Enhancing recovery orientation within mental health services: expanding the utility of values

Author(s):  
Virginia C Williams ◽  
Frank P. Deane ◽  
Lindsay G Oades ◽  
Trevor P Crowe ◽  
Joseph Ciarrochi ◽  
...  

Purpose – The purpose of this paper is to review the role of values within contemporary mental health recovery services, outlining the rationale and approach for a specific values-focused staff intervention to promote autonomously motivated uptake of recovery-oriented practices. Design/methodology/approach – Recent advances in understanding of the enduring gap between ideological and applied acceptance of personal recovery within mental health services are outlined, with particular focus on the limited utility of training programmes as a means to promoting implementation. Frequently, mental health service organisations have adopted recovery policies in a primarily “top-down” fashion standing in contrast to the high autonomy approaches espoused for service users. Drawing from the extensive research related to Self-Determination Theory (SDT), a complementary focus on “bottom-up” approaches that enable service-delivery staff to develop a sense of autonomy for changed work practices in order to increase implementation is indicated. Findings – Application of values-focused interventions for mental health recovery staff parallel to the approaches acknowledged as effective for service participants are likely to be effective in promoting implementation of newly trained recovery-oriented practices. Research limitations/implications – The paper is conceptual in nature and therefore reflects the priorities and views of the authors but the paper draws together well-established literature to develop a novel approach to a highly relevant issue. Practical implications – Training transfer and implementation of evidence-based practice are issues with broad relevance and the explication of additional methods to promote employee uptake of new practices is a key priority for organisations and policy makers. Social implications – Significant social implications include furthering the discussion and insight to the development of effective delivery of mental health services to individuals accessing service. Originality/value – A novel aspect of this paper is the provision of a theoretical rationale for the application of SDT as a framework for understanding the continuing challenge of recovery operationalisation, which despite the conceptual good-fit, currently stands as an association not well exploited. Moreover, this paper proposes values-clarification and coaching as a specific and reproducible approach to enhancing recovery-oriented service provision.

2016 ◽  
Vol 20 (3) ◽  
pp. 149-152
Author(s):  
Emma Watson

Purpose – The purpose of this paper is to share the experiences and reflections of a peer support worker over the course of a day working in mental health services. Design/methodology/approach – A narrative approach has been taken to structure reflections based on the experience of returning to work after taking sick leave. Findings – Reflections are offered based on the process of returning to work and the way that this experience sheds light on personal recovery. Originality/value – This paper adds to the small number of accounts of the experiences of peer support working in mental health services and as such is highly original.


Kuntoutus ◽  
2020 ◽  
Vol 43 (3) ◽  
pp. 34-50
Author(s):  
Mari Kivistö

Mielenterveyden häiriöiden merkityksen kasvaminen sekä haasteet mielenterveyspalveluiden järjestämisessä ovat tehneet sähköisten mielenterveyspalveluiden kehittämisestä ja tutkimuksesta ajankohtaista. Nyt COVID-19-pandemia on lisännyt sähköisten mielenterveyspalveluiden tarvetta mutta tuonut samalla näkyviksi organisaatioiden eriytyvät lähtökohdat sähköisten mielenterveyspalveluiden järjestämisessä. Tämän tutkimuksen tavoitteena oli kuvata sähköisten mielenterveyspalveluiden vaikutuksia palvelunkäyttäjien näkökulmasta sekä tunnistaa positiivisesti vaikuttavien sähköisten mielenterveyspalveluiden edellytyksiä. Tutkimus toteutettiin kansainvälisistä tutkimusartikkeleista (n = 27) tietoa kokoavana integroivana kirjallisuuskatsauksena. Analyysimenetelmänä sovellettiin teemoittelua ja tulkintakehyksenä toipumisorientaation (recovery) viitekehystä. Kirjallisuuskatsauksen perusteella sähköiset mielenterveyspalvelut tarjoavat mahdollisuuksia toipumiseen ja sen tukemiseen, mutta toipuminen ehdollistuu sähköisiin mielenterveyspalveluihin liittyvissä toimintakäytännöissä. Tulokset jäsennettiin yksilön laaja-alaista toipumista ja toipumista kokonaisvaltaisesti tukevia sähköisiä mielenterveyspalveluja ilmentävinä yläteemoina, joista edelliseen sisällytettiin alateemat kliininen toipuminen, henkilökohtainen toipuminen ja osallisuuden vahvistuminen ja jälkimmäiseen tietoperusteisuus, tilannekohtaisuus, tuen tarjoaminen, vuorovaikutteisuus, henkilökohtaisuus ja asiakaslähtöisyys. Kirjallisuuskatsaus osoittaa, että tutkimustarpeista huolimatta tiedämme jo paljon tekijöistä, jotka mahdollistavat toipumista edistävien sähköisten mielenterveyspalveluiden toteuttamista. Tätä tietoa on tarpeen hyödyntää myös COVID-19-pandemian muuttamassa toimintaympäristössä. Tulosten sovellettavuutta rajoittaa tutkimustiedon pirstaleisuus sekä se, että tutkimukset kohdistuivat vain henkilöihin, joilla oli pääsy, kyky ja halu sähköisten mielenterveyspalveluiden käyttöön.Abstract Digital mental health services and recovery. An Integrative literature review The increase of mental health disorders and the challenges of delivering mental health services have made the development and research of digital mental health services topical. Currently, the COVID-19 pandemic has increased the need for digital mental health services, but at the same time it has made visible the various potential of organizations for providing digital services. The aim of this study is to describe the effects of digital mental health services from the service users’ perspective and to identify the features of the services that make an impact. The study was conducted as an integrative literature review of international research articles (n = 27). The method used was thematic analysis and a recovery orientation was applied as the interpretation framework. Based on the review, digital mental health services offer opportunities for and support the recovery of service users, but the recovery is conditioned on digital mental health practices. The results were presented as two main-themes: a person’s extensive recovery and digital mental health services that support recovery holistically. The former includes the sub-themes of clinical recovery, personal recovery and participation, and the latter the sub-themes of knowledge orientation, situationality, provision of support, interactivity, personality and client orientation. The integrative literature review shows that despite the need for future research, we already know a great deal about the factors that enable the implementation of digital mental health services that promote recovery. This knowledge needs to be utilized in the operating environment of mental health services, which is currently changing because of the COVID-19 pandemic. The review has some limitations, because research on the subject is fragmentary and the studies involved in the review were only targeted at persons with access to digital mental health services and the ability and motivation to use them. Keywords: mental health, digital services, recovery, integrative literature review


2010 ◽  
Vol 16 (6) ◽  
pp. 459-467 ◽  
Author(s):  
Rani Bora ◽  
Saija Leaning ◽  
Alison Moores ◽  
Glenn Roberts

SummaryMental health services are increasingly expected to engage in a process of cultural change to fulfil guiding values and hopes for choice, personalisation, self-determination, social inclusion and personal recovery. It is unclear how this will be achieved. This transformational agenda also engages with an ambition for progressive change in practice across mental health professions to support people in self-care and self-management, based on a new relationship between practitioners and users of mental health services. There is little consistent guidance on the content of recovery-oriented and socially inclusive practice and what may be the new competencies and skills that would most effectively support recovery outcomes. Life coaching to support recovery for people with mental health needs is emerging as a creative possibility with considerable potential to support this ambition. This is an exploratory article which offers an overview of experience so far, suggests further routes for development and, in line with the College's Fair Deal campaign, underlines the need for evaluation.


2017 ◽  
Vol 16 (4) ◽  
pp. 159-168 ◽  
Author(s):  
Rebecca Collins ◽  
Caitlin Notley ◽  
Tim Clarke ◽  
Jon Wilson ◽  
David Fowler

Purpose Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the purpose of this paper is to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services. Design/methodology/approach The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analysis of the “Have Your Say” event data which explored perceptions of CAMHS and future service re-design. Data were thematically analysed. Findings Knowledge of the existence and purpose of CAMHS was variable. Participants wanted accessible information about services, rights, confidentiality and for this to be provided in multiple media. Young people wanted staff who were easy to talk to, genuine, understanding and who valued their insights. Participants wanted to be offered choice about appointments, location and timing. An ideal mental health service was described as a “one-stop-shop” of co-locality and multi-agency collaboration. Young people clearly expressed a desire to influence the design and delivery of the radical service re-design and to be embedded in its development. Practical implications The results highlighted multiple problems with CAMHS provision and provided a clear justification for the re-design of services. Originality/value This was a novel approach demonstrating the importance, utility and power of effective participatory practices for informing the re-design of services.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eleni Sofouli

Purpose This paper aims to review how the recovery concept among cultural and ethnic minorities has been conceptualized within extant literature. Drawing on the Connectedness; Hope and optimism about the future; Identity; Meaning in life; and Empowerment (CHIME) framework, this paper highlights the cultural adaptations of supported housing – a prominent recovery-oriented intervention – as it has been implemented in a multicultural western country and delineates the future implications for research, policy and practice in regard to mental health recovery interventions for cultural and ethnic minorities. Design/methodology/approach An online search was performed to identify recent empirical studies published in English in peer-reviewed journals. Findings The reviewed studies confirmed what Leamy et al. (2011) had initially reported: spirituality and support networks can act as enablers or inhibitors in the recovery process of mental health services users with diverse cultural backgrounds. The stigma surrounding mental illness is a key challenge that skews the recovery experience among minority groups. Other cultural-specific factors influencing recovery include linguistic peculiarities of the maternal language and gender. The cultural adaptation of a recovery-oriented intervention is not only feasible and effective but also challenging. Originality/value By studying the cultural variations of mental health recovery, the intention is to inform mental health practitioners and other key stakeholders of the distinct cultural components that influence the recovery process, thereby promoting the development of culturally sensitive, accessible and effective recovery-oriented interventions. It is worth noting that providing culturally appropriate mental health services could be viewed as a human right issue for minority groups.


2018 ◽  
Vol 23 (4) ◽  
pp. 246-252
Author(s):  
Susan Atkinson ◽  
Benjamin Collis ◽  
Justine Schneider

Purpose The purpose of this paper is to focus on the findings of a review of the Learning Advice Service which provided mainstream learning opportunities and individual support to people using mental health services. The service was decommissioned after 15 years due to service reconfiguration and cost-cutting. Design/methodology/approach Semi-structured interviews were carried out with members of the Learning Advisor’s caseload by a researcher with no affiliation to the NHS or the Institute of Mental Health and no connection to the clients. The researcher also transcribed and analysed the interviews. This ensured that there could be no personal or positive bias. The clients faced significant mental health challenges and used the Learning Advice Service to facilitate and support their entry into mainstream learning. Findings The service enabled individuals facing significant mental health challenges to gain access to adult, community, distance and further and higher education facilitated by individual advice, guidance and support. They were able to broaden their sense of identity beyond that of someone using mental health services and to widen their social and educational base. Research limitations/implications Lack of funding within mental health services to continue this type of work limits research which would further explore the value of mainstream education in the recovery of people with a mental health diagnosis. While this cohort was small because of funding and staffing constraints, it would be possible to generalise to a larger scale, using flexible person-centred ways of working if the will, staffing and funding were made available. Further research is certainly indicated as current practice has moved away from mainstream inclusion to discrete provision with associated limitations. Practical implications The practical implications include the development of autonomy and the development of a sense of identity that is separate from a mental health diagnosis and where appropriate to gain qualifications and further the student’s knowledge. Social implications Social implications include broadening one’s experience, developing communication skills in a broad context, transferable skills, independence and strengthening one’s sense of identity separate from a mental health diagnosis. Originality/value Individuals from a variety of educational and other backgrounds who expressed an interest in pursuing education in mainstream facilities were encouraged and supported in doing so in flexible and individual ways. It appears to be more usual that people using mental health services are encouraged to learn in groups comprising other people using such services, frequently on mental health service premises with associated limitations.


2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
C Le Boutillier ◽  
V Bird ◽  
M Leamy ◽  
J Williams ◽  
M Slade

2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.


2017 ◽  
Vol 45 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Laura Moloney ◽  
Daniela Rohde

Purpose Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme. Design/methodology/approach Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health. Originality/value This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.


2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.


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