Personal recovery and socio-structural disadvantage: A critical conceptual review

Despite its seeming breadth and diversity, the bulk of the personal (mental health) recovery literature has remained strangely ‘silent’ about the impact of various socio-structural inequalities on the recovery process. Such an inadequacy of the empirical literature is not without consequences since the systematic omission or downplaying, at best, of the socio-structural conditions of living for persons with lived experience of mental health difficulties may inadvertently reinforce a reductionist view of recovery as an atomised, individualised phenomenon. Motivated by those limitations in extant scholarship, a critical literature review was conducted to identify and critique relevant research to problematise the notion of personal recovery in the context of socio-structural disadvantage such as poverty, homelessness, discrimination and inequalities. The review illuminates the scarcity of empirical research and the paucity of sociologically-informed theorisation regarding how recovery is shaped by the socio-structural conditions of living. Those inadequacies are especially pertinent to homelessness research, whereby empirical investigations of personal recovery have remained few and undertheorised. The gaps in the research and theorising about the relational, contextual and socio-structural embeddedness of recovery are distilled. The critical review concludes that personal recovery has remained underresearched, underproblematised and undertheorised, especially in the context of homelessness and other forms of socio-structural disadvantage. Understanding how exclusionary social arrangements affect individuals’ recovery, and the coping strategies that they deploy to negotiate those, is likely to inform anti-oppressive interventions that could eventually remove the structural constraints to human emancipation and flourishing.

Recovery-oriented support work: the perspective of people with lived experience

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-02-2018-0011 ◽

2019 ◽

Vol 14 (6) ◽

pp. 457-468

Author(s):

Dagmar Narusson ◽

Jean Pierre Wilken

Keyword(s):

Mental Health ◽

Lived Experience ◽

Health Care Services ◽

Recovery Process ◽

Structured Interview ◽

Personal Recovery ◽

Content Type ◽

Care Services ◽

Support Work

Purpose The purpose of this paper is to focus on individuals who experience mental health difficulties with the services they receive from “support workers” as part of a personal recovery model, this study will obtain individuals reflections, experiences and opinions on how support helps them stay well and facilitates their personal recovery process. Recovery is seen through the lens of the CHIME framework (Connectedness–Hope–Identity–Meaning–Empowerment). Design/methodology/approach The sample size included 13 people who experience mental health difficulties and are receiving support from mental health care services. The structured interview was designed based on the INSPIRE measurement and the CHIME framework structure. The qualitative content analyses, discursive framing approach and CHIME as a framework made it possible to examine the key activities of recovery-oriented support work revealed in the data. Findings Participants valued the enhancement of hope provided by support workers and also expressed it was important as they were non-judgemental. Identity and meaning in recovery could be enhanced by sharing powerful stories about the individuals’ own life and health experiences, and those of support workers or others. Inclusive behaviour in public spaces and trying out new interest-based activities together were considered as empowering. Originality/value This research helps to understand the value of personal recovery support activities given the societal changes (tension between survival vs self-expression values) and highlights the need for value-based recovery-oriented education and practice.

“From the Edge of the Abyss to the Foot of the Rainbow – Narrating a Journey of Mental Health Recovery” The Process of a Wounded Researcher

The Qualitative Report ◽

10.46743/2160-3715/2017.2993 ◽

2017 ◽

Author(s):

Samantha Robertson ◽

Diane Carpenter ◽

Maggie Donovan-Hall

Keyword(s):

Mental Health ◽

Lived Experience ◽

Mental Health Recovery ◽

Clinical Settings ◽

Management Skills ◽

Positive Identity ◽

Treatment Plans ◽

The Uk ◽

In the UK, mental health service users are asked to “tell their stories” within clinical settings as a tool for diagnosis, formulation and treatment plans. Retelling, reliving and reflecting on traumatic and distressing experiences is not a benign activity. Yet the process of reframing lived experience within a personal narrative could support the development of: a more positive identity; self-management skills and improved social connections (Slade, 2009) and therefore contribute to mental health recovery. This is an exploration of my process as a wounded researcher in the development of a version of my narrative as an autoethnography. I developed a series of 54 vignettes that described memories of my lived experience. To start, I used memorable quotes - the voices of others within my narrative. Developing and analyzing my autoethnography was visceral. It highlighted aspects of my process (and the likely process of others) and raised many unresolved dilemmas. For example: what was left out or left unsaid and the issue of “narrative truth” (Craib, 2004); reordering the vignettes for coherence; the role of relational ethics; and the impact on my identity of this difficult on-going process. It impacted on my mental health, but it has been a crucial part of my recovery.

The Lived Experience of Recovery: The Role of Health Work in Addressing the Social Determinants of Mental Health

Canadian Journal of Community Mental Health ◽

10.7870/cjcmh-2019-018 ◽

2020 ◽

pp. 1-17

Author(s):

Colleen Reid ◽

Nancy Clark ◽

Ania Landy ◽

Maya Alonso

Keyword(s):

Mental Health ◽

Lived Experience ◽

Social Determinants ◽

Recovery Process ◽

Well Being ◽

Policy Framework ◽

Health Work ◽

Policy And Practice ◽

The Social ◽

Recovery is a policy framework for mental health in Canada. Key challenges to the integration of recovery include a gap in knowledge about the work that people do to promote their health and well-being in the context of living with mental ill health. This study used Photovoice to explore the lived realities of people living with mental ill health and the impact of the social determinants on their recovery process. Findings from this study inform policy and practice on promoting health work as an important dimension of recovery and community inclusion.

The lived experience of art making as a companion to the mental health recovery process

Disability and Rehabilitation ◽

10.3109/09638288.2010.505998 ◽

2010 ◽

Vol 33 (8) ◽

pp. 652-660 ◽

Cited By ~ 45

Author(s):

Theresa Van Lith ◽

Patricia Fenner ◽

Margot Schofield

Keyword(s):

Mental Health ◽

Lived Experience ◽

Recovery Process ◽

Mental Health Recovery ◽

Art Making

Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001622 ◽

2020 ◽

pp. bmjmilitary-2020-001622 ◽

Cited By ~ 1

Author(s):

Dominic Murphy ◽

C Williamson ◽

J Baumann ◽

W Busuttil ◽

N T Fear

Keyword(s):

Mental Health ◽

Social Support ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Increased Risk ◽

Post Traumatic ◽

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

Assessing the impact of the European resilience curriculum in preschool, early and late primary school children

School Psychology International ◽

10.1177/01430343211025075 ◽

2021 ◽

pp. 014303432110250

Author(s):

Celeste Simões ◽

Anabela C. Santos ◽

Paula Lebre ◽

João R. Daniel ◽

Cátia Branquinho ◽

...

Keyword(s):

Mental Health ◽

Intervention Group ◽

Well Being ◽

Primary School Children ◽

Control Group ◽

Physical And Mental Health ◽

Quasi Experimental ◽

Prosocial Behaviours ◽

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.

The importance of peer support in the recovery process of persons with mental disorders

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1025 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Stimac Grbic ◽

I Pavic Simetin ◽

A Istvanovic

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Peer Support ◽

Community Intervention ◽

Recovery Process ◽

Therapeutic Interventions ◽

Hospital Treatment ◽

Personal Recovery

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.

Recovery colleges: long-term impact and mechanisms of change

Mental Health and Social Inclusion ◽

10.1108/mhsi-01-2021-0002 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Holly Thompson ◽

Laura Simonds ◽

Sylvie Barr ◽

Sara Meddings

Keyword(s):

Mental Health ◽

Lived Experience ◽

Positive Impact ◽

Evidence Base ◽

College Attendance ◽

Personal Recovery ◽

Structured Interviews ◽

Content Type ◽

Educational Paradigm ◽

Long Term Impact

Purpose Recovery Colleges are an innovative approach which adopt an educational paradigm and use clinician and lived experience to support students with their personal recovery. They demonstrate recovery-orientated practice and their transformative role has been evidenced within mental health services. The purpose of this study is to explore how past students understand the influence of the Recovery College on their on-going recovery journey. Design/methodology/approach An exploratory, qualitative design was used and semi-structured interviews took place with 15 participants. Data was analysed using the “framework method” and inductive processes. Findings All participants discussed gains made following Recovery College attendance that were sustained at one year follow-up. Three themes emerged from the data: Ethos of recovery and equality; Springboard to opportunities; and Intrapersonal changes. Originality/value This research explores students’ experiences a year after attendance. This contrasts to most research which is completed immediately post course. This study contributes to the emergent evidence base highlighting the longitudinal positive impact of Recovery Colleges. This study is of value to those interested in recovery-oriented models within mental health. Recovery Colleges are gaining traction nationally and internationally and this research highlights processes underlying this intervention which is of importance to those developing new Recovery Colleges.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-05-2021-0046 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Karen Louise Bester ◽

Anne McGlade ◽

Eithne Darragh

Keyword(s):

Mental Health ◽

Lived Experience ◽

Social Care ◽

The Body ◽

Bibliographic Databases ◽

Service Users ◽

Content Type ◽

Practitioner Attitudes ◽

Health And Social Care ◽

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Consumer-run services research and implications for mental health care

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796016000287 ◽

2016 ◽

Vol 25 (5) ◽

pp. 410-416 ◽

Cited By ~ 8

Author(s):

S. P. Segal ◽

S. L. Hayes

Keyword(s):

Mental Health ◽

Lived Experience ◽

Self Determination ◽

Functional Improvement ◽

Way Of Life ◽

Services Research ◽

Self Help ◽

Mental Health Consumers ◽

The Individual ◽

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. ‘Nothing about us without us’ is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims lived experience. In considering the effectiveness of CRSs, fidelity should be defined by the extent to which the organisation's process conveys agency. Unidirectional helping often does for people what they can do for themselves, stealing agency. The consequence of the lack of fidelity in CRSs to the origins of the self-help movement has been a general finding in multisite studies of no or little difference in outcomes attributable to the consumer service. This, from the perspective of the research summarised herein, results in the mixing of programmatic efforts, some of which enhance outcomes as they are true mutual assistance programmes and some of which degrade outcomes as they are unidirectional, hierarchical, staff-directed helping efforts making false claims to providing agency. The later CRS interventions may provoke disappointment and additional failure. The indiscriminate combining of studies produces the average: no effect.