Search

Accessible Summary: What is known on the subject?: Co‐production aims to value service user voices and is increasingly used in healthcare.Less is known about how co‐production in nursing education is experienced by service users. What the paper adds to existing knowledge?: This paper shares the experience of one service user who teaches student nurses in a UK university.For the first author, the paper highlights that co‐producing nurse education has been valuable and rewarding for both a service user and students. What are the implications for practice?: Co‐production has the potential to benefit student nurses, including challenging their perceptions of 'difficult' patients. To achieve this, teaching sessions must be equally produced and delivered. By employing and including service users, universities have the potential to improve experiences for students and service users alike. Introduction: Co‐production is increasingly used in health care but there is less attention to a co‐produced mental health nurse education. Aim: This article sought to explore the co‐production experiences of a service user who teaches mental health nurses, alongside the benefits of this to nurse education. Methods: The article is a lived experience narrative co‐written with a nursing lecturer. Thesis: Co‐produced mental health nurse education challenges students' perceptions towards self‐harm and encourages empathy and understanding of service user distress. Implications for Practice: Co‐production has many benefits to nurse education including a positive student experience, and validation of the service user experience to support meaningful recovery. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the psychological and relational processes of a service user reflective group on a medium secure forensic ward. The group was conceptualised by the service as a component of the therapeutic offer contributing to the patients' journey towards recovery and this study aimed to explore whether the group was being experienced as beneficial, by service users and staff, in relation to recovery concepts. Design/methodology/approach: Qualitative data were collected using semi-structured interviews from 10 participants who had experience of an existing service user reflective group on a medium secure forensic ward. Participants in the study were patients who attended the group (6) and staff members who facilitated the group (4). The data collected were analysed using constructivist grounded theory methodology. Findings: Results formed a flexible, cyclical model based on five key categories: "Group Identity", "Linking Self with Others", "The Changing Self", "Living Visibly in a System" and "Moving On." Practical implications: Findings indicate that service user reflective groups in forensic inpatient settings can contribute to increased interpersonal effectiveness and personal recovery. Originality/value: The role of service user reflective groups in secure recovery has not been explored empirically to date, although they are a suggested intervention to enhance relational security and to aid therapeutic progress within a secure recovery framework. This study aimed to begin to address this gap in research and understanding. [ABSTRACT FROM AUTHOR]

Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital. [ABSTRACT FROM AUTHOR]

Objective: Admissions to hospitals for people with anorexia nervosa (AN) often last over 2 months, during which significant time is often spent with other patients, but there is little qualitative research on the impact on recovery of the inter‐patient relationships. Our aim was to conduct qualitative interviews with people with a history of inpatient treatment for AN, focusing on the impact of interactions and relationships between patients during hospital admission on recovery, including short‐term and long‐term effects. Method: We conducted nine semi‐structured, one‐to‐one interviews, specifically exploring the helpful and unhelpful aspects of inter‐patient relationships during inpatient treatment for AN. No type of relationship was either included or excluded. Participants were recruited as volunteers in response to an online advertisement; all who met the eligibility criteria were selected. Interviews were transcribed and analyzed using thematic analysis. Results: Thematic analysis identified five themes: (1) comparison and justification, (2) learnt unhelpful behaviors, (3) dealing with distress, (4) compassion, and (5) role‐modeling. All participants expressed conflicting feelings about their relationships with other patients, but generally described developing more resilience to negative effects as they got closer to recovery. Positive effects, such as compassion, appeared to hold significance long term in participants' recovered lives. Discussion: The detailed exploration of themes in this study provides a deeper understanding of inter‐patient relationships during inpatient treatment for AN. This could aid clinical decision‐making when choosing appropriate treatment settings for individual patients as well as informing clinical practice in hospital. Public Significance: This study closely examines the effect on recovery of relationships with other patients during hospital treatment for AN, a severe eating disorder. Findings might help hospital staff to understand the feelings of those they look after and develop ways to protect patients from the negative effects of peer relationships and enhance the positive ones, to support recovery in hospital. [ABSTRACT FROM AUTHOR]

Background: In 2019, coronavirus disease 2019 (COVID‐19) broke out worldwide, leading to a pandemic. Studies have shown that COVID‐19 patients in intensive care units (ICUs) require more nursing care than other patients. ICU nurses who care for patients with COVID‐19 have shown signs of psychological and physical strain. Aim: The aim of this study was to illuminate ICU nurses' experiences of caring for patients with COVID‐19 in ICUs during the first wave of the pandemic. Study Design: A qualitative, descriptive and inductive approach was used. A total of 70 blog posts from 13 bloggers in the United States, Great Britain, Finland and Sweden were analysed using qualitative inductive manifest content analysis. Results: The results reveal an overall theme: 'An overturned existence under extreme conditions'. Furthermore, three categories—'the virus caused changes in work and private lives', 'unreasonable demands', and to hold on to caring ideals thanks to the support of others'—and seven subcategories were identified. Conclusions: Caring for patients with COVID‐19 during the first wave of the pandemic was demanding because of a lack of knowledge about the disease and the severity of the illness. This led to ICU nurses experiencing extreme conditions that affected various aspects of their lives. Support from colleagues and teamwork were revealed to be particularly important for how nurses dealt with the demands of working during a pandemic, as was sufficient recovery time between work shifts. Relevance to Clinical Practice: Work in ICUs was challenging and demanding, even before the pandemic. This study contributes to an understanding of the complex work environment that existed in hospitals during the first wave of the COVID‐19 pandemic. The knowledge obtained from this study can be used to revise working conditions and identify health interventions for ICU nurses. [ABSTRACT FROM AUTHOR]

Identity has been empirically established as a recovery process from serious mental illness (SMI) yet is often overlooked within intervention evaluations. Community arts presents one such intervention with emerging evidence illustrating the potential for recovery to occur within this context. However, research indicates numerous mechanisms may be involved in the identity recovery process, making it difficult to determine what works, for whom and in what context. The current review aimed to generate new theories to explain how, why and in what context community arts enable the identity change recovery process for individuals with SMI. A realist review was conducted between January and September 2021, with 22 articles and reports reviewed and synthesised to develop a theory. A safe and empowering intervention context was found to be vital to activate three key mechanism pathways: (a) feeling in control of SMI through coping; (b) achieving acceptance through connectedness and (c) overcoming personal challenges. The outcome was the development of positive self‐awareness, which enables individuals to redefine identity beyond SMI through both social and personal identities. Novel insights are presented through theory development, utilising the Social Identity Approach to Health and Transformative Learning Theory to conceptualise the findings through a multi‐theoretical lens. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

There is a significant diversity in approach to 'resilience' in the context of mental health recovery following experiences of psychosis, varying from clinically measurable outcomes to a personal trait within a recovery 'journey'. Given the contested nature of resilience within mental health literature, this study aimed to complete a scoping review to synthesise understandings of resilience by individuals with experiences of psychosis. Drawing on the holistic and person-centred principles that underpin social work approaches to mental distress, these perspectives are considered in the statutory, policy and critical contexts of British social work, establishing learning for practice. A meta-synthesis of qualitative studies was completed, drawing on searches of five databases (Social Care Online, APA PsychInfo, Cinahl, Medline and Web of Science), identifying twelve relevant papers. A thematic analysis identified three overarching themes (personal, social and professional factors) and eight associated sub-themes (personal responsibility, use of experience, coping strategies, peer support, social relationships, contribution, relationships with professionals and structured support). The study identifies systemic and life-course approaches as empowering service user engagements with psychosis, recovery and resilience, suggesting that the social work profession is well placed to engage with resilience enhancement in the context of mental health recovery. [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]

Health precautions implemented by the United Kingdom (UK) government to limit the spread of the Coronavirus Disease 2019 (COVID-19) led to the closure of many well-being support services in 2020. This created a need to re-think how impactful recovery support courses can be provided. One such service was that of the five-day Multi Activity Course (MAC) which was redesigned in accordance with national health guidelines to allow continued access for Wounded, Injured and Sick (WIS) military personnel to the service; the positive impacts of which are well established. This study investigated the influence of the newly developed Reduced numbers MAC (R-MAC) on the WIS participants lives during and for 12 months after attending. The R-MAC led to comparable impacts for participants well-being, at a time in which people's mental well-being was often being adversely affected. The positive mental well-being of the 261 participants improved by 33% throughout the course and remained 14% higher for the 37 participants who provided data six months after attending. Key facets of the experience that were most impactful for the participants were (i) shared experience with other veterans, (ii) discussing issues in a safe environment while receiving support from the staff and (iii) developing knowledge around self-help/personal development. Adapting to the challenging circumstances and developing the R-MAC mitigated against the already adverse impact of the COVID-19 pandemic for the WIS participants. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive analytic therapy (CAT) is used within UK mental health settings as a treatment for transdiagnostic complex psychological presentations. However, it is not routinely offered by the NHS Talking Therapies, for anxiety and depression (NHS Talking Therapies) programme which provides psychological treatments for common mental health difficulties. We aimed to evaluate the outcomes of providing CAT treatment to patients presenting with depression and/or anxiety, within the context of relational difficulties, adverse childhood experience or difficulty managing emotions, returning for further psychological treatment within NHS Talking Therapies. Methods: This was a pragmatic, real‐world evaluation, involving routinely collected self‐report measures of depression and anxiety, to examine the treatment outcomes of NHS Talking Therapies patients offered CAT over an 18‐month period. Quantitative validated measures of depression and anxiety were administered at the beginning and end of CAT treatment, and at follow up. Within‐group change in depression and anxiety scores were examined statistically, and rates of reliable improvement and recovery calculated. Results: Statistically significant decreases in depression and anxiety scores were observed during the CAT active treatment phase. The recovery rate was 46.4%, and 71.4% of patients showed a reliable improvement post‐treatment. Positive outcomes continued to be observed at follow‐up, with a recovery rate of 50% and a reliable improvement rate of 79.4%. Conclusions: CAT shows promise as a treatment option for NHS Talking Therapies patients re‐presenting with depression and/or anxiety. More research is required to determine if CAT should be offered more widely within NHS Talking Therapies services. [ABSTRACT FROM AUTHOR]

Those who experience parental domestic abuse in childhood are affected in multiple ways, but existing research uses a narrow lens, relying on psychotherapeutic and neuroscientific understandings. This article uses a dialogical theory to explore women's recovery stories. Interviews were conducted with 10 women in England and a voice-centered narrative analysis was used. This article attends to gendered, psychotherapeutic, and neoliberal narrative resources that shaped participants' stories. It concludes that recoveries after domestic abuse in childhood can be considered as dynamic processes that are individual, as well as shaped by social, political, and relational contexts that shape storytelling practices. [ABSTRACT FROM AUTHOR]

Purpose: In 2019, the world was hit by a life threatening severe acute respiratory syndrome causing a global pandemic; Coronavirus disease (COVID-19). In the UK, a nationwide "lockdown" of public isolation and reduced social contact followed. The experience of COVID-19 and the lockdown for forensic secure mental health patients is yet to be understood. This study aims to explore this phenomenon from the patients' perspective. Design/methodology/approach: A qualitative approach was taken. Semi-structured interviews were carried out with six patients from a low secure unit in the UK, between November 2020 and March 2021. Findings: Interpretive phenomenological analysis generated three superordinate themes from the data, providing insight into patients' experience: "treading water"; how they managed: "learning to swim"; and what was helpful during this time: "in the same boat". Practical implications: Further consideration should be given to creating a sense of safety in wards, along with ways to continue to address the power imbalance. Interestingly, social connection may be cultivated from within the hospital setting and would benefit from further research. Originality/value: To the best of the authors' knowledge, this is the first study to explore secure patients' experience of COVID-19 from the patients' perspective, within a population often neglected within recovery research. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: It is known that people with a diagnosis of borderline personality disorder often experience crises in their mental wellbeing.There is little evidence about the approaches of mental health nurses in community‐based crisis teams when working with people with a diagnosis of BPD. What the paper adds to the existing knowledge?: This paper highlights that limited resources, work‐patterns and issues of stigma present challenges to delivering recovery‐oriented care.The paper highlights that nurses typically try to navigate the challenges to continue to provide individualized care, though their self‐assessment is that this is with mixed success. What are the implications for practice?: The findings suggest that support is needed to develop brief interventions specific to teams working with people with a diagnosis of BPD who are at a point of crisis. Introduction: People with a diagnosis of borderline personality disorder (BPD) are often in contact with mental health services at a point of crisis, and in the UK, this includes Crisis Resolution Home Treatment teams (CRHTT). There is a drive for services to be recovery orientated; however, there is little evidence about the degree to which community services achieve this for people with a diagnosis of BPD when in crisis. Research Aim: To understand the perceptions held by CRHTT clinicians about their provision of recovery‐orientated acute care, for people with a diagnosis of BPD. Method: From a purposive sample of a single CRHTT, seven registered mental health nurses were interviewed and Braun and Clarke's thematic analysis framework was used to interpret the data. Results: Five themes emerged: person‐centred care; the timing is wrong; inconsistent staffing; the risks are too great; and BPD as a label. Discussion: The results demonstrate tensions between a drive to deliver person‐centred care and a range of challenges that inhibit this, with the possibility of reframing a recovery approach as "recovery‐ready". Implications for Practice: A whole‐system approach is required to enable a consistent recovery‐oriented approach, but research is also needed for brief interventions specific to this context. [ABSTRACT FROM AUTHOR]

To investigate the effect of home and away game travel on risk of concussion across different levels of rugby union. Exploration study across school, university, and professional rugby teams. Retrospective analysis of concussion incidence and symptomology of surveillance data and prospective data collection for potential concussions via surveys. Data was collected from school rugby teams (n = 344 matches, over 2 years), a university rugby (n = 6 matches), and a professional rugby team (n = 64 matches, over two seasons). School level rugby had an increased prevalence of concussions in away matches (p = 0.02). Likewise, there was a significant increase (p < 0.05) in concussions at away matches in university rugby. In addition, the professional rug by team had significant differences in recovery times and symptoms with away fixtures, including longer recovery times (p < 0.01), more initial symptoms (p < 0.01), as well as greater and more severe symptoms at 48 hours (p < 0.05). This research highlights an increased prevalence of concussion in school and university-aged rugby players away from home, as well as increased symptoms, symptom severity, and recovery times in professional rugby players. [ABSTRACT FROM AUTHOR]

Background: The current emphasis among addiction treatment providers is to use person-first language, such as "a person with a substance use disorder," as a way to reduce stigma around addiction and resulting barriers to treatment. This study considers how individuals recovering from substance use feel about the terms "alcoholic" and "addict," particularly how they self-identify and whether they believe the terms carry stigma. Method: Thirty-five individuals were interviewed, recruited primarily, but not exclusively, from 12-step meetings (Alcoholics Anonymous, Narcotics Anonymous), from 3 locations throughout a rural New England state. Interviews were transcribed and coded in Atlas Ti qualitative analysis software, and a content analysis of text coded with "stigma" was conducted. Results: Some comments reflected a belief that the terms "addict" and "alcoholic" carry a stigma. However, more comments rejected the notion of these being stigmatized terms; or acknowledged the stigma but reflected the subject's lack of internalizing of any stigma. Comments reflected other themes including a sense of pride, identity and ownership when self-identifying as an addict or alcoholic. Several comments suggested that person-first language is part of a larger movement to "soften everything," without changing the underlying condition (addiction). The findings may reflect the fact that subjects were recruited from 12-step programs, where the convention is to self-identity using the terms "alcoholic" and/or "addict." Conclusions: Some individuals seeking treatment for addiction may prefer self-identifying using old-school terminology (addict, alcoholic) rather than person-first language, for a variety of reasons (eg, they do not internalize the stigma of such terms). [ABSTRACT FROM AUTHOR]

Background: The positive and negative effects of interacting with web-based content on mental health, and especially self-harm, are well documented. Lived experience stories are one such type of static web-based content, frequently published on health care or third-sector organization websites, as well as social media and blogs, as a form of support for those seeking help via the web. Objective: This study aimed to increase understanding about how people who self-harm engage with and evaluate web-based lived experience stories. Methods: Overall, 4 web-based focus groups were conducted with 13 people with recent self-harm experience (aged 16-40 years). In total, 3 example lived experience stories were read aloud to participants, who were then asked to share their reactions to the stories. Participants were also encouraged to reflect on stories previously encountered on the web. Data were analyzed thematically. Results: Overall, 5 themes were generated: stories of recovery from self-harm and their emotional impact, impact on self-help and help-seeking behaviors, identifying with the narrator, authenticity, and language and stereotyping. Conclusions: Lived experience stories published on the web can provide a valuable form of support for those experiencing self-harm. They can be motivating and empowering for the reader, and they have the potential to distract readers from urges to self-harm. However, these effects may be moderated by age, and narratives of recovery may demoralize older readers. Our findings have implications for organizations publishing lived experience content and for community guidelines and moderators of web-based forums in which users share their stories. These include the need to consider the narrator's age and the relatability and authenticity of their journey and the need to avoid using stigmatizing language. [ABSTRACT FROM AUTHOR]

Supported living has been shown to improve functioning and social inclusion in people with severe and persistent mental health problems, reduce hospitalisation and provide secure accommodation in a population where housing needs are often unmet. Conversely, living in supported accommodation has been depicted by some as depersonalising, marginalising and an ordeal to survive. Discussions regarding housing and support often lack a thorough consideration of individual experiences, with a reliance on quantitative surveys. The question remains how to assure that supported accommodations actually are supportive of the residents' ongoing recovery process. The present study sought to shed light on the experiences of residents in an enhanced supported living service in the United Kingdom. Semi‐structured interviews were conducted with nine residents of the service between July 2020 and February 2021. Transcripts were analysed using thematic analysis and indicated three superordinate themes of experiences considered valuable to residents: (1) support from care staff which was readily available; (2), a sense of community and daily activity offered by the residence and on‐site activities; and (3) the experience of supported living as a stepping‐stone in an ongoing recovery process. Findings indicate the power of comprehensive care with supportive staff, peer‐relations, autonomy and fostering hope in empowering individuals in their ongoing recovery. [ABSTRACT FROM AUTHOR]

The purpose of the current review is to synthesize the evidence of patients' perspectives of recovery after hip fracture across the care continuum. A systematic search was conducted, focusing on qualitative data from hip fracture patients. Screening, quality appraisal, and a subset of articles for extraction were completed in duplicate. Themes were generated using a thematic synthesis of data from original studies. Fourteen high-quality qualitative studies were included. Four review themes were identified: recovery as participation, feelings of vulnerability, driving recovery, and reliance on support. Patients considered recovery as a return to pre-fracture activities or "normal" enabling independence. Feelings of vulnerability were observed irrespective of the time since hip fracture and only diminished when recovery of function and activities enabled participation in valued activities, e.g., outdoor mobility. Participants expressed a desire to engage in recovery with realistic expectations and the benefits of meaningful feedback reported. While reliance on healthcare professionals decreased towards a later stage of recovery, reliance on social support persisted until recovery was perceived to have been achieved. Patient perspectives highlighted hip fracture as a major life event requiring health professional and social support to overcome feelings of vulnerability and enable active engagement in recovery. Rehabilitation professionals should ensure expectations and goals are set early in the recovery process. Rehabilitation professionals should ensure goals set with patients are tailored to the individual's pre-fracture activities or "normal" promoting independence. Rehabilitation professionals should monitor goals ensuring they are providing support, motivation, and managing expectations across the care continuum. Rehabilitation professionals should address patients' feelings of vulnerability, particularly in the absence of social support, and ensure appropriate ongoing input to maximize recovery. [ABSTRACT FROM AUTHOR]

A life course approach recognizes the role of turning points in adding twists and turns in individuals' addiction recovery processes. The notion of certain key life events that trigger turning point experiences offers a valuable theoretical construct for understanding processes of change. The current study aimed to identify turning points and assess the role of contextual dynamics in generating long-term changes, based on lived experiences of persons in drug addiction recovery. A qualitative research design was applied using a Lifeline Interview Method (LIM), allowing a retrospective lens to elicit recovery narratives. Purposive sampling was utilized to compose a heterogeneous group of thirty persons in self-defined drug addiction recovery in Flanders (Belgium). An interpretative phenomenological approach was adopted during a thematic analysis, grounding the research claims in respondents' lived experiences. Key moments of change that were reported by participants are: (1) adverse drug-induced experiences; (2) becoming a parent; (3) 'hitting rock bottom'; (4) (dis)engagement of social networks and environments; and (5) addiction treatment. The findings illustrate the role of contextual dynamics that can facilitate (or hamper) experiencing these life events as turning points toward change. This study contradicts the notion of a single event or turning point causing abrupt changes in individuals' addiction trajectories. Contextual dynamics and meaning-making processes simultaneously influence whether specific life events can facilitate change. Treatment providers, researchers, and policymakers should take into account the process-based, situational, and relational nature of recovery. [ABSTRACT FROM AUTHOR]

Few adventurous training courses have been formally designed to assist military personnel in their recovery and/or transition into civilian life by supporting psychological health and well-being. This study examines, for the first time, the longitudinal effects of a five-day Multi Activity Course (MAC) on the mental well-being of serving but wounded, injured, and/or sick (WIS) UK armed forces personnel. The MAC is delivered using a participant-centered approach to encourage engagement in adaptive sports, adventurous activities, and personal development coaching sessions. This work extends previous research showing powerful short-term well-being benefits. Measures of positive well-being and psychological need satisfaction were provided by participants before and after attending the course, as well as two weeks, three months, six months and 12 months later. Self-reported well-being measures of psychological need satisfaction and positive mental well-being improved significantly throughout the course. These remained significantly higher at six and 12 months after the course, respectively. [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]

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]

Summary: Additional physiotherapy in the first postoperative week was associated with fewer days to discharge after hip fracture surgery. A 7-day physiotherapy service in the first postoperative week should be considered as a new key performance indicator in evaluating the quality of care for patients admitted with a hip fracture. Introduction : To examine the association between physiotherapy in the first week after hip fracture surgery and discharge from acute hospital. Methods: We linked data from the UK Physiotherapy Hip Fracture Sprint Audit to hospital records for 5395 patients with hip fracture in May and June 2017. We estimated the association between the number of days patients received physiotherapy in the first postoperative week; its overall duration (< 2 h, ≥ 2 h; 30-min increment) and type (mobilisation alone, mobilisation and exercise) and the cumulative probability of discharge from acute hospital over 30 days, using proportional odds regression adjusted for confounders and the competing risk of death. Results: The crude and adjusted odds ratios of discharge were 1.24 (95% CI 1.19–1.30) and 1.26 (95% CI 1.19–1.33) for an additional day of physiotherapy, 1.34 (95% CI 1.18–1.52) and 1.33 (95% CI 1.12–1.57) for ≥ 2 versus < 2 h physiotherapy, and 1.11 (95% CI 1.08–1.15) and 1.10 (95% CI 1.05–1.15) for an additional 30-min of physiotherapy. Physiotherapy type was not associated with discharge. Conclusion: We report an association between physiotherapy and discharge after hip fracture. An average UK hospital admitting 375 patients annually may save 456 bed-days if current provision increased so all patients with hip fracture received physiotherapy on 6–7 days in the first postoperative week. A 7-day physiotherapy service totalling at least 2 h in the first postoperative week may be considered a key performance indicator of acute care quality after hip fracture. [ABSTRACT FROM AUTHOR]

To explore older adult's perceptions of early rehabilitation and recovery after hip fracture, as a complement to the UK standards for acute physiotherapy after hip fracture. In-depth semi-structured interviews with 15 adults aged 60 years or more in hospital after hip fracture surgery. A thematic analysis approach with interpretation informed by Bury's biographical disruption theoretical framework. Participants voiced the importance of self-determination, professional support, meaningful feedback, and social capital after hip fracture. Collaborative working with staff was required for meeting the UK standards. Participants voiced anxieties about their hip fracture when considered in conjunction with their age and co-existing conditions, anticipating a disruption to their previous physical and social activities. This new, more dependent, life situation was not acceptable to participants. This study suggests hip fracture alone, was not perceived as a biographical disruption by older adults although it is presented as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions. For successful implementation of the UK standards, goal setting should consider patients in the wider context of their advancing age and co-existing conditions to empower them to define a fresh narrative of self. Hip fracture was perceived as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions. Participants expressed uncertainty over their ability to recover their previous identity in the absence of professional support and/or social capital. Healthcare professionals need to educate and empower older adults to take charge of their own recovery. For successful implementation of the UK standards for acute physiotherapy, there is a need to contextualize goal setting to empower patients to define a fresh narrative of self. [ABSTRACT FROM AUTHOR]

Objective: Cervical cancer is predominantly a cancer of younger women, and improvements in oncological outcomes have led to an increase in cervical cancer survivors living with the long‐term effects of treatment. Understanding the recovery process after treatment is essential to increase awareness of the short‐ and long‐term needs of survivors. The aim of this study was to qualitatively explore the recovery process and return to daily activity of cervical cancers survivors from a biopsychosocial perspective. Methods: Participants were 21 women treated for cervical cancer between the ages of 18 and 60 years, living in the United Kingdom. Interviews were undertaken face to face and via the telephone using a semi‐structured interview schedule. Results: Data analysis revealed themes which represented participants' experience and perceptions of treatment as a paradox; emotional needs after treatment; and a journey of adversarial growth. A key finding from this analysis was the nuanced experiences between treatment modalities, with physical changes perceived to be more disruptive following radical treatments, whilst psychological repercussions were significant regardless of treatment type. Conclusion: This study provides novel insight into the varied recovery experiences of those treated with surgery and/or chemoradiotherapy for cervical cancer, which can be used to improve the survivorship experience. [ABSTRACT FROM AUTHOR]

To understand how the social networks of a new recovery community can help sustain recovery, focusing on processes of social identity change, in the context of the wider UK recovery movement. A cross-sectional, mixed-methods social network analysis (SNA) of ego-network sociograms to map network transitions, using retrospective measures. Ten men were recruited from a peer-worker programme, in the South Ayrshire Alcohol and Drug Partnership (ADP), West of Scotland. Network measures were compared between two timepoints, just prior to current recovery and the present time. Measures included size and density, closeness of members, and their positive or negative influence, proportion of alcohol and other drug (AOD) using and recovery peers, and extent of separate subgroups. These were complemented with qualitative interview data. There was a significant transition in network composition, with the replacing of AOD-using peers with recovery peers and a broader transformation from relationships being framed as negative to positive. However, there was no significant transition in network structure, with AOD-using and recovery networks both consisting of strong ties and a similar density of connections between people in the networks. The transition in network composition between pre-recovery and the present indicates a different set of social influences, while the similarities in network structure indicate that the recovery network replaced the role of the using network in providing close bonds. This helped reduce social isolation experienced in early-recovery and provided a pathway into more structured opportunities for volunteering and employment. [ABSTRACT FROM AUTHOR]

Recovery is now the defining feature of UK drug and alcohol policy. Despite this policy emphasis, little attention has been paid to the lived experience of those in recovery. Instead, research has typically concentrated on treatment populations, which are predominantly male. Consequently, we have little insight into recovery experiences in general, and specifically how they might differ for females and males. This article makes an important contribution through offering a unique insight into the addiction/recovery pathways of 342 female and 410 male participants using data gathered via the UK Life in Recovery survey. Participants were recruited via social media and recovery groups. Bivariate analyses were used to explore gender differences in relation to personal characteristics, addiction and recovery (self-defined), well-being, and family life. These data suggest that a greater proportion of females in recovery report having specific needs in relation to mental health and relationships with children or partners whilst a greater proportion of males disclosed having specific needs in relation to physical health. Whilst the findings reflect the importance of ongoing support for everyone in recovery, they also suggest the need to provide gender-responsive recovery support. [ABSTRACT FROM AUTHOR]

An increasing body of evidence shows that informal mutual aid groups benefit those in addiction recovery. However, attention for mutual aid groups in practice and policy varies internationally and is only recently emerging in continental Europe. Existing evidence is mostly limited to studies of Alcoholics Anonymous groups in the United States. The aim of this cross-sectional study is to examine the relationship between membership of a variety of mutual aid groups and recovery capital, participation in social networks, and commitment to sobriety for individuals in drug addiction recovery (N = 367), living in the UK, the Netherlands, and Belgium. A convenience sample of participants completed an extensive assessment about their recovery experiences. Sixty-nine percent of participants reported lifetime (ever) membership of different mutual aid groups. Analyses reveal that membership of mutual aid groups is strongly associated with more participation and (self-reported) changes in social networks, greater levels of recovery capital, and a stronger commitment to sobriety. The findings suggest that participation in mutual aid groups may support addiction recovery through multiple mechanisms of change in favor of recovery. These findings highlight how mutual aid support may complement formal addiction treatment. [ABSTRACT FROM AUTHOR]

Purpose: The benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research; however, a "gold standard" psychosocial intervention has not been established. This small-scale study aimed to evaluate the psychosocial group ("Straight Ahead") currently running at a substance use inpatient unit based in the UK. Design/methodology/approach: A mixed-methods questionnaire design aimed to capture service user perspectives of the group programme via a questionnaire and assess whether an individual's recovery capital and emotion regulation scores improved during their stay. Findings: Thirty-four service users participated in the evaluation. Results indicate the group significantly increased individuals' recovery capital scores; however, it did not significantly improve emotion regulation. The three themes from the qualitative results focused on the importance of shared experiences, learning of new skills and the group as a positive experience. Service users provided suggestions for improvements, and these informed the provision of service-specific recommendations for the team and project commissioner. Originality/value: The evaluation provides tentative support for the use of the Straight Ahead programme and provides an insight into what service users find helpful when attending a psychosocial group during an inpatient detoxification admission. [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]

Little is known about what recovery means to those with chronic fatigue syndrome/myalgic encephalomyelitis, a poorly understood, disabling chronic health condition. To explore this issue, semi-structured interviews were conducted with patients reporting improvement (n = 9) and deterioration (n = 10) after a guided self-help intervention, and analyzed via "constant comparison." The meaning of recovery differed between participants—expectations for improvement and deployment of the sick role (and associated stigma) were key influences. While some saw recovery as complete freedom from symptoms, many defined it as freedom from the "sick role," with functionality prioritized. Others redefined recovery, reluctant to return to the lifestyle that may have contributed to their illness, or rejected the concept as unhelpful. Recovery is not always about eliminating all symptoms. Rather, it is a nexus between the reality of limited opportunities for full recovery, yet a strong desire to leave the illness behind and regain a sense of "normality." [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]

Background: Outpatient interventions for adult anorexia nervosa typically have a modest impact on weight and eating disorder symptomatology. This study examined whether adding a brief online intervention focused on enhancing motivation to change and the development of a recovery identity (RecoveryMANTRA) would improve outcomes in adults with anorexia nervosa. Methods: Participants with anorexia nervosa (n = 187) were recruited from 22 eating disorder outpatient services throughout the UK. They were randomised to receiving RecoveryMANTRA in addition to treatment as usual (TAU) (n = 99; experimental group) or TAU only (n = 88; control group). Outcomes were measured at end-of-intervention (6 weeks), 6 and 12 months. Results: Adherence rates to RecoveryMANTRA were 83% for the online guidance sessions and 77% for the use of self-help materials (workbook and/or short video clips). Group differences in body mass index at 6 weeks (primary outcome) were not significant. Group differences in eating disorder symptoms, psychological wellbeing and work and social adjustment (at 6 weeks and at follow-up) were not significant, except for a trend-level greater reduction in anxiety at 6 weeks in the RecoveryMANTRA group (p = 0.06). However, the RecoveryMANTRA group had significantly higher levels of confidence in own ability to change (p = 0.02) and alliance with the therapist at the outpatient service (p = 0.005) compared to the control group at 6 weeks. Conclusions: Augmenting outpatient treatment for adult anorexia nervosa with a focus on recovery and motivation produced short-term reductions in anxiety and increased confidence to change and therapeutic alliance. [ABSTRACT FROM AUTHOR]

Objectives: The concept of recovery has exerted considerable traction in mental health services for adults of working age, but less so in older people's mental health services. The aim of this study was to evaluate the feasibility of a staff-level recovery intervention in older people's mental health services. Method: The study used a mixed-method pre-post design. The study took place in NHS older people's mental health services, UK. Staff participants were multi-disciplinary mental health team members from the same service. The intervention was a manualised staff-level recovery intervention called the Older Adults Recovery Intervention (OARI). Measurement included the Recovery Knowledge Inventory and the Recovery Attitudes Questionnaire (RAQ-7) as well as fidelity data and in-depth qualitative interviews. Results: OARI was delivered to 204 staff in 15 clinical teams. There was a statistically significant change towards improvement in four of the six recovery attitude and knowledge sub-scales. There were positive findings in change in practice at individual level, but not at team level. A number of context barriers were identified leading to the intervention not being delivered as intended. Conclusions: Further development of OARI will involve a clearer distinction about the practice implications for service users with dementia versus functional illnesses, a stronger focus on implementation support, more use of evidence in training materials and a tailoring of context to meet professional group training needs. Overall, this study contributes novel data to the evidence base for recovery within older people's mental health services. [ABSTRACT FROM AUTHOR]

Background: Guillain‐Barré syndrome (GBS) is a rare inflammatory disorder affecting the peripheral nerves. Although typically there is full neurological recovery, some people continue to experience residual physical, psychological or social problems longer term. Evidence describing the experiences of people with GBS is limited. Objective: We aimed to explore the experiences of people with GBS in the UK. Design: We used qualitative (face‐to‐face and telephone) interviews to explore experiences of people with GBS. Audio‐recorded data were transcribed verbatim and analysed using the Framework Method supported by NVivo 11. Setting and Participants: We purposively recruited a sample of 16 volunteers with a prior diagnosis of GBS of varying age, sex, ethnicity, location, marital status, time since diagnosis and length of hospital stay to maximize differences in experience. Interviewees were required to have been discharged from hospital, able to give informed consent, able to speak and understand English and currently resident in the United Kingdom. Results: The key themes arising from the analysis were as follows: the importance of early diagnosis; the experiences of inpatient care; the importance of active support for recovery; the need for communication throughout the course of the illness; the need for greater awareness, knowledge and provision of information by health‐care staff; and path to achieving function. Conclusion: This is the first qualitative study exploring experiences of people with GBS in the UK through their whole illness journey from onset to recovery. The findings contribute to our understanding of the experiences and support needs of people recovering from GBS. [ABSTRACT FROM AUTHOR]

Purpose: Dual Diagnosis Anonymous (DDA) is a peer-led programme developed in the USA, which aims to address mental and addictive disorders in an integrated manner. This study is part of a mixed-methods evaluation of the first DDA pilot in the UK, and the purpose of this study is to explore the impact and mechanism of change of the programme through the perspective of DDA attendees, facilitators and the funding commissioners. Design/methodology/approach: Six DDA members were interviewed three times over a period of 12 months, the facilitators were interviewed twice and the commissioner was interviewed once. The qualitative longitudinal data were analysed using a trajectory thematic analysis. Findings: DDA attendance was perceived to have had a positive impact on five main areas: acceptance of self, of others and from others; social functioning; self-development; recovery progression; and feeling of hope. The possibility of addressing both mental health and addiction at the same time was a key factor in the recovery process. The facilitators observed that DDA had contributed to integrate members into employment and education, while the commissioner stressed the importance of joint commissioning and sustainability. Originality/value: The longitudinal approach provided a unique insight into the recovery process of DDA members. Being able to address the mental health as well as the substance use problems was considered to be a fundamental strength of DDA in comparison to the single purpose peer-support fellowships. [ABSTRACT FROM AUTHOR]

Aims: Experiencing shame can be a risk factor for relapse for people recovering from alcohol dependence, but for some it may act as a necessary protective factor for preventing relapse. Knowing how best to manage shame is therefore an important issue, yet the precise nature of the relationship between shame and alcohol dependence remains largely unexplored. Research questions: (1) In what ways do participants tell their stories of shame? (2) How is shame experienced and/or understood by those in recovery from alcohol dependence? Method: Eight participants were recruited from Alcoholic Anonymous (AA) groups and invited to tell their story of recovery. Stories were then analysed using a narrative analysis, focusing on how participants narrated their stories and made sense of their experiences of shame in particular. Findings: Participants spoke about an inherent deep-rooted negative view about themselves, which was present long before alcohol dependence developed. Alcohol served as a means of connection to others and a way of artificially relieving feelings of worthlessness. Recovery was about finding somewhere safe to talk about feelings of shame and make sense of these experiences. Conclusions: The results indicate that management of shame is an important component of recovery programmes for alcohol dependence. [ABSTRACT FROM AUTHOR]

Recovery Colleges aim to assist people with mental health difficulties in the journey to recovery through education. They bring together professional and lived experience of mental health challenges in a non‐stigmatising college environment and operate on college principles. All courses are designed to contribute towards well‐being and recovery. Despite the ever‐growing number of Recovery Colleges (both in the UK and internationally), the evaluative evidence is limited; comprising mostly non‐peer‐reviewed evaluations, audits and case studies. The present article comprises a mixed‐methods evaluation of a newly established Recovery College in South East Essex, UK. The evaluation comprised questionnaires of mental well‐being and social inclusion at baseline and 3 and 6 month follow‐up, in addition to three focus groups. There were significant improvements in both mental well‐being and social inclusion from baseline to 6 month follow‐up (25 participants completed the measure of well‐being at both time points and 19 completed the measure of social inclusion). This was supported by additional free‐text questionnaire comments and focus group findings (17 participants participated across the focus groups), with reports of increased confidence, reduced anxiety and increased social inclusion/reduced social isolation. Additionally, at 6 month follow‐up a majority of respondents were planning on attending courses external to the Recovery College, volunteering and/or gaining paid employment. Challenges and recommendations identified through the focus groups indicate the importance for standardisation of processes (which is particularly important when multiple organisations are involved in the running of a Recovery College), as well as consideration of longer‐running courses. Funders should continue to invest in the Recovery College movement as the growing evidence‐base is demonstrating how these colleges can help address the high prevalence of mental health difficulties, by promoting mental well‐being and social inclusion. [ABSTRACT FROM AUTHOR]

Objective: This study compared post-tonsillectomy pain scores and recovery using the coblation-only technique, comparing extracapsular versus intracapsular approaches. Methods: A prospective study was performed in our paediatric ENT department. Pain scores were recorded on days 0, 2, 4 and 8, using a visual analogue scale ranging from 0 (no pain) to 10 (extreme pain). Information was also collected on: return to normal fluid and solid intake, and any post-operative visits to primary care. Results: In total, 101 patients were included in the analysis. Average pain scores were statistically lower on days 2, 4 and 8 in the intracapsular group compared to the extracapsular cohort. The intracapsular cohort also returned sooner to normal fluid and solids intake. The extracapsular group were more likely to visit the general practitioner post-operatively. Conclusion: Intracapsular tonsillectomy appears to result in reduced morbidity overall and should be considered as a viable alternative in relevant cases. [ABSTRACT FROM AUTHOR]

Websites advocating the benefits of eating disorders ("Pro-Ana") tend to reinforce and maintain restrictive eating and purging behaviors. Yet remarkably, no study has explored individual accounts of disengagement from these sites and the associated meanings. Using narrative inquiry, this study sought to address this gap. From the interviews of six women, two overarching storylines emerged. The first closely tied disengagement to recovery with varying positions of personal agency claimed: this ranged from enforced and unwelcomed breaks that ignited change, to a personal choice that became viable through the development of alternative social and personal identities. A strong counternarrative to "disengagement as recovery" also emerged. Here, disengagement from Pro-Ana was storied alongside a need to retain an ED lifestyle. With "recovery" being just one reason for withdrawal from Pro-Ana sites, clinicians must remain curious about the meanings individuals ascribe to this act, without assuming it represents a step toward recovery. [ABSTRACT FROM AUTHOR]

Background: The recent interest in recovery from mental health problems has not meaningfully addressed the perspectives of ethnic minorities. Aim: To contribute to the discussion of recovery-oriented service with a study on the experience of Chinese people using UK mental health services. Methods: In-depth life history interviews were carried out with the users. The qualitative data were analysed using thematic analysis. Results: Four themes emerged as hindrances to personal recovery: (1) language difficulty creates hurdles, (2) diagnostic label is experienced as a double-edged sword, (3) treatment-related stigma and (dis)empowerment are identified, and (4) grievances are found in hospitalisation. Discussion: Having mental illness and being an ethnic minority in the UK experienced double hazard in their recovery journey. While the deprivation of agency and the stigma process in the health care system hinders their recovery, they are further disadvantaged by their ethnic minority status. Four pointers for service improvement, that apply to Chinese users in the United Kingdom and have general implications for users beyond this group, are proposed. [ABSTRACT FROM AUTHOR]

Hope is considered crucial to mental health recovery. However, the manner in which social inequalities shape individuals' meaning of hope has received little attention. Based on a close analysis of the recovery journeys of six Chinese service users in the UK, this paper explores the diverse meanings of hope among service users from non-dominant cultures. Illustrative stories are selected from in-depth life history interviews conducted with twenty-two participants. Based on the capabilities approach and intersectionality analysis, the findings reveal a paradox of hope and show how hope can be embraced, cautiously pursued or held at bay by individuals. Whilst hope is one expression of human agency, service users with reservations about hope maintain agency in other ways, despite their diminished life chances. This paper argues for an increased focus on individuals' agency development to support recovery and advocates for the challenging of inequalities to achieve this. [ABSTRACT FROM AUTHOR]

We analysed news articles published in national and local British newspapers between 2007 and 2015 to understand (1) how mental health and arts participation were framed and (2) how the relationships between participants in arts initiatives were conceptualised. Using corpus-assisted qualitative frame analysis, we identified frames of recovery, stigma and economy. The recovery frame, which emphasised that mental illness can be treated similarly to physical illness, positioned arts participation as a form of therapy that can complement or substitute medication. The stigma frame presented arts participation as a mechanism for challenging social conceptions that mentally ill individuals are incapable of productive work. The economy frame discussed the economic burden of mentally ill individuals and portrayed arts participation as facilitating their return to employment. Using thematic analysis, which paid attention to the representation of social actors, we found that service users were identified as the prime beneficiaries of arts initiatives, and arts participation was conceptualised as a way to bring people with mental health issues together. We discuss these findings against existing research on media representations of mental health and the concept of 'mutual recovery' and suggest what wider concurrent developments in the areas of mental health and the media may account for the uncovered frames and themes. [ABSTRACT FROM AUTHOR]

Objective: Qualitative research has identified personal costs and benefits for peer supporters associated with their role; however, quantitative evidence is sparse. This study used quantitative methods to explore relationships in experiences of providing peer support with constructs of empowerment, hope, recovery, quality of life and internalised stigma. Differences were examined for those in statutory versus non-statutory services; who had themselves received peer support versus those who had not and who identified having had negative experiences in clinical teams versus those without such experiences. Methods: A cross-sectional online and postal survey was undertaken in tandem with a linked consensus study. In all, 147 peer supporters were recruited from a variety of organisations across the United Kingdom. Validated questionnaires were used to examine constructs. Instruments created for the study measured peer support experiences, and personal costs and benefits involved. Correlations were calculated and results informed further regression analysis. Chi-square tests and independent samples t-tests tested group differences. Results: Peer supporters indicated they experienced almost twice as many role-related personal benefits than personal costs. Benefits included improvements to mental health and well-being, reduced use of services, increased social functioning and development of skills. Total number of personal costs experienced was significantly negatively related to peer supporters' empowerment and quality of life. There were no significant differences between the groups examined. Conclusions and Implications for Practice: An accumulation of personal costs may result in reduced quality of life; however, costs can be minimised by organisations. Limitations of the research are discussed and recommendations for future research are made including the need for longitudinal research. [ABSTRACT FROM AUTHOR]

The evidence is now clear that more than one half of those who have a lifetime addiction to alcohol or drugs will eventually achieve stable recovery. As documented in the Life in Recovery surveys and elsewhere, recovery often brings about positive changes across a diverse range of life domains. Although this suggests that there are some universal experiences of recovery, there has been a lack of comparative recovery research examining the variations in recovery experiences across different settings and cultures. Using a combined data set of the United Kingdom and Australian Life in Recovery surveys and the three-stage model of recovery, the authors compare life achievements at each stage across the two settings. There are differences in patterns of recovery, with elevated levels of ongoing mental health problems in Australia, and significant involvement with the criminal justice system in the United Kingdom, suggesting a contextual and structural role in understanding recovery pathways. The implications for policy and practice are reviewed around structural barriers and the role of social justice in advancing recovery models and pathways. [ABSTRACT FROM AUTHOR]

As the concept of recovery has expanded, and become embedded in drug and alcohol policy, so too has the proliferation of online recovery support. This article explores data from the UK Life in Recovery survey, focusing on online recovery methods categorized as online groups, websites, and smartphone applications. Although 301 people (39.30%) reported involvement with at least one online recovery method, chi-squared tests reveal significant associations between people in stable recovery (5 years or more) and the use of recovery applications (Cramer’s V = .114), as well as between people in full-time employment and the use of online recovery websites or recovery applications. Having dependent children was not associated with use of any online recovery method, yet gender was (Cramer’s V = .088). This study extends the relatively limited literature and knowledge base of online recovery methods. Although the evidence points to higher engagement of recovery websites and apps for people in stable recovery, encouraging online recovery methods for individuals in early recovery may support recovery efforts when the risk of returning to substance misuse and active using social networks remains high. Further research should investigate the mechanisms of recovery change, with a focus on gender differences. [ABSTRACT FROM AUTHOR]

Rhetorically contextualised against a history of poor outcomes and negative attitudes, New Labour's mental health policy introduced recovery as a turn towards optimism, control and choice for those who provide and use mental health services. Recovery continues to occupy a key role within contemporary policy and practice. Despite such privilege, recovery remains a contested concept, not least because it means different things to different people. This article reports empirical work conducted during 2010–11 and explores two interpretive repertoires (traditional and responsibilised-progressive) that mental health practitioners draw upon in their accounts of recovery. Grounded in constructionist theory, the findings suggest that practitioner accounts of recovery are diverse and produce many different subject positions from which recovery may be experienced. Developing Webber and Joubert's (2016) editorial comments on the challenge for social work, it is argued that professional social work must practise in a manner compatible with its own value base and any model of recovery must be held up for scrutiny. A knowledgeable position for the practitioner is advocated—one that is capable of working multiple paradigms in order to better understand and meet service user need. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to reflect on the development of a recovery-oriented training programme for mental health care-givers. It also considers the effectiveness of using participatory research methods that promote involvement of people with diverse expertise to co-produce this programme. It presents a rationale for developing recovery-oriented training, which employs blended learning, comprising face-to-face and e-learning.Design/methodology/approach A small advisory group consisting of professionals, experts-by-experience (service users) and -by-caring (care-givers) and an academic developed a blended learning programme about the recovery approach for mental health carer-givers. This paper details the participatory approach supported by an action research cycle that contributed to the design of the programme, and the specific impact of experiential knowledge on its development.Findings Reflections on the advisory group process are described that led to the co-production of the course. This leads to consideration of the value of using this research approach to develop a carer-focused programme. The content of the recovery-oriented training programme is presented which adopts blended learning. This leads to discussion of potential of this format to improve carers’ access to training.Originality/value It is proposed that this recovery-oriented course, building on a previous study, has the potential to positively influence outcomes for the training programme participants (the care-givers) and the person they support. It is suggested that blended learning may in part overcome some of the barriers carers experience to accessing and participating in traditional interventions. Reflections on the process of co-production underline the value of participatory research in designing this recovery-oriented course for carers. [ABSTRACT FROM AUTHOR]

Abstract: The notion of recovery has become prominent in mental healthcare discourse in the UK, but it is often considered as if it were a relatively novel notion, and as if it represented an alternative to conventional treatment and intervention. In this paper, we explore some of the origins of the notion of recovery in the early 20th century in movements such as Alcoholics Anonymous and Recovery Inc. Whilst these phenomena are not entirely continuous with recovery in the present day, some important antecedents of the contemporary notion can be detected. These include the focus on the sufferers’ interior space as a key theatre of operations and the reinforcement and consolidation of medical ways of seeing the condition without any immediate medical supervision of the actors being necessary. This has resonance with many contemporary examples of recovery in practice where the art of living with a mental health condition is emphasised without the nature of the psychopathological condition itself being challenged. [ABSTRACT FROM AUTHOR]

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research. [ABSTRACT FROM AUTHOR]