discussion and developing resources. Active involvement of stakeholders and evaluation of the current capacity of the field informed the ongoing development of the initiative. Recovery served as a guiding framework for formulating and understanding community mental health outcomes. Despite the interest of the field in evaluation activities, programs were constrained by limited resources and accountability structures. Sustainability of the project would be enhanced by direct work with programs to facilitate application of Continuous Improvement.
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Affiliation(s)
- Bonnie Kirsh
- Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario
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Green CA. Fostering Recovery from Life-Transforming Mental Health Disorders: A Synthesis and Model. SOCIAL THEORY & HEALTH 2004; 2:293-314. [PMID: 23264751 DOI: 10.1057/palgrave.sth.8700036] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In the past, "recovery" from serious mental health problems has been variously defined and generally considered rare. Current evidence suggests that some form of recovery is both possible and common, yet we know little about the processes that differentiate those who recover from those who do not. This paper discusses approaches to defining recovery, proposes a model for fostering, understanding, and studying recovery, and suggests questions for clinicians, researchers, and policy makers. The proposed model is a synthesis of work from the field of mental health as well as from other disciplines. Environment, resources, and strains, provide the backdrop for recovery; core recovery processes include development, learning, healing, and their primary behavioral manifestation, adaptation. Components facilitating recovery include sources of motivation (hope, optimism, and meaning), prerequisites for action (agency, control, and autonomy), and capacity (competence and dysfunction). Attending to these aspects of the recovery process could help shape clinical practice, and systems that provide and finance mental health care, in ways that promote recovery.
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Affiliation(s)
- Carla A Green
- Oregon Health & Science University & The Kaiser Permanente Center for Health Research
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