World Mental Health: Problems and Priorities in Low-Income Countries

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised.Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems.Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods.Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence.Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention.Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.

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Recovery from severe mental health problems: A systematic review of service user and informal caregiver perspectives

10.1101/2021.05.13.21257172 ◽

2021 ◽

Author(s):

Norha Vera San Juan ◽

Petra C Gronholm ◽

Margaret Heslin ◽

Vanessa Lawrence ◽

Matt Bain ◽

...

Keyword(s):

Mental Health ◽

Low Income ◽

Mental Health Problems ◽

Grey Literature ◽

Health Problems ◽

Social Needs ◽

Low Income Countries ◽

Service Development ◽

Service Users ◽

Personal Recovery

Introduction: The recovery approach aims to have users′ perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised. Aims: This review aimed to develop a framework and contextualise service users′ and informal caregivers′ understanding of recovery from severe mental health problems. Methods: A systematic search of 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through grey literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods. Results: Sixty-two studies were analysed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. Recovery domains included Legal, political and economic recovery; Social recovery; Individual recovery; and Clinical recovery experience. Service users′ definitions of recovery tended to prioritise social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasised individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence. Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritised populations, or included caregivers′ perspectives. These are important gaps in the literature that require further attention.

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Mental health services for children in public care and other vulnerable groups: Implications for international collaboration

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104510377715 ◽

2010 ◽

Vol 15 (4) ◽

pp. 555-571 ◽

Cited By ~ 14

Author(s):

Panos Vostanis

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Low Income ◽

International Collaboration ◽

Mental Health Problems ◽

Health Problems ◽

Service Planning ◽

Low Income Countries ◽

Public Care

Children in public care and other vulnerable young groups (homeless, adopted, refugees) are increasingly becoming the focus of policy and service planning. There is strong evidence that all these client populations have high rates of mental health problems which are closely associated with other needs. We also have good knowledge on the factors that predispose individuals to and maintain mental health problems, as well as on the reasons for their not easily accessing and engaging with services. There is less evidence on the effectiveness of interventions or service models, although some interesting patterns are beginning to emerge. These include the need for inter-agency commissioning, clear care pathways, designated provision, applied therapeutic interventions, training for carers and frontline practitioners, and multi modal programmes. This paper discusses these issues, as well as ways forward, both for systems with relatively well developed child mental health services and for low-income countries. Service quality can be greatly strengthened by international collaboration on policy, practice and research networks, training and research.

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