Search

This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

In 2019, the World Health Organization urged a global shift towards recovery‐focused practices in mental health care. In Western nations, this transition often prioritised individualism over collectivism. In contrast, collectivist societies prioritise recovery through community and social support. This study explored mental health recovery from the perspectives of consumers, carers and registered nurses in a mainly collectivist society (Saudi Arabia) using a qualitative exploratory descriptive design. Sixteen consumers, ten carers and eight registered nurses participated in online semi‐structured interviews. Inductive thematic analysis was employed to analyse English‐translated versions of the 34 interviews. Consolidated criteria for reporting qualitative studies 32‐item checklist were used. The study found that recovery was perceived as a process of transforming towards living a meaningful life of goals and values supported by trusted people who share moments of comfort and empowerment. A unique finding was the 'bond of recovery' a collectivist value that aid consumers' community integration in society. Saudi consumers' experiences of recovery were similar to consumers' movement narratives of recovery. Future research should establish a recovery‐focused educational program that incorporates our findings into a recovery‐oriented approach. This will facilitate providing a collaborative care between consumers, carers and nurses that centres around consumers' recovery goals and values. [ABSTRACT FROM AUTHOR]

A significant change in mental health care has involved the need to implement recovery-oriented practices and services. However, recovery-oriented care has been poorly defined within acute care mental health settings. The central aims of the study were to increase knowledge about what constitutes a recovery-oriented environment within contemporary acute care units and to inform recovery-oriented nursing practice. Interpretative description was applied to answer the question: What strategies and resources do nurses identify as being most conducive to fostering a recovery-oriented environment in acute care mental health units? Purposive sampling was used to recruit 11 nurses from 6 acute care units. The inclusion criteria included a minimum of 1-year patients and holding active nursing registration. Nursing experience in community-based or chronic care settings and with children and adolescents were exclusion criteria. Six nurses also participated in a focus group. Key aspects of a recovery-oriented acute care environment included understanding the needs of individual patients along with the dynamics of the healthcare team. Nurses had important roles in promoting recovery-oriented environments and reported a need for increased resources to move beyond the bio-medical model and align practice with personal recovery. A recovery-oriented environment was described as a safe, peaceful and holistic environment with adequate space to balance needs for privacy, interaction and activity. This environment is fostered through respectful communication and healthy relationships among team members, patients, family and formal supports. These nurses had the knowledge, skill and desire to promote recovery-oriented environments, yet resources such as leisure activities and group therapy were required to promote personal recovery. [ABSTRACT FROM AUTHOR]

The rate of relapse for people in recovery for substance use disorder is as high as 85% within the first 12 months of recovery, however, research on the lived experience of relapse is limited. The present qualitative study investigated the experience of relapse with people who have Methamphetamine use disorder and the reasons why they returned to recovery. The exploratory study recruited five (n = 5) adults who identified as having Methamphetamine use disorder. All participants had sought treatment for more than 12 months, they were attending an addiction support service, and had experienced a relapse within the past 15 months. Interviews were conducted in which participants were asked an open-ended question about their most recent relapse and the negative consequences associated with their drug use. Data were analyzed using thematic analysis. A return to daily drug use led to negative consequences such as relationship breakdowns, poor mental health and acting in ways that went against the participant's morals and values. This study provides an insight into the types of experiences people who relapse after seeking treatment for Methamphetamine use disorder may have and how these experiences can influence their decision to return to recovery. People who regularly attend a recovery program are still susceptible to relapse. Those who have maintained abstinence for a period of time prior to relapse may be able to assess the negative consequences of their drug use more easily. This prior experience of recovery might influence their decision to stop using again. A return to daily drug use led to negative consequences of substance misuse. The negative consequences encountered by people who relapse may include relationship breakdowns, poor mental health and acting in ways that go against the person's morals and values. The negative consequences of substance misuse can influence people's decisions to return to recovery. People who regularly attend an addiction support service remain vulnerable to relapse. [ABSTRACT FROM AUTHOR]

Context: Best practice guidelines for the recovery and return to work (RTW) of people with mental disorders recommend access to the services of an interdisciplinary team combining pharmacological, psychological and work rehabilitation interventions. In the Canadian context, primary healthcare services are responsible for providing these services for people with common mental disorders, such as depressive or anxiety disorders. However, not everyone has easy access to these recommended primary healthcare services, and previous studies suggest that multiple personal, practice‐related and organizational factors can influence the patient's journey. Moreover, previous studies documented that family physicians often work in silos and lack the knowledge and time needed to effectively manage by themselves patients' occupational health. Thus, the care and service trajectories of these patients are often suboptimal and can have important consequences on the person's recovery and RTW. Objective and Population Studied: Our study aimed to gain a better understanding of the patient journeys and the factors influencing their access to and experience with primary healthcare services while they were on sick leave due to a common mental disorder. Methods: A descriptive qualitative research design was used to understand and describe these factors. Conventional content analysis was used to analyze the verbatim. Results: Five themes describe the main factors that influenced the patient's journey of the 14 participants of this study: (1) the fragmented interventions provided by family physicians; (2) patients' autonomy in managing their own care; (3) the attitude and case management provided by the insurer, (4) the employer's openness and understanding and (5) the match between the person's needs and their access to psychosocial and rehabilitation services. Conclusions: Our findings highlight important gaps in the collaborative practices surrounding the management of mental health‐related sick leave, the coordination of primary healthcare services and the access to work rehabilitation services. Occupational therapists and other professionals can support family physicians in managing sick leaves, strengthen interprofessional and intersectoral collaboration and ensure that patients receive needed services in a timelier manner no matter their insurance coverage or financial needs. Patients of Public Contribution: This study aimed at looking into the perspective of people who have lived or are currently experiencing a sick leave related to a mental health disorder to highlight the factors which they feel hindered their recovery and RTW. Additionally, two patient partners were involved in this study and are now engaged in the dissemination of the research results and the pursuit of our team research programme to improve services delivered to this population. [ABSTRACT FROM AUTHOR]

Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Eating disorders (EDs) remain a major health concern, and their incidence has further increased since the COVID-19 pandemic. Given the equally increasing demands on treatments and service provision and the high levels of relapse post-treatment, it is important that research explore novel and innovative interventions that can further support recovery for individuals with EDs. There is growing evidence that arts interventions are beneficial for recovery from EDs. This study aims to evaluate the feasibility of conducting a stand-up comedy course to support ED recovery. Design/methodology/approach: The study used a qualitative interview study design to evaluate the recovery benefits of participating in stand-up comedy workshops for a pilot group of people in recovery from EDs (n = 10). Findings: The comedy intervention was well-attended and had high acceptability and feasibility. For most individuals, participating in the course had a positive impact, including promoting personal recovery (PR) outcomes across all five elements of the CHIME framework. Unique assets of the course included providing participants with an opportunity to distance themselves from everyday worries of living with an ED; the opportunity to cognitively reframe situations by making them the object of humour; and providing a safe space to (re-)build a positive sense of self. Originality/value: This is the first study, to the best of the authors' knowledge, that evaluates stand-up comedy workshops for ED recovery and further demonstrates the potential of arts interventions and the relevance of PR frameworks in this field. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues. Design/methodology/approach: A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis. Findings: Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice. Practical implications: The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice. Originality/value: This study offers a unique insight into psychologists' perceptions of seclusion and considers the implications of these views. Participants' nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics. [ABSTRACT FROM AUTHOR]

There is a well-established literature examining how perpetrators of child sexual abuse (CSA) neutralise the norms and beliefs that ordinarily prohibit such behaviours. However, there has been substantially less focus on how such techniques of neutralisation might also be applied by people and groups who were not directly involved in the abuse, who we might expect to be more supportive. Drawing on a thematic analysis of an open-ended survey (n=140) and semi-structured interviews (n=21) with adults who experienced childhood sexual abuse this paper examines societal responses to disclosure. Identifying three key techniques of neutralisation, it explores how families, professionals and institutions use wider discourses that deny the victim/survivor, deny or minimise harm and silence by appealing to loyalty. The results demonstrate how significant others can constrain, rather than support, the process of disclosure and recovering from CSA. [ABSTRACT FROM AUTHOR]

Background: The recovery‐oriented care approach in mental health is recognised as the vision for mental health. People with a diagnosis of mental illness value the support and the individualistic approach emphasised in the recovery‐oriented mental health care approach as they believe it facilitates their recovery. However, as a developing country, Botswana has a long way to go in availing mental health care resources to people with mental illness, let alone adopting new mental health approaches such as recovery. Aim: The study aimed to explore the perceptions of nurses working in mental health care facilities of recovery‐oriented mental health care. Methods: Four mental health facilities from Botswana consented to participate in the study. A descriptive qualitative approach was utilised to explore nurses' views on how they perceive recovery from mental illness. Thirty nurses participated in the focus group discussions across the four study sites. All participants consented to participate and to be recorded. Tesch's (in Qualitative enquiry and research design: Choosing among five approaches. 3th ed. SAGE, 2013:198) thematic analysis was used for this study. Results: Three main themes were identified in participants' perceptions of recovery‐oriented care mental health: Recovery from mental illness is possible, the Meaning of recovery from mental illness and Factors facilitating recovery from mental illness. Public Contribution: The study offers a perspective into how nurses perceive recovery‐oriented approaches from a developing country and add to the gap existing in recovery‐oriented mental health care approach from the African context. [ABSTRACT FROM AUTHOR]

Current research views hope as a process that plays a positive role in the recovery of individuals with mental health problems. However, little attention has been given to the role of hope in the lives of their families. We aimed to address that gap. We deployed a qualitative descriptive design and carried out individual interviews with nine family members who supported a relative with mental health problems. A cross‐comparison of the data generated three major themes: understandings of hope; factors that diminish hope and factors that nurture hope. The participants viewed hope as a positive and productive feeling or attitude that was life‐affirming, and empowering. They also associated it with behaviours and dispositions such as attentiveness and empathy and the possibility of a return to a more stable and 'normal' life. The participants experienced hope as initially eroded when their relative was first diagnosed and institutionalized. Hope was further diminished due to the poor communication practices of some mental health professionals and the stress of the caring role itself. On the other hand, hope was nurtured through the support of other family members, friends, neighbours and peers. Acquiring knowledge and understanding about the relative's state of mental health nurtured hope and enabled the participants to have a more meaningful role in their recovery process. Practices of self‐care such as independent activities and counselling also strengthened hope and some mental health professionals played a positive role in supporting these. Most striking about the reports of many of the participants was their assertion of their abiding love for their relative. Their account of their ability to see beyond the illness of their relative was an insight that we did not find in other accounts of the experiences of family members. We highlight the need for family members to have timely access to relevant information about their relatives' illness. We conclude that hope is relational at its core because of the interplay of intrapersonal, interpersonal and social factors that diminish or nurture it over time. Specifically, we propose that friends, neighbours and peer support groups as key actors in nurturing the hope of both family members and their relatives. [ABSTRACT FROM AUTHOR]

Objectives: Self‐harm rates and clinical presentations differ by ethnicity. South Asian women are at risk of self‐harm. Previous research suggested investigating individuals' experiences with self‐harm with qualitative studies in developing self‐harm prevention strategies. This research aims to explore self‐harm experiences among South Asians in the United Kingdom. Design: Qualitative study. Methods: Participants were recruited via third‐sector organizations and online platforms. Semi‐structured interviews were conducted with 11 South Asian individuals with a history of self‐harm living in the United Kingdom. The data were analysed based on a reflective thematic analysis approach. Results: Results revealed four main themes: (1) reasons for self‐harm; (2) recovery journey; (3) culture and mental health; and (4) the transition to suicidal thoughts and behaviours. Reasons for self‐harm included negative life circumstances, social life difficulties, challenges faced during COVID‐19 and mental health problems. Participants described their recovery journey by acknowledging the role of professional help, self‐care, psychoeducation and personal growth, improving social relationships, and faith and spirituality. Cultural factors included generational differences and stigma. Culturally adapted psychological interventions were perceived as promising. The reported transition from self‐harm to suicidal behaviours was linked to experiencing major stressful life events and the use of severe methods of self‐harm. Conclusions: The findings suggest that socio‐cultural factors impact mental health and recovery processes among South Asians. Mental health services should consider improving culturally sensitive clinical practices in responding to self‐harm among South Asian communities. [ABSTRACT FROM AUTHOR]

Recovery is known to be enhanced by meaningful interactions between patients and mental health staff. However, nurses may become distanced from patients, and patients may spend most of their time in inpatient mental health care alone. This study aimed to explore how patients experience the intervention Daily Talks, a patient-driven innovation intended to enhance meaningful interactions between patients and staff. Fourteen in-depth interviews were performed with patients who participated in Daily Talks. The interviews were analysed using reflexive thematic analysis. The results of the participants' experiences of Daily Talks are presented in four themes: 1.Interpersonal and active interaction where individual factors matter 2.A patient-controlled space 3.A multi-use intervention and 4.A part of the daily healthcare structure. Participants stated that Daily Talks improved the relationship between patients and their nursing staff, and they stressed the importance of patients having control over both time and content in the Daily Talks. Daily Talks was used to vent emotions and thoughts, handle situations and create strategies, and become part of a helpful structure. The results support the value of Daily Talks, indicating that Daily Talks may facilitate helpful structures and meaningful relationships between patients and nursing staff. [ABSTRACT FROM AUTHOR]

To examine the lived experiences of young people successfully managing life with ADHD and investigate the applicability of adult models of Recovery to these individuals. Twenty-seven young people aged 15–31 years participated in qualitative interviews. Participants' success was indicated by employment, school attendance, absence of acute mental health episodes, or absence of chronic alcohol or drug use. Thematic analysis identified specific components of their life successes and challenges. The emergent framework comprised four elements: (i) Recovernance (RE) (a portmanteau merging 'Recovery' and 'Maintenance'; ongoing adjustment to maintain one's personal best without an end point); (ii) Personal Optimization (PO) (continuously striving to maximize function and adjust one's goals given fluctuating impairments and internal resources); (iii) Self (S) (facing internal challenges and developing internal resilience); and (iv) Environment (E) (facing external challenges and fostering external resilience). These four elements yielded the acronym 'REPOSE'. Recovery in young people with ADHD was not a linear journey, with many missteps leading to greater self-knowledge, life skills and mastery. Progress was leveraged on securely anchored internal and external resilience factors against the prospect of setbacks. Findings provide new concepts and novel lexicons to extend existing concepts in Recovery. Counselling and therapy for young people with ADHD should foster self-understanding, goal setting and self-vigilance as an ongoing process to build their capacity to tackle setbacks and adversities. Counselling and therapy for young people with ADHD focus on a strengths-based approach building internal and external resources, such as developing skills and establishing social connections that build infrastructure in the environment for meaningful participation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand how older adults in recovery from substance use disorders experienced the transition from in-person to virtual 12-step meetings. We interviewed 11 older adults (age 50+) who self-identified as being members of 12-step programs. Participants completed an online survey including standardized measures assessing depression, anxiety, social isolation, and quality of life. Three themes emerged from interviews: Importance of the program; Promises and Limits of Technology; and Concern for Others. Participants' high level of commitment to their groups enabled them to adapt quickly to virtual meetings. Participants described their concerns about members of their groups who were unable to make this transition. Older adults in this study adapted quickly to virtual recovery groups. The social support participants received during groups, whether virtual or in person, may have acted as a buffer protecting them from the isolative effects of the pandemic. [ABSTRACT FROM AUTHOR]

The rates of mental health hospitalisations in Australia are rising. This paper presents the findings of a study undertaken in a regional mental health unit. The aim of the study was to obtain user perspectives to inform the redesign of the unit, which provides inpatient mental health services to rural and regional adults. A qualitative descriptive study with data collected via focus groups and in‐depth interviews was undertaken with 38 participants, including current inpatients, carers and 27 staff members of a single regional inpatient mental health unit. The 25‐bed mental health inpatient unit accommodates adults from 18+ years of age. The mental health unit sits within a referral hospital precinct and is associated with community‐based mental health services within a large regional and rural Australian public health service. The analysis of interviews and focus groups with patients, carers and mental health professionals revealed three major themes congruent with the literature These were: Firstly, Theme 1: Rooms should be designed to promote physical security. Next, Theme 2: Purposeful planning to support interactions between users and systems will promote relational security. And finally, Theme 3: Optimizing service integrity should promote procedural security. Based on the themes arising from the study, a list of recommendations was produced to inform the design of a new build for a regional mental health unit. In particular, all users of the space should expect that the built environment will promote their physical security and psychological safety and accommodate a wide range of diversity and acuity. The aesthetics should align with the promotion of recovery in the context of person‐centred and trauma‐informed models of care. Designers should plan to alleviate boredom and accommodate meaningful wayfinding. Mental health nurses should have spaces that support their work without compromising their relational security with consumers. Building designers should optimize therapeutic environments to facilitate dignified intensive and stabilizing treatments and eliminate vicarious stigma associated with caring for people with mental illness. This study provides valuable insights from a community of users who have experienced receiving and delivering mental health care within a regional and rural mental health unit. [ABSTRACT FROM AUTHOR]

Relatively few studies have explicitly examined whether and how shelter-type, temporary or emergency accommodation shapes homeless clients' personal (mental health) recovery. A transatlantic phenomenological qualitative study was conducted to examine the influence of those services on personal recovery. Eighteen chronically homeless adults with a history of serious mental illness were recruited from several temporary accommodation services in New York City (NYC), U.S., and Glasgow, Scotland. Participants completed repeat in-depth interviews and a novel one-week multimedia mobile phone diary. The interpretative phenomenological analysis (IPA) produced three overarching group experiential themes: ' everything was just starting to fall into place'; 'caught in a trap' ; and ' trials and tribulations '. Collectively, the findings underscore the duality of influence of temporary accommodation on recovery. Those ambiguous spaces confronted participants with existential uncertainty, volatility and chronic boredom, but also proffered opportunities for envisioning and enacting recovery. Embarking on recovery while residing in temporary accommodation is possible, even for those enduring chronic life adversity. However, it is contingent upon enabling socio-material, affective and relational resources. Implications are discussed for theorising recovery as a contextually embedded, relational phenomenon, and for providing recovery-oriented support across the housing continuum. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The delivery of mental health recovery orientated acre is a requirement of mental health professionals and an acknowledged desired outcome for individuals presenting with mental health issues.Hope has been recognized as one of 5 key processes of mental health recovery, and critically as the key catalyst of recovery.Mental health nurses are required to be competent in cultivating service user hope. What the paper adds to existing knowledge?: Novel exploration of how people described and made sense of the lived experience of hope in mental health recovery.Participants described hope as intrinsic to life in the context of its ability to cultivate desire and provide energy for life and living.Participants with experience of attempts to end life had a very clear concept of hope as missing at these times.Participants described the concept of hope as present but hidden to explain their survival through tortuous circumstances.The themes generated contribute to a greater understanding of the dynamic role and process of hope in mental health recovery. What are the implications for mental health nursing practice?: Mental health practitioners need to be competent in understanding and cultivating hope as part of a person‐centred approach, embedded in a therapeutic relationship.All stakeholders including service users, mental health nurses and educators need a more accessible reified dialogue of "hope" that harnesses its therapeutic potential. Introduction: Mental health services have embraced the philosophy and practice of recovery. Research has confirmed hope as a micro‐process of recovery. The lived experience of hope has received scant attention. This is required to improve understanding and optimize its therapeutic potential. Aim: To explore how individuals describe and make sense of their experience of hope in mental health recovery. Method: A qualitative interpretative phenomenological analysis (IPA) approach was used. The sample was accessed via email networks. Data were generated through semi‐structured interviews and analysed using an IPA framework. Results: Three superordinate themes emerged: "Without it we would wither up and die"—Hope as intrinsic to life; "I will be ok"—Having a sense of possibility and "Making it happen"—Moving forward. Individuals referenced hope by its absence when attempts were made to end life, and as present but hidden in tortuous circumstances. Discussion: Individuals were more familiar with the concept of hopelessness, had a ready‐to‐hand vocabulary of "having no hope" and used this by default to inform what hope meant. Implications for Practice: It is important that all stakeholders appreciate the context specific interpretation of hope and cultivate dialogue and understanding to harness its therapeutic potential. [ABSTRACT FROM AUTHOR]

Objective: This article examines the relationship between inpatient mental health units' adherence to recovery-oriented care and 30-day patient readmission. Method: The sample included patients admitted to one of 34 Veterans Health Administration inpatient mental health units. Recovery-oriented care was assessed using interviews and site visits. Patient characteristics and readmission data were derived from administrative data. Findings: Overall recovery orientation was not associated with readmission. Exploratory analyses found higher scores on a subsample of items pertaining to inpatient therapeutic programming were associated with lower patient readmissions. Additionally, patients with more prior service use and substance abuse or personality disorders were more likely to be readmitted. Conclusions and Implications for Practice: A growing body of literature supports the association between psychotherapeutic services in inpatient units and better patient outcomes. However, further research is needed to examine this association. More work is needed to develop appropriate psychotherapy services for the inpatient setting and support their implementation. Impact and Implications: While this study did not find an overall association between recovery-oriented inpatient mental health services and patient readmission, it did show an association between the provision of therapeutic services and readmissions. These findings support the importance of developing therapeutic models appropriate for acute inpatient settings as well as supporting their provision. [ABSTRACT FROM AUTHOR]

The existing psychosocial Support activities in the Northern Territory, Australia, are mostly delivered through individualised outreach and client‐centred Support programs and do not currently have a strong Peer focus. To address this gap, a Peer‐Led Education Pilot was developed and implemented in Darwin, Australia. The pilot was comprised of three separate but overarching stages, and each stage was independently evaluated. In this article, results from Stage 1 will be presented, with a specific focus on the role of Peer‐to‐Peer communication in improving participants' mental health and Recovery skills. This stage involved the delivery of the My Recovery program to self‐nominated participants, and the evaluation was aimed at reporting on the appropriateness and effectiveness of the program. The evaluation was qualitative in design involving individual pre‐ and post‐program interviews with program participants (npre = 14, npost = 16) between August and October 2019. The program was well received by participants and helped build their capacity to understand and self‐manage their mental health and/or alcohol and other drug issues in an inclusive, non‐clinical, non‐judgemental space. The results highlighted the importance of including a strong Peer focus in the existing psychosocial Support services available for people with mental health issues in Darwin. The findings also underscored the inclusion of those with lived experience of mental health challenges in the design and delivery of such programs. [ABSTRACT FROM AUTHOR]

Mental health 'recovery narratives' are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing 'acceptable' stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience. [ABSTRACT FROM AUTHOR]

Background: The lack of social and material perspectives in descriptions of recovery processes is almost common in recovery research. Aim: Consequently, we investigated recovery stories and how people with mental health and/or addiction challenges included social and material aspects in these stories. Method: We conducted focus group and individual interviews. We investigated how the participants narrated their stories and how they assembled places and people in their recovery stories. Results: We found that narratives of recovery became assemblages where humans and their environments co-exist and are interdependent. Conclusion: As such, narratives about recovery are about everyday assemblages of well-being into which stories of insecurity are interwoven, without a start or stop point. [ABSTRACT FROM AUTHOR]

Recent years have seen a renewed interest in integrating creative activities into statutory mental health practice in high‐income countries. In this article, we offer an exploratory analysis of an arts project delivered within UK mental health services, Creativity for Enablement and Wellbeing (CREW). Drawing on data collected for a process evaluation of the project, we suggest that conceptualising CREW as liminal and liminoid provides a helpful way to articulate the processes, atmospheres, relationships, and practices of the project. Through this theoretical lens, we identify CREW as a mode of engagement comprising looseness, possibility and collectivity, all brought together through a unique community event, the showcase. We explore CREW's mode of engagement through three themes: 'carving out a liminal space', 'looseness and experimentation,' and 'from liminal to liminoid'. Implications for service delivery are discussed, focussing on how CREW managed to create a transformative space of liminoid possibility rather than a recovery journey delineated by service‐defined imperatives. [ABSTRACT FROM AUTHOR]

Recovery from homelessness for women is often a long, complex and highly individualised journey. This study investigated women's experiences of exiting homelessness and examined the factors that influenced recovery. The qualitative interpretive study involved auto‐driven photo elicitation and in‐depth interviews with 11 women who had previously been homeless. It took place in Australia between August 2018 and August 2019. Women took photographs that represented their experiences of exiting homelessness to guide discussion during interviews. Data were analysed using thematic analysis. Findings indicate that recovery from homelessness involves more than becoming housed. Recovery from homelessness is the overarching theme being presented, described using five subthemes: Finding the right house, Making a house a home, Connection, Building confidence and Helping others. Housing was only the starting point for recovery from homelessness for women. The women drew on their own self determination to create factors necessary for recovery from the experience of homelessness. We conclude that ongoing support is necessary to empower and assist women recovering from the traumatic experiences of homelessness. Trauma‐informed care offers service providers a framework for supporting women who have lived through homelessness. Services can draw on this framework to provide support beyond the point of securing a house and assist women to create a home environment, build confidence in themselves and form connections to their community as they transition out of homelessness. [ABSTRACT FROM AUTHOR]

Introduction: Recovering from bulimia nervosa challenges a person to learn, revise, and do occupations that contribute to rather than detract from health. This study utilized Interpretative Phenomenological Analysis to (a) explore the recovery experiences of six adult women with histories of bulimia nervosa and (b) interpret how their accounts reflected the assumptions and characteristics of occupation. Methods: Data were collected via audio-recorded, semi-structured interviews. Data analysis within and between cases identified six superordinate themes, which included interpretation in terms of criteria of occupation. Findings: Superordinate themes reflect (1) occupation emerged in recovering from bulimia nervosa through committed action, not doing what fueled bulimia nervosa, adopting new ways of living, prioritizing self-care, connecting with others, and creating supportive environments and (2) recovery from bulimia nervosa can be construed as an occupation. Conclusion: This study provides insight into nuances of recovery from bulimia nervosa. Results offer novel implications distinct to an occupational therapy lens, for example, consideration of self-care beyond eating and meal preparation; modification of the home, work, and social environment; and setting goals associated with not doing versus doing. Further, the interpretative finding of recovery as occupation holds implications for the evolving philosophical considerations within occupational science and therapy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Psychological recovery is typically measured in improving access to psychological therapies (IAPT) services as the reduction of symptoms on routine outcome measures (ROMs). However, conceptualisations of psychological recovery vary, and there are concerns that ROMs may not be suitable for measuring recovery from complex mental health difficulties. To gain insight into psychological recovery and measurement in clinical practice. A qualitative study at a step-4 IAPT service in the North of England. Eight clinicians contributed to focus groups, and 10 service users were later interviewed individually. Factors that informed four congruent and interacting themes of recovery were identified among participants as an ongoing personal process, of intra-therapeutic and extra-therapeutic factors impacting on recovery in helpful and unhelpful ways, and the need for idiographic long-term recovery measures. The functional and long-term nature of recovery and the socio-economic context for recovery were considered particularly crucial. The need for idiographic long-term recovery measures to support the ongoing process of recovery was reported in the majority of instances. Study findings mirrored existing recovery and outcome measurement literature, provided new evidence in relation to recovery from complex mental health difficulties, and made recommendations for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Recovery-oriented, strengths-based intervention engages service users' strengths and resources to support their recovery process. This model was developed in an American context and has been applied in Hong Kong. It is important to formulate an understanding of strengths better fit to Hong Kong Chinese. Aims: This exploratory qualitative study examined Hong Kong Chinese service users' views on strengths and preferred translation for the word strengths, along with its cultural nuances. Method: Twenty-six people with serious mental illnesses were individually interviewed at a mental health center in Hong Kong, based on a photo-elicitation technique and reflection on Chinese terms related to strengths. Analysis of data employed the constant comparative method. Results: Participants reported that social factors, such as support by helping professionals and engagement in family roles, as well as spiritual beliefs and practices, are important for recovery. These insights and their preferred translations of strengths generate a culturally nuanced understanding of strengths. Conclusions & Implications for Practice: The strengths model applied in Hong Kong can be enhanced by a more culturally nuanced perspective, for example, including the importance of family-based identity and filial piety, beliefs related to harmony and fate, and practices such as a temple or church attendance. Impact and Implications: This study investigates how Hong Kong Chinese people view strengths in facilitating recovery from mental illnesses. The term "strengths" in recovery was deemed synonymous with the terms ability (néng lì; 能力) and expertise (zhuān cháng; 專長) in Chinese. This study sheds light on how Chinese conceptualizations of "strengths" in recovery may be applied in interventions. [ABSTRACT FROM AUTHOR]

The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Eight pairs of participants were interviewed together, in accordance with the dyadic interview method. The dyads/pairs consisted of service users and professional helpers. A collaborative hermeneutic-phenomenological analysis was used to analyse data. Data were analysed into three overarching and entangled themes, exploring how recovery-oriented collaboration and knowledge encompasses (a) recovery as relational processes. These processes are entangled with (b) recovery as situated in time and place. Furthermore, relational processes and dimensions of time and place are situated in and supported or hindered by (c) recovery orientation as part of the municipal policies, understood as the regulations, frameworks and decisions guiding mental health and substance abuse services in the municipality. The further development of recovery-oriented services should focus on facilitating open-ended and flexible ways of developing practices and relationships. This involves recognizing how relationships contribute to the development of knowledge and practices. [ABSTRACT FROM AUTHOR]

We explore young adults' narrations of life events in association with nonsuicidal self-injury (NSSI) discontinuation, psychological growth, and agency. Transcripts from eleven face-to-face interviews with individuals who quantitatively reported injuring themselves in adolescence (2007–2008) but not in young adulthood (2017) were narratively analysed. We found that at starting points, a period preceding an agentic shift in the narrative, participants endured stressful living conditions and mental illness. During this period, participants perceived no point in trying to initiate change because they did not perceive themselves as having the capacity to do so and nor could they adequately utilize any formal or informal support. After a turning point that enabled agency due to gaining a sense of belongingness, liberation, or perspective, participants underwent a process of attaining psychological well-being. However, narrating psychological growth also required momentum points, encompassing the management of and moving on from stressful contexts, along with the recognition of milestones marking improvement relative to the starting points. NSSI discontinuation was narrated in conjunction with psychological growth when participants also experienced themselves as situated within an agentic context, because agency is understood as necessary to react to and manage current and future life circumstances. [ABSTRACT FROM AUTHOR]

Certified peer specialists refer to a category of trained mental health professionals who self-disclose serious mental illness to support the rehabilitation and recovery goals of others with serious mental illnesses. The purpose of the current study was to better understand certified peer specialists' perceptions of: (a) the role of self-determination in vocational rehabilitation programs, (b) experiences with vocational rehabilitation services, and (c) the conceptualization of mental health and vocational recovery. A total of 12 participants completed the qualitative interviews in-person or over the phone. This study utilized a Consensual Qualitative Research approach. Study participants described self-determination as an important component in attaining work, as well as overall mental health and vocational recovery. Overall, our findings indicated that certified peer specialists have unique descriptions for self-determination and recovery, as well as diverse experiences with vocational rehabilitation services. [ABSTRACT FROM AUTHOR]

Restorative justice (RJ) is a way of doing justice following an offense that is primarily oriented towards repairing individual, relational, and social harm. This study examined how RJ processes, conducted following intrafamilial sexual abuse, helped restore the family relationship, and assessed their contribution to the healing and recovery of the victims and the family system. Twenty-three adults who have chosen to take part in RJ processes were interviewed for this study, including incest survivors, non-offending family members, friends, and RJ facilitators. We used a thematic approach within an experiential framework to analyze the qualitative data. Analysis of the interviews highlights the unique role played by the family affected by incest in the journey of recovery undertaken by the survivor and other family members. Together, the participants' voices join into a multifaceted portrait of a highly complex process that enables survivors and their family to make themselves heard, become empowered, and grow towards recovery and restoration. The present study adds to recent studies on RJ in cases of sexual offense, and in the particular intrafamilial context. It enriches the literature with descriptions of the participants' experiences, shedding light on the unique characteristics of RJ processes in incest cases. The study also refines the contribution of the RJ process as an alternative for or as complementary to legal or therapeutic processes, as well as in highlighting the importance of restoring the family system and the suitability of the process for incest cases. [ABSTRACT FROM AUTHOR]

Community treatment orders (CTOs) require individuals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery‐focused, although justification for use is predominantly risk‐based, and care often coercive. Although CTOs are contested, individuals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of individuals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18‐month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for individuals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities individuals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship. [ABSTRACT FROM AUTHOR]

Introduction: Canadian occupational therapists are employed as case managers on assertive community treatment (ACT) teams to support community living for individuals with severe and persistent mental illnesses. In this position, occupational therapists act primarily as generalists, typically attending appointments with clients, supervising medication adherence, supporting basic living needs, and managing client crises. Occupational therapists may also provide psychotherapy and coping skill groups, as well as profession-specific practices, such as skills training. Exploring how ACT occupational therapists describe their perceived ideal practice may support transformation in long-standing, occupational therapy practices on ACT teams. Method: This qualitative, interpretive description study involved 11 Canadian ACT team occupational therapists in one individual, semi-structured in-depth interview using an interview guide containing open-ended questions. Interview transcripts were analyzed to identify themes pertaining to therapists' descriptions of their perceived ideal occupational therapy practice on ACT teams. Results: Three themes emerged: (a) Engaging in practice "with intention"; (b) Finding the space for occupational therapy practice; and (c) Supporting clients in their recovery to find their best occupational self. Conclusions: The findings highlight practice possibilities for occupational therapist working on ACT teams and provide a foundation for advocating for better use of specific occupational therapy practices within community mental health settings. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy has long had a strong presence in military mental healthcare. Today's veterans have complex needs and can face challenges reintegrating into civilian life. This exploratory study investigated whether veterans receiving mental health treatment who participated in a bespoke occupational therapy and resilience workshop intervention improved their perceived participation in everyday life. Method: An interpretivist hermeneutic phenomenological approach was used to explore veterans' perspectives. Ten participants took part in two semistructured focus groups. Thematic analysis was used to identify and analyse patterns within the data. Findings: Most participants developed occupational goals and started to make lifestyle changes; participants developed an appreciation of the value of occupation; participants developed insight into their recovery journeys; and value was placed on the 'healing power' of the group. Conclusion: This exploratory study provides preliminary evidence to suggest occupational therapy was influential in helping participants understand the impact of occupation on health and start making lifestyle changes. Participants also reflected on their recovery journeys. The benefits of doing this within a group environment appear to have been particularly therapeutic. Original occupational therapy research in this specialism is sparse. This novel study provides insight that can further discussion and enhance understanding about what the profession can offer this client group. [ABSTRACT FROM AUTHOR]

Since the 1990s, New Zealand mental health policy has shifted from a focus on the management of symptoms and risk to the recovery of psychological, social, cultural, and physical well‐being. Despite a vision for recovery‐oriented services being integrated within national and regional policies, there is growing concern that barriers to recovery‐oriented service provision continue to exist. Such barriers include the attitudes, skills, and knowledge of front‐line staff, as well as system issues. This study explored the experience and meaning of recovery‐oriented practice for 10 nurses working in an acute inpatient mental health service. A phenomenological and hermeneutic lens was used to explore the nurses' experience of working in a recovery‐focused manner alongside service users. Stories of practice were collected from participants through open‐ended conversational interviews. Transcribed narratives were analysed to explore taken‐for‐granted aspects of working in acute mental health care and to uncover the meaning of being recovery‐oriented in this setting. Findings revealed that although the experience and meaning of recovery‐focused care varied among nurses, there were common elements in the practice accounts. The accounts highlighted the nurses' role in creating different therapeutic spaces to promote safety, relational commitment, and healing for service users. However, the nurses faced challenges to recovery‐oriented care within the team hierarchical culture and the broader service systems. The nurses were, at times, fearless in advocating for service users and recognized that this was essential for developing recovery‐focused services. The findings have implications for nursing practice, as well as training and service development. [ABSTRACT FROM AUTHOR]

This research aimed to gain an understanding of the acute mental health inpatient experience as described by Aboriginal women during admission. It recorded for the first time the words of Aboriginal women within the inpatient unit, including their perceptions of factors which may promote or impede a culturally safe environment. Eleven Aboriginal women inpatients gave interviews before discharge from the inpatient unit. Five Aboriginal Reference Group (ARG) members with experience of the inpatient unit also gave interviews, adding 'insider–outsider' perspectives. Interviews were recorded, transcribed, entered into NVivo software, and analysed inductively to raise codes and develop themes. Five interconnecting themes emerged: Social Context: life experience preceding, shaping, and following admission; Connection: with kin, community, and culture. Control: self‐determination, legally and physically curtailed; Caring: actions promoting reconnection and self‐determination; Communication: conveying caring and supporting agency, reconnection, and return to community. Findings reflected inpatient issues reported in previous studies, adding insights into the cultural concerns of Aboriginal women and offering practical clinical implications for culturally secure service delivery in an inpatient setting. Existing literature offered a basis for developing the model offered here for transcultural interaction for recovery in an inpatient setting. Attention to these findings can enhance Aboriginal women's inpatient experience and promote further research. The article complies with the COREQ‐32 checklist for describing qualitative studies. [ABSTRACT FROM AUTHOR]

Open Dialogue (OD) is a needs-based, service-user initiated approach to mental health service delivery that emphasises dialogue, and shared understanding between service users, and their support network. The aim of this study was to explore the lived experience of being part of an OD-informed mental health service in Ireland. Data were collected through semi-structured group interviews and analysed using thematic analysis. Three primary themes were identified across the data set namely: diversity across practice; unpacking the taken-for-granted and mental health as shared experiences. Participants experienced enhanced communication, improved relationships with mental health staff and developed shared understandings of mental health. This small-scale implementation demonstrates the received value for service users and their networks of an OD-informed approach within a traditional care pathway. As a relational and collaborative way of working, it requires a shift in clinical practice for mental health staff and service users that is experienced as a welcome change from treatment-as-usual (TAU). [ABSTRACT FROM AUTHOR]

Objective: There is a dearth of longitudinal data on outcomes in prevalent cases of psychotic illness across a range of ages and levels of chronicity. Our aim was to describe changes over time in mental and physical health outcomes, as well as patterns of service utilisation that may have influenced outcomes, in a representative prevalence sample of 641 Western Australians with a psychotic illness who, at Wave 1, were part of the National Survey of High Impact Psychosis. Methods: In Wave 1 (2010, 2012), a two-phase design was employed to ensure representativeness: Phase 1 psychosis screening took place in public mental health and non-government organisation services, while, in Phase 2, a randomised sample was interviewed. In Wave 2, 380/641 (59%) of participants were re-interviewed, with interviews staggered between 2013 and 2016 (follow-up time: 2.3–5.6 years). Data collection covered mental and physical health, functioning, cognition, social circumstances and service utilisation. Mental health outcomes were categorised as symptomatic, functional and personal recovery. Physical health outcomes covered metabolic syndrome and its component criteria. Results: In mental health, there were encouraging improvements in symptom profiles, variable change in functional recovery and some positive findings for personal recovery, but not quality of life. Participants ranked physical health second among challenges. Metabolic syndrome had increased significantly. While treatment for underlying cardiovascular risk conditions had improved, rates of intervention were still very low. More people were accessing general practices and more frequently, but there were sharp and significant declines in access to community rehabilitation, psychosocial interventions and case management. Conclusion: Although we observed some positive outcomes over time, the sharp decline in access to evidence-based interventions such as community rehabilitation, psychosocial interventions and case management is of great concern and augurs poorly for recovery-oriented practice. Changes in service utilisation appear to have influenced the patterns found. [ABSTRACT FROM AUTHOR]

Many studies show that long-term poor mental health outcomes for disaster-affected people are predicted by postdisaster stressors. Despite this finding, existing recovery frameworks vary in how these stressors are conceptualised. This paper examines community members' subjective perceptions of what they found problematic and useful in their recoveries after the Australian 2009 Black Saturday bushfires, and considers them in the light of these frameworks. We report the findings from responses to semi-structured survey questions as part of the Beyond Bushfires study, 3–4 years after these bushfires (n = 811). Participants identified the biggest problems as managing rebuilding processes and managing their own mental health, memories of the Black Saturday fires, and their concerns for family members. The four most useful supports were family, friends, rebuilding resources, and their community. We found a complex interplay of the same factors operating as both stressors and supports, particularly in relation to family levels of coping. Disaster recovery efforts require the simultaneous management of physical rebuilding and human processes. Families, friends, and neighbours are underestimated resources in postdisaster recovery. Given the complex interplay of the same factors operating as both stressors and supports, interventions are needed that maximise the positive dimensions of these factors. To manage this complexity, multiple frameworks are needed to guide disaster recovery. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about the Recovery Star and how its use can empower patients to develop their skills and self-reliance • To understand the benefits and constraints associated with using the Recovery Star in mental health inpatient services • To consider methods you could implement in your area of practice to support frequent and appropriate use of the Recovery Star The Recovery Star is a collaborative tool used by staff to support the recovery of adults who are using mental health services, including inpatient rehabilitation services. However, staff experiences of completing this tool with patients have seldom been reported. Therefore, a service evaluation was undertaken to explore staff perspectives about the useful elements and barriers associated with using the Recovery Star, to determine whether staff believe it is an appropriate tool to use in inpatient rehabilitation services, and to understand the reasons for the tool's underuse. Semi-structured interviews were conducted with nine staff members who worked across four wards in an inpatient rehabilitation service in Leicester, England. Four main themes were identified through a thematic analysis of the interview transcripts: it is a helpful tool; it is patient-dependent; it is underused due to constraints such as lack of time; and wider issues affecting its use. Subthemes for each of these themes were also identified. Staff reported that the Recovery Star is an appropriate tool to use in mental health rehabilitation services, although they recognised some barriers to its use and amendments required to ensure the tool is used more often. [ABSTRACT FROM AUTHOR]

Children and youth are among the most vulnerable to the detrimental effects of disaster due to their unique physical, cognitive and psychological life stage. Despite their increased vulnerability, children and youth also demonstrate resilience when faced with the adverse circumstances of disasters, and can act as important catalysts for change in their families and communities. This article discusses research conducted with eighty-three children and youth (five to seventeen years) who experienced the 2013 flood in Alberta, Canada. A mixed-methods approach was utilised. The Child and Youth Resilience Measure was used to examine the factors that contribute to resilience post-disaster, including individual, care-giver and contextual factors. In-depth qualitative interviews further examined the specific ways in which individual, caregiver and contextual factors contribute to higher levels of resilience. Findings reveal that despite numerous post-flood challenges, children and youth had higher than average levels of resilience. The findings demonstrate that high levels of resilience are associated with individual factors, specifically peer support and caregiver factors, namely caregiver psychological support. We discuss the implications of these findings for social work policy and practice, and for understanding the factors that best support the resiliency processes and overall recovery of children and youth following disaster. [ABSTRACT FROM AUTHOR]

Objective: Role-playing games elicit narratives of heroism, mastery and agency. These are factors considered to promote mental health recovery. This study investigates whatthemes emerge from the stories of role-playing game players in recovery from mental health difficulty and how their stories reflect existing models of mental health recovery. Method: This study utilised narrative inquiry to understand the experiences of Dungeons and Dragon players in recovery from mental health difficulties. Thirteen Dungeons & Dragonsplayers (M = 33.31; SD = 10.05) were interviewed about their experience with the game and recovery. Analysis of narratives was conducted inductively and deductively. Result: Participants discussed a number of factors that linked Dungeons & Dragons to their mental health wellbeing. These included a) experiencing through characters, b) skill building, c) finding space from mental health symptoms, d) safely engaging with mental health difficulties, and e) building relationships. All five stages of the Psychological Recovery Model (Andresen, Oades & Caputi, 2003) were present, and participants engaged with Dungeons & Dragons in a manner reflective of their mental health recovery process. Conclusion The current study expands on research that conceptualizes recovery asa multidimensional process and highlights new elements that have implications for consumers and theoretical frameworks. KEY POINTS What is already known about this topic: (1) Mental health difficulties can severely impact a person's quality of life and disrupt their internal narrative. (2) Mental health difficulties can severely impact a person's quality of life and disrupt their internal narrative. (3) Community based activities can foster a sense of growth, self-mastery and agency that may ultimately lead to identity reconstruction and a sense of personal recovery. (4) Role-playing games have been identified as potentially helpful in assisting people with mental health difficulties restore a sense of agency and positive identity. What this topic adds: (1) Australian Dungeon and Dragon (D&D) players with a history of mental health difficulties were interviewed in regards to their experiences of role-playing and their mental health recovery. (2) Participants reported D&D assisted with building relationships with other players, experiencing emotions through their character, developing adaptive skills, engaging with difficult mental health topics and experiencing a safe space from mental health difficulties. (3) All five stages of the Psychological Recovery Model were present, and participants engaged with D&D in a manner reflective of their mental health recovery process. [ABSTRACT FROM AUTHOR]

Community-based Mental Health (MH) organisations in the United Kingdom (UK) are facing challenges for sustaining in-person service delivery. Without empirical evidence that demonstrates the value of a place-based approach for MH recovery, and the types of resources needed to build nurturing spaces for peer support, community-based MH organisations will struggle to maintain their physical spaces. We present empirical insights from a case study involving interviews with 20 students accessing peer support services at the Recovery College Collective, a community-based MH organisation located in the North East of England. The interview study aims to evidence how a place-based approach can afford MH recovery. We draw from discourses on place-making and interpret our interview findings through an established framework that highlights four mechanisms through which place impacts recovery: place for doing , being , becoming and belonging. We use this framework to structure our findings and highlight key qualities of place for establishing and maintaining MH recovery. Our contribution is two-fold: we address a gap in the literature by providing empirical understandings of how place influences MH recovery, whilst extending previous research by considering the role that place plays in community-based organisations. This is timely because of the challenges faced in securing in-person service delivery post-pandemic, and a shift towards remote service provision models. We highlight key implications: (i) Accessing a physical place dedicated to MH support is vital for people who do not have anywhere else to go and are socially isolated due to their health conditions; (ii) Connecting through peer-to-peer interaction is an integral part of the recovery process, and learning from people with lived experience can inform a place-based approach that best suit their needs; and (iii) Recognising the value of place for MH support, and the resources needed for peer support delivery in the community, will help secure places that our research participants described as lifesaving. • Places for peer support are critical in fostering mental health recovery. • Resources for sustaining a place-based approach need to be better recognised. • More contextual understandings of people's experience of place are needed. • Future service delivery should consider recovery as a lifelong journey. [ABSTRACT FROM AUTHOR]

Aims: To understand barriers and facilitators of recovery for critical illness survivors', who are discharged home from the hospital and do not have access to dedicated outpatient care. Design: Multi‐site descriptive study guided by interpretive phenomenology using semi‐structured interviews. Methods: Interviews were conducted between December 2017 ‐July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors' personal experiences and perception of those experiences. Results: Participants encountered several barriers to their recovery; however, they were resilient and initiated ways to overcome these barriers and assist with their recovery. Facilitators of recovery experienced by survivors included seeking support from family and friends, lifestyle adaptations, and creative management of their multiple medical needs. Barriers included unmet needs experienced by survivors such as mental health issues, coordination of care, and spiritual needs. These unmet needs left participants feeling unsupported from healthcare providers during their recovery. Conclusion: This study highlights important barriers and facilitators experienced by critical illness survivors during recovery that need be addressed by healthcare providers. New ways to support critical illness survivors, that can reach a broader population, must be developed and evaluated to support survivors during their recovery in the community. Impact: This study addressed ICU survivors' barriers and facilitators to recovery. Participants encountered several barriers to recovery at home, such as physical, cognitive, psychosocial, financial, and transportation barriers, however, these survivors were also resilient and resourceful in the development of strategies to try to manage their recovery at home. These results will help healthcare providers develop interventions to better support ICU survivors in the community. [ABSTRACT FROM AUTHOR]

Objective: Understanding factors that promote and hinder the recovery process for people living with serious mental illness remains of critical importance. We examine factors, including limited literacy, associated with mental health recovery among public mental health service users. Method: This study uses data from a mixed-methods, service-user informed project focused on the impact of limited literacy in the lives of people with serious mental illness. Data from structured interviews evaluate perceptions of recovery as assessed with the Recovery Assessment Scale (RAS). Regression models examine factors related to recovery controlling for sociodemographic factors, literacy, neurocognition, mental health status, perceived social support, and stigma. Results: Despite bivariate relationships between RAS and limited literacy, the full models suggest that other factors account for this relationship. These include mental health status, higher social support, higher self-reported community status, and higher stigma consciousness, as well as race for some models. Conclusions and Implications for Practice: Our findings that social support and perceptions of community status are associated with higher scores on the RAS echo prior work demonstrating the importance of social connection and context in mental health recovery. Though literacy was not a predictor of recovery, further research should examine the relationship between literacy and recovery given the deep literature on literacy on health outcomes. In order to better support people in the recovery process it is important that more research is done to examine the complex relationship between stigma consciousness and recovery as well as understand the racial disparities that exist within the recovery subscales. Impact and Implications: Limited literacy was not significantly associated with recovery attitudes; however, individual and social level factors, mental health status, social support, perception of community status, and stigma consciousness were found to positively impact one's recovery attitudes. These factors need to be understood so they can be leveraged to help people move toward recovery. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate how adults with serious mental illness learn and utilize an illness self-management framework for pursuing recovery through a program called Wellness Recovery Action Plan (WRAP). The researchers employed an interpretive descriptive methodology with thematic analysis. Data were collected from three focus groups (n = 26) and in-depth interviews with follow-up member checks with 10 participants (n = 20 interviews). Findings aligned with main constructs of self-determination theory (SDT) to explain how an autonomy-supportive environment created opportunities for participants to build competency, implementing personalized recovery strategies that are socially endorsed by peers, resulting in internalized motivation for continued application of WRAP's framework. SDT appears to explain mechanisms of change for WRAP. Recommendations for mental health organizations include broadly ensuring autonomy-supportive environments and services that maximize opportunities to build competence in recovery strategies in collaboration with peers. Future research may utilize SDT as the theoretical basis for investigating self-management programs. [ABSTRACT FROM AUTHOR]

Men account for three‐quarters of suicide deaths in the UK, yet we know little about how at‐risk men construct their experiences of moving towards – and then subsequently stepping back from – suicide, nor the part played by relational factors therein. An inductive thematic analysis was used to examine narrative interviews with eleven UK men who self‐reported serious thoughts, plans and up‐to and including suicide attempts in progress, but who consciously decided against carrying out an attempt. Their accounts suggest a highly social process of movements towards and away from suicide (e.g. frustrated help‐seeking). Stepping back from suicide represents not a discrete issue, but a linked process in suicidality and wider recovery. Here, the use of military metaphors in particular (e.g. waging war, fighting back) highlights the gendered nature of the issue. Additionally, our article illuminates a range of social relations and forces that circulate in and around suicidality, which itself is embedded in varying forms of relationality, normativity and gendered practices. [ABSTRACT FROM AUTHOR]

Despite the importance of carers supporting the lives of people with mental illness, there are limited studies investigating the well‐being and needs of Malay carers in multicultural Singapore. The Malays consist of 13.4% of Singapore's population. A mixed methods qualitative dominant research approach was used to explore the well‐being and needs of Malay carers in a voluntary welfare organisation. The Kessler‐10, Friendship Scale and Carers' and Users' Expectations of Services—Carer version were used to assess the needs and well‐being of 17 Malay carers. Findings show that Malay carers experienced poor well‐being and had numerous unmet needs. Four main themes were found: (a) Concerns related to relatives with mental illness, (b) Mental health practices related to carers, (c) Holistic support for carers and (d) Preference for greater spiritual support in mental health. Recovery‐oriented mental health practice implications are discussed. Spirituality of Malay carers needs to be given greater consideration in recovery‐oriented mental health services. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore how material things might become involved in the recovery process of people with mental health difficulties. Empirical material from three different studies on various aspects concerning mental health issues that each of the authors had conducted was reanalysed through a phenomenological item analysis. We discovered that mundane objects such as a mobile phone, a bench, a door and a key have agency to contribute to peoples' recovery and wellbeing. Things became agents that created contexts that initiated physical, social and emotional movements. By giving attention to materiality we might become aware of the importance of things as agents in living in general and in recovery processes for people with mental health difficulties in particular. [ABSTRACT FROM AUTHOR]