Supporting Recovery Orientated Services for People With Severe Mental Illness

Family involvement moderates the relationship between perceived recovery orientation of services and personal narratives among Chinese with schizophrenia in Hong Kong: a 1-year longitudinal investigation

PURPOSE

Family has been found to have an influential role on clinical and recovery outcomes of people with schizophrenia. While recovery-oriented services can facilitate service users to develop a rich and positive identity, it is unclear how different levels of family involvement may interact with recovery-oriented services in affecting personal recovery. The present study aimed to examine how family involvement moderates the relationship between perceived recovery-orientation of services and personal narratives of Chinese people in Hong Kong who had recent onset of schizophrenia spectrum disorder longitudinally.

METHOD

Multi-method approach (semi-structured interview, researcher ratings, self-report measures) was adopted. 167 participants completed assessments at baseline; 93 and 68 of them were retained at 6-month and 12-month follow-up assessment, respectively.

RESULTS

Baseline perceived recovery orientation of services significantly predicted richer personal narratives at 6-month follow-up when baseline family involvement was optimal (B = 0.26, p = 0.03, 95% CI [0.02-0.48]). As to 12-month assessment, baseline perceived recovery orientation of services significantly predicted poorer personal narratives when family was perceived as under-involved at baseline (B = - 0.45, p = 0.02, 95% CI [- 0.88 to - 0.07]).

CONCLUSION

Without proper family involvement, recovery-oriented services could be ineffectual in facilitating the development of rich personal narratives for Chinese people in Hong Kong.

Psychosocial well-being construct in people with severe mental disorders enrolled in supported employment programs

The main purpose of this prospective study is to validate the construct of psychosocial well-being (PSWB) for people with severe mental disorders enrolled in Supported Employment (SE) programs. This paper also aims to assess the impact of job acquisition on PSWB after obtaining competitive employment. A two-phase study approach was used and 231 individuals with severe mental disorders enrolled in SE programs who took part in both phases. The shortened versions of the Psychological Well-Being Scale (Keyes et al. in J Personal Soc Psychol, 82(6):1007-1022, 2002; Ryff and Keyes in J Personal Soc Psychol 69(4):719-727, 1995) and the Social Well-Being Scale (Keyes in Soc Psychol Q 61(2):121-140, 1998) were used. The PSWB's multidimensionality construct was confirmed. The results of repeated measure ANOVA analyses revealed that job acquisition, as well as, being involved in a work-seeking process increase the PSWB of people with severe mental disorders. Employment specialists might find clinical utility in using this validated tool for assessing PSWB in their clients with severe mental disorders. In a recovery oriented approach to psychiatric services and SE programs, clinicians and employment specialists should continue to encourage their clients in their work integration process even though they may not all obtain competitive employment quickly.