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Badu N, Usher K, Rice K, Schutte N, Islam MS. An exploration of the concept of mental health recovery: Insights from practitioners and trainees. Int J Soc Psychiatry 2023; 69:1176-1184. [PMID: 36786372 DOI: 10.1177/00207640231152752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Recovery concepts were conceived by, and for, people living with mental health issues. Practitioners are key in translating recovery principles into action. Therefore, practitioners' perceptions should be routinely assessed to facilitate in-service training, professional development, and curriculum redesign. AIM To explore practitioners' and trainees' current perspectives regarding the concept of recovery. METHODS The study used a qualitative exploratory design with in-depth interviews to explore ten fully trained practitioners and eight trainees' perspectives on recovery. RESULTS The findings revealed a shared understanding of recovery among practitioners and trainees. Many responses explained recovery as a process involving internal and external conditions, however, some revealed medically oriented perspectives and/or were unclear about recovery terminologies. CONCLUSIONS There is convergence and growing acceptance of the recovery practice principles among practitioners and trainees. However, the results suggest that the recovery principles/terminologies have not yet been universally adopted. IMPLICATIONS FOR PRACTICE AND RESEARCH Continuous training on recovery principles is needed, incorporating emerging terminologies and principles. Also, education providers are encouraged to continue to review their training to incorporate emerging issues and trends in recovery-oriented practice. Finally, research is needed to enhance the development and delivery of recovery-focused practice.
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Affiliation(s)
- Naomi Badu
- School of Health, Faculty of Medicine and Health, University of New England, Australia
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Australia
| | - Kylie Rice
- School of Psychology, Faculty of Medicine and Health, University of New England, Australia
| | - Nicola Schutte
- School of Psychology, Faculty of Medicine and Health, University of New England, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Australia
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Kronkvist MB, Forsberg KA, Rämgård M, Sandlund M, Janarv T, Dahlqvist Jönsson P. User participation in decision-making – a qualitative intervention study on mental health professionals’ experiences. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-11-2021-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study was to describe mental health professionals’ experiences of changes in attitudes towards, and knowledge about, users of mental health-care recovery and decisional participation in clinical practice after an educational intervention.
Design/methodology/approach
Users of mental health care want to participate in decisions regarding their own mental health care. Shared decision-making as a method is coherent with recovery orientation in mental health services and results in better-informed patients and fewer conflicts regarding decisions. A qualitative intervention study was designed to evaluate changes in attitudes and knowledge about mental health recovery in Sweden. Nine participants were interviewed, and the data were analysed by content analysis.
Findings
Three categories were generated from the analysis: Increased theoretical knowledge, changing attitudes about practical approaches and the significance of social factors in recovery.
Originality/value
When shared decision-making is to be implemented in mental health, professionals need to gain knowledge about recovery and need to adopt changed roles as health professionals. Educational interventions therefore seem necessary if such changes are to happen.
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Gyamfi N, Bhullar N, Islam MS, Usher K. Models and frameworks of mental health recovery: a scoping review of the available literature. J Ment Health 2022:1-13. [PMID: 35535928 DOI: 10.1080/09638237.2022.2069713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/11/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The recovery approach involves providing a holistic and integrated service that is centered on and adapts to the aspirations and needs of consumers, who are seen as the expert on their health and well-being. Evidence is needed to address the current ambiguities related to the concept of recovery and its application. AIM A scoping review was conducted to identify papers describing theories, models, and frameworks of recovery to delineate the central domains of recovery. METHODS Three literature search strategies were used: electronic database searching; hand-searching of key journals; and a reference list review of included papers. Inclusion criteria outlined theories, models and frameworks developed to support consumers' recovery and those supporting mental health professionals (MHPs) to deliver recovery-oriented services. RESULTS Twelve studies (eleven articles and one book) were included in the review. The dimensions of recovery were synthesized into a framework named the Consolidated Framework for Recovery-oriented Services (CFRS). There are three domains within the framework: mechanisms/strategies; recovery as an internal process; and recovery as an external process. Each of these domains, as well as their relationships, are discussed. CONCLUSIONS The CFRS can be used by practitioners, researchers, funders, and collaborative members to conceptualize, implement, and evaluate recovery-oriented services.
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Affiliation(s)
- Naomi Gyamfi
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
| | - Navjot Bhullar
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, Australia
| | - Md Shahidul Islam
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
| | - Kim Usher
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
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Badu E, O'Brien AP, Mitchell R, Osei A. A Qualitative Study of Consumers' Experiences of the Quality of Mental Health Services in Ghana. Issues Ment Health Nurs 2022; 43:172-183. [PMID: 34129434 DOI: 10.1080/01612840.2021.1931584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Integrating consumers' experiences into quality mental health service assessment is relevant to improve service outcomes. Despite this, limited studies have attempted to explore consumers' experiences, particularly in developing countries, such as Ghana. This paper aims to explore consumers' subjective experiences of the quality of mental health services. A qualitative method involving in-depth interviews was used to collect data from 21 consumers of mental health services. Thematic analysis was used to analyse the data, which is discussed using a realistic evaluation approach. The study identifies four themes, 33 inductive codes and 594 references. The themes used to interpret the verbatim narratives are the available mental health services, therapeutic interaction with the professionals, competency and skills of the professionals, and the changes experienced in the consumers' lives. The study indicates that the mental health services aim to provide a range of treatments and medications as well as recovery-oriented services, using mechanisms such as ensuring an effective therapeutic relationship and improving technical competency and skills. The contextual factors and the mechanisms have helped to achieve some changes in the lives of consumers (increased satisfaction, reduced symptoms, improved functionality, feeling normal, improved living skills and self-care, work and capabilities, and social inclusion). The study concludes that policymakers and clinicians should integrate evidence-based recovery services, principles and values into the existing mental health services. The mechanisms used to promote quality of mental health services should be strengthened, through periodic monitoring and evaluation, using approaches such as sensor data capturing, to ensure good coordination and continuity.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Anthony Paul O'Brien
- School Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Rebecca Mitchell
- Health & Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Macquarie Park, NSW, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Badu E, O'Brien AP, Mitchell R, Osei A. A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes. BMC Health Serv Res 2021; 21:1013. [PMID: 34563183 PMCID: PMC8466714 DOI: 10.1186/s12913-021-06993-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/07/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06993-1.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
| | | | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Zanato S, Miscioscia M, Traverso A, Gatto M, Poli M, Raffagnato A, Gatta M. A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit. Healthcare (Basel) 2021; 9:1241. [PMID: 34575015 PMCID: PMC8465245 DOI: 10.3390/healthcare9091241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. METHODS 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. RESULTS Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. CONCLUSIONS These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.
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Affiliation(s)
- Silvia Zanato
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (S.Z.); (A.T.); (A.R.); (M.G.)
| | - Marina Miscioscia
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (S.Z.); (A.T.); (A.R.); (M.G.)
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy; (M.G.); (M.P.)
| | - Annalisa Traverso
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (S.Z.); (A.T.); (A.R.); (M.G.)
| | - Miriam Gatto
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy; (M.G.); (M.P.)
| | - Mikael Poli
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy; (M.G.); (M.P.)
| | - Alessia Raffagnato
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (S.Z.); (A.T.); (A.R.); (M.G.)
| | - Michela Gatta
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (S.Z.); (A.T.); (A.R.); (M.G.)
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Badu E, O’Brien AP, Mitchell R. An Integrative Review of Recovery Services to Improve the Lives of Adults Living with Severe Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168873. [PMID: 34444622 PMCID: PMC8393579 DOI: 10.3390/ijerph18168873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/02/2022]
Abstract
There is an increasing call for recovery-oriented services but few reviews have been undertaken regarding such interventions. This review aims to synthesize evidence on recovery services to improve the lives of adults living with severe mental illness. An integrative review methodology was used. We searched published literature from seven databases: Medline, EMBASE, PsycINFO, CINAHL, Google Scholar, Web of Science, and Scopus. Mixed-methods synthesis was used to analyse the data. Out of 40 included papers, 62.5% (25/40) used quantitative data, 32.5% used qualitative and 5% (2/40) used mixed methods. The participants in the included papers were mostly adults with schizophrenia and schizoaffective disorder. This review identified three recovery-oriented services—integrated recovery services, individual placement services and recovery narrative photovoice and art making. The recovery-oriented services are effective in areas such as medication and treatment adherence, improving functionality, symptoms reduction, physical health and social behaviour, self-efficacy, economic empowerment, social inclusion and household integration. We conclude that mental health professionals are encouraged to implement the identified recovery services to improve the recovery goals of consumers.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence: ; Tel.: +61-452414632
| | - Anthony Paul O’Brien
- Faculty of Health, Southern Cross University, East Lismore, NSW 2480, Australia;
| | - Rebecca Mitchell
- Faculty of Business and Economics, Macquarie University, Macquarie Park, NSW 2109, Australia;
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Chang YC, Chang LH, Hsu ST, Huang MW. Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study. BMC Psychiatry 2021; 21:154. [PMID: 33726694 PMCID: PMC7962288 DOI: 10.1186/s12888-021-03152-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/04/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals' experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. METHODS Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. RESULTS The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals' self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients' lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education. CONCLUSIONS To date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.
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Affiliation(s)
- Yen-Ching Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Hui Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Su-Ting Hsu
- grid.414813.b0000 0004 0582 5722Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Meng-Wen Huang
- Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
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