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According to the WHO, people diagnosed with schizophrenia in developing countries recover more fully than people with the same diagnosis in developed countries. At a time when international organizations are attempting to scale up biomedical psychiatric interventions in India and other low-income countries, it is important to understand why a place like India is doing better in recovery from serious psychosis. Interviews of 20 people diagnosed with schizophrenia in Kerala, India were conducted to determine level of functioning and quality of worklife. Quantitative assessments of the relations between these factors were undertaken along with qualitative, ethnographic analysis of narratives of interviewees. Analysis of interviews shows that quality of worklife is correlated with higher functioning among this group, and service user narratives claim that work enabled their recovery. Comparisons to other research further indicates that people in India with this diagnosis are more often employed than people with the same diagnosis in the United States and Europe. Employment and the quality of worklife appear to be positively related to recovery in terms of increasing functionality among people diagnosed with schizophrenia in this part of India. Certain employment programs and sociocultural factors likely contribute to differences in outcome. [ABSTRACT FROM AUTHOR]

In India, mental illness is generally perceived as a lifetime adversity with high vulnerability to problems such as social marginalization, health hazards, and economic deprivation. But anecdotal evidence has shown that many individuals struggling with mental illness have led outstanding lives of courage, dignity and have contributed to society in different ways. Yet scientific research has not focused adequately on such cases and instead has largely studied negative outcomes associated with mental illness. The objective of the present study was to explore positive outcomes through the subjective experiences of individuals diagnosed with mental illness. Interviews of participants (n = 48) were analyzed using thematic analysis. The imperative finding was that despite mental illness and cumulative risks, participants were able to bounce back to a functional level and in a few instances even excelled in specific areas they engaged in. The major implication of such strength-based studies is that it highlights positive outcomes that can assist in building a life of wellness thereby challenging the deficit-based approach that is more popularly followed in studying mental illness. These findings establish that the possibility of living well even after being diagnosed with a mental illness is not a fictional likelihood, rather an achievable reality. [ABSTRACT FROM AUTHOR]

Background: Understanding the concept of recovery in severe mental illnesses such as schizophrenia from the social and cultural aspects is important as it will help in developing models of recovery and appropriate interventions. Client and caregiver perspectives on recovery play a significant role in shaping these models and interventions. Hence, the aim of this study was to understand how clients with schizophrenia and their caregivers perceive recovery and to examine the differences between male and female clients with schizophrenia. Materials and methods: A total of 100 clients with schizophrenia and 80 caregivers of clients with schizophrenia were included in the study after written informed consent. A semi-structured proforma was used to collect the sociodemographic profile and illness variables. A questionnaire was developed to assess the indicators of recovery from mental illness and was administered to study participants. Descriptive statistics including frequency and percentages were used along with the chi-square test for analysis. Results: The most common indicators of recovery for the clients with schizophrenia were absence of symptoms (88%), no relapse (70%) and going back to work (70%), while for the caregivers were absence of symptoms (100%), becoming independent (92.5%) and no relapse (91%). Indicators of recovery were similar between male and female clients with schizophrenia except for the need to stop medication as an indicator of recovery observed significantly more in females (p =.006). Most clients used internal validation of indicators to assess their recovery (79%). Conclusion: Results indicate that clients and caregivers from India perceive recovery as being symptom free, able to go back to work and being independent. Clients with schizophrenia use internal validation to assess recovery. Gender does not play a role in the perceptions toward recovery in schizophrenia. These results will help in developing models of recovery for severe mental illness in Indian context leading to tailored interventions. [ABSTRACT FROM AUTHOR]

Background: Identifying patient perspectives about recovery may help the service providers to enhance active participation of patients in their recovery. Aim: This study aimed to explore patients' perspectives about factors affecting recovery from schizophrenia. Methods: A semi-structured interview schedule was used to explore the perceptions of 18 patients diagnosed with schizophrenia. The interviews were recorded, transcribed and analysed. Codes were identified and similar codes were grouped together and main themes were identified. Results: Nine main themes on facilitators and barriers of recovery from schizophrenia were derived. Conclusion: Deeper understanding of patients' perspectives of recovery from schizophrenia can help mental health professionals to plan appropriate recovery-oriented services. [ABSTRACT FROM AUTHOR]

CSA is prevalent internationally and its negative impact can continue in adulthood. India has a high prevalence of child maltreatment. The present study recorded the ‘recovering’ experiences of adult survivors of child sexual abuse (CSA) in India and developed a clinically applicable framework of recovery. Qualitative semi-structured individual interviews were conducted. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify recurrent themes. A total 20 adult survivors were interviewed. Results identified four core stages/processes of ‘moving on from CSA’ based on the descriptions provided by participants in India: The Affected Self - Keeping the Self Together; Accurate Symbolisation; Activation of the Recovering Self; Re-connection, Integration and Growth. We have developed the first survivor-centred relational growth – based model of recovery from CSA in India and potentially internationally. The findings support relational approaches to treatment and service delivery. A clear recovery process within and outwith services has been identified, thus emphasising the need for psychosocial support for facilitating personally meaningful recovery within the community through consistent practice. The findings have implications for continuing professional development (CPD), training, supervision, social reform, service delivery and policy as well as self-recovery of adult survivors. It is recommended to include relational approaches in working with survivors in India and internationally. [ABSTRACT FROM AUTHOR]

Background: CHIME (connectedness, hope and optimism about the future, identity, meaning in life and empowerment) is a framework for conceptualising personal recovery from mental illness. To date, there has been limited research on its cross-cultural applicability. Aims: To apply CHIME to two culturally diverse groups’ conceptualisation of recovery from depression. Method: Qualitative interviews with 30 Anglo-Australians and 28 Indian-Australians living with depression in Melbourne, Australia. Data were thematically analysed. Results: Both groups valued connectedness but experienced stigma and struggled to broker family support. Identity, hope and optimism for the future were associated with positive thinking, being ‘cured’ and discontinuing treatment. Spirituality gave Indian participants meaning in life; Anglos derived meaning from the illness experience itself. Feeling empowered, for both groups, was related to improved socio-economic status and being ‘settled’ (e.g. having gainful employment, a home and family). Conclusions: CHIME was applicable in both groups, but culture mediated how cross-cutting issues (e.g. stigma) and sub-components of CHIME were operationalised. Recovery was also influenced by participant’s socio-economic context. Research, policy and practice implications are discussed. [ABSTRACT FROM AUTHOR]