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BACKGROUND: Promoting spiritual well-being aids the mental health recovery process. Furthermore, nursing governance bodies and national mental health care regulators support spiritual care as a mental health–promoting approach. Although spiritual well-being is integral to quality of life in people with mental illness, little is known about the psychiatric mental health (PMH) nurses' provision of spiritual care. AIMS: Spiritual perspectives, frequency of spiritual care, and knowledge of recovery-oriented practice were measured. Variables were explored to identify a model of spiritual care. METHOD: A descriptive correlational cross-sectional design was employed. Analyses of data using descriptive statistics, correlations, and hierarchical multiple regression were conducted with a convenience sample of 171 PMH nurses. RESULTS: Participants scored high on measurement of spiritual perspectives, moderate on measurement of knowledge about recovery-oriented practice, and indicated a moderate degree of frequency of provision of spiritual care. Nurses who viewed themselves as "spiritual and religious" provided more frequent spiritual care and had higher levels of spiritual perspectives than those who viewed themselves as "spiritual but not religious." Significant contributors to spiritual care were spiritual perspectives and years of experience as a PMH nurse. Knowledge of recovery-oriented practice, however, did not contribute to a model of spiritual care. CONCLUSIONS: Nurses' spiritual perspectives, religiosity, and years of experience are factors that may explain nurse-provided spiritual care. Findings imply that spiritual and/or religious development may support PMH nurses to provide spiritual care. [ABSTRACT FROM AUTHOR]

Substance‐related disorders can adversely impact quality of life. This study assessed a 12 step program on health‐related quality of life for Iranian individuals seeking to recover from substance use. The study used a quasi‐experimental, two group, three stage, pre‐ and post‐test design and collected data at baseline, and at 1 and 3 months' post‐intervention. The treatment group comprised 35 participants in a 12 step program with a non‐equivalent comparison group of individuals admitted to addiction treatment centers. Physical and mental health quality‐of‐life domains were assessed using the Short Form 36 Health Survey Questionnaire. The treatment group improved in all aspects of health‐related quality of life. The treatment group improved compared to the comparison group for two of eight quality of life dimensions – physical functioning and role limitations due to emotional problems – at 1 month post‐intervention. There were additional improvements at 3 months' follow up in six of eight quality‐of‐life subscales compared to the comparison group. The benefits to quality of life related to mental health recovery extended beyond the treatment program, indicating that the program principles were effectively implemented in daily life. [ABSTRACT FROM AUTHOR]

The life expectancy gap experienced by people living with severe mental illness is primarily a result of cardiometabolic disease that is often exacerbated by side effects of antipsychotic medication. Commencement of atypical antipsychotic medication is commonly associated with weight gain. The Keeping the Body in Mind programme has demonstrated that early intervention with lifestyle activities can attenuate this weight gain and potentially improve long‐term health outcomes. The aim of this study was to explore the experiences of young people who participated in the Keeping the Body in Mind programme, a targeted lifestyle intervention programme. A qualitative approach was used employing a semi‐structured interview format. The interview schedule included questions related to four topics: aspects of the programmes that were useful, attributes of staff members that influenced the programme, changes in attitudes towards their own physical health, and suggestions for programme improvements. Interviews were recorded with duration ranging from 40 to 65 min. Thematic analysis was used to detect and assemble codes. These were then synthesized and classified into themes. Eleven participants were interviewed (seven males), aged between 18 and 25 years. Thematic analysis revealed four main themes: the role of physical health in mental health recovery; the importance of staff interactions; the value of peer interaction; and graduation to a sustainable healthy lifestyle. Study participants reported that they valued the programme for both their physical health and mental health recovery. [ABSTRACT FROM AUTHOR]

Patients find forensic psychiatric care inadequate in that they are not treated as individuals and not involved in their own care. The purpose of this study was to describe patients' experiences and perceptions of forensic psychiatric inpatient care. Semi‐structured interviews were conducted with 11 inpatients. A qualitative content analysis resulted in a recurring theme, 'I know what I need to recover', and three main categories: 'A need for meaning in a meagre existence', 'A need to be a person in an impersonal context', and 'A need for empowerment in a restricted life'. Participants experienced and perceived forensic care as predominantly monotonous, predetermined, and not adapted to them as individuals, forcing them to fight and adapt to get through it and not lose themselves. Perceived needs were largely ignored or opposed by staff due to the content and structure of care. Findings suggest a need for reflective practices and patient involvement in order to develop and maintain a person‐centred and recovery‐oriented nursing practice. The study adds to previous research showing the importance of patients in forensic psychiatric inpatient care being listened to and involved in their care. The study is reported in accordance with the COREQ guidelines. [ABSTRACT FROM AUTHOR]

The issue of complex nonlinear change processes is one of the least understood aspects of recovery and one of the most difficult to apply in recovery-oriented health care. The purpose of this article is to explore the recovery stories of 17 mental health peer support workers to understand their narrative identity reconstruction in recovery using a complexity perspective. Using the Life Story Model of Identity (LSMI), a narrative thematic analysis of interviews suggests that self-mastery as part of personal agency is an important component of participants' narrative identity reconstruction. Self-mastery is particularly evident in redemptive story turning points (positive outcome follows negative experience). A complexity perspective suggests that participants realized their adaptive capacity in relation to self-mastery as part of recovery and that its use at story turning points critically influenced their recovery journey. Further exploring self-mastery as adaptive growth in narrative identity reconstruction appears to be a fruitful research direction. [ABSTRACT FROM AUTHOR]

One in five young adults (aged 18–25 years) in the United States experiences a past year mental disorder, commonly including depression or anxiety. Yet, 1.5 million each year do not receive needed mental health services and are unlikely, in general, to seek formal mental healthcare. We aimed to inform the development of a novel programme for young adult mental health by first eliciting their positive and negative prior experiences with mental health providers. Four focus groups with 19 young adults (aged 19–26 years) recruited from the community and with moderate to severe depression and/or anxiety were conducted in 2018 in a western US state. Participants' prior experiences with services/providers were elicited along six pre‐defined recovery‐related concepts: feeling listened to and validated, inclusivity, full information and consent, hope and optimism, connectedness, and change. Focus groups were audio‐recorded, transcribed verbatim and uploaded into NVivo version 12 software. Two independent coders used deductive thematic analysis to identify patterned responses. Feeling listened to and validated appeared as a cornerstone of other recovery concepts. Participants discussed past negative experiences with psychiatrists and regret for being put on medications in their teenage years without information or options. Hope and optimism were low because of a general focus by professionals to address immediate symptom‐based issues, rather than on improving their overall lives. Service providers' focus on medication‐taking, and other one‐size‐fits‐all tools, was interpreted as lacking a sincere desire to help. Young adults were particularly sensitive to inauthentic interactions and superficial strategies, which left them craving care that incorporated their whole lives, acknowledged biopsychosocial interconnections and prioritised improving their lives over 'feeling better' in a given moment. Mental health providers should consider developing programmes that shift focus away from an exclusively medical understanding of distress and towards holistic, educational or relational approaches that value body, mind, self‐exploration and authentic connection. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of traumatic experience (TE) among patients in psychiatric settings in Hong Kong and the associations between TE and levels of distress and anxiety and depressive symptoms. Methods: 129 patients who have received inpatient psychiatric services were recruited. Their lifetime TE was assessed using the Life Event Checklist (LEC), and TE in psychiatric settings using the Psychiatric Experiences Questionnaire (PEQ). Their level of distress symptoms was assessed using the Impact of Event Scale-Revised (IES-R), and the level of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of direct and indirect TE was 84.5%, as was the prevalence of TE in psychiatric settings. Common TE in psychiatric settings included witnessing another patient being taken down (61.2%), being put in restraints of any kind (41.1%), and witnessing another patient being physically assaulted by another patient (36.4%). TE in psychiatric settings associated with high prevalence of severe or extreme distress 1 week after the event included being forced to take medication against their will (52.2%), being threatened with physical violence (52.2%), and experiencing a physical assault (50.0%). Lifetime TE (the total number of LEC items reported) was associated with severity of distress and anxiety and depressive symptoms, whereas TE in psychiatric settings (the total number of PEQ items reported) was associated with severity of distress only. The total number of LEC items reported is the only predictor of levels of distress and anxiety and depressive symptoms. Conclusions: Lifetime TE and TE in psychiatric settings are common among patients with SMI. Trauma-informed care is suggested for mental health services. [ABSTRACT FROM AUTHOR]

Addiction treatment services usually prioritize the recovery of the user, despite the fact that problematic consumption often leads to distress among families that requires attention. The purpose of this study is to identify types of narratives constructed by relatives of people with substance dependence disorders regarding their condition and recovery process. Additionally, we seek to understand the conditions that facilitate or hinder the recovery process from the perspective of family members. Seven in-depth interviews were conducted with a narrative approach. Progressive, stable, and regressive narratives were identified, corresponding to various stages in the addiction and recovery processes. These narratives revealed different forms of distress, obstacles to treatment, and critical junctures with respect to attending care services. Families represent a valuable resource for user recovery, and therefore must be included in the treatment process. [ABSTRACT FROM AUTHOR]

ObjectiveThe purpose of this paper is to construct a conceptual framework for investigating the reconstruction of narrative identity in mental health recovery from a complexity perspective. This conceptual framework provides the foundation for developing a health boardgame to facilitate narrative identity reconstruction.MethodsA selective integrative review of the theoretical and empirical literature relevant to narrative identity reconstruction in recovery was conducted. Sources included books, dissertations, internet resources, and professional journals.FindingsThe reviewed material provides a conceptual framework that offers an enriched understanding of narrative identity reconstruction in recovery as a process of adaptive growth. It identifies the Hero’s Journey, the life story model of identity (LSMI), and intentional change theory (ITC) as particularly relevant in informing strategies for narrative identity reconstruction. The conceptual framework can be operationalized in a narrative coaching treatment approach using a boardgame.Conclusion and Implications for PracticeIn practice, mental health professionals could use the narrative coaching boardgame to facilitate people’s adaptive change with a focus on building skills to reconstruct their preferred narrative identity and foster hope. Future research should explore what aspects of narrative identity and non-linear dynamic processes of change are most important in people’s recovery narratives and in particular these processes can be assessed in response to the use of the boardgame.

Background: Recommender systems help narrow down a large range of items to a smaller, personalized set. NarraGive is a first-in-field hybrid recommender system for mental health recovery narratives, recommending narratives based on their content and narrator characteristics (using content-based filtering) and on narratives beneficially impacting other similar users (using collaborative filtering). NarraGive is integrated into the Narrative Experiences Online (NEON) intervention, a web application providing access to the NEON Collection of recovery narratives., Objective: This study aims to analyze the 3 recommender system algorithms used in NarraGive to inform future interventions using recommender systems for lived experience narratives., Methods: Using a recently published framework for evaluating recommender systems to structure the analysis, we compared the content-based filtering algorithm and collaborative filtering algorithms by evaluating the accuracy (how close the predicted ratings are to the true ratings), precision (the proportion of the recommended narratives that are relevant), diversity (how diverse the recommended narratives are), coverage (the proportion of all available narratives that can be recommended), and unfairness (whether the algorithms produce less accurate predictions for disadvantaged participants) across gender and ethnicity. We used data from all participants in 2 parallel-group, waitlist control clinical trials of the NEON intervention (NEON trial: N=739; NEON for other [eg, nonpsychosis] mental health problems [NEON-O] trial: N=1023). Both trials included people with self-reported mental health problems who had and had not used statutory mental health services. In addition, NEON trial participants had experienced self-reported psychosis in the previous 5 years. Our evaluation used a database of Likert-scale narrative ratings provided by trial participants in response to validated narrative feedback questions., Results: Participants from the NEON and NEON-O trials provided 2288 and 1896 narrative ratings, respectively. Each rated narrative had a median of 3 ratings and 2 ratings, respectively. For the NEON trial, the content-based filtering algorithm performed better for coverage; the collaborative filtering algorithms performed better for accuracy, diversity, and unfairness across both gender and ethnicity; and neither algorithm performed better for precision. For the NEON-O trial, the content-based filtering algorithm did not perform better on any metric; the collaborative filtering algorithms performed better on accuracy and unfairness across both gender and ethnicity; and neither algorithm performed better for precision, diversity, or coverage., Conclusions: Clinical population may be associated with recommender system performance. Recommender systems are susceptible to a wide range of undesirable biases. Approaches to mitigating these include providing enough initial data for the recommender system (to prevent overfitting), ensuring that items can be accessed outside the recommender system (to prevent a feedback loop between accessed items and recommended items), and encouraging participants to provide feedback on every narrative they interact with (to prevent participants from only providing feedback when they have strong opinions)., (©Emily Slade, Stefan Rennick-Egglestone, Fiona Ng, Yasuhiro Kotera, Joy Llewellyn-Beardsley, Chris Newby, Tony Glover, Jeroen Keppens, Mike Slade. Originally published in JMIR Mental Health (https://mental.jmir.org), 29.03.2024.)

Background: Evidence supports the positive influence of compassion on care experiences and health outcomes. However, there is limited understanding regarding how compassion is identified by people with lived experience of mental health care., Aim: To explore the views and experiences of compassion from people who have lived experience of mental health., Methods: Participants with a self-reported mental health condition and lived experience of mental health ( n =  10) were interviewed in a community setting. Characteristics of compassion were identified using an interpretative description approach., Results: Study participants identified compassion as comprised three key components; 'the compassionate virtues of the healthcare professional', which informs 'compassionate engagement', creating a 'compassionate relational space and the patient's felt-sense response'. When all these elements were in place, enhanced recovery and healing was felt to be possible. Without the experience of compassion, mental health could be adversely affected, exacerbating mental health conditions, and leading to detachment from engaging with health services., Conclusions: The experience of compassion mobilises hope and promotes recovery. Health care policymakers and organisations must ensure services are structured to provide space and time for compassion to flourish. It is imperative that all staff are provided with training so that compassion can be acquired and developed.

More contemporary personal recovery conceptualisation of mental health recovery emphasize the need to consider the perspectives of people who experience mental ill-health. Most lived experience research has been done in Western cultures with relatively few studies in Asian ones, creating a gap that needs to be addressed due to differences in cultural worldviews. This study explores the notion of recovery from the lens of people experiencing mental health challenges in Singapore. We adopted a constructivist grounded theory perspective to evaluate qualitative data from 21 participants. The core category which best represented what recovery meant was "reconciling and living with experiences of mental ill-health". Our findings suggest that a variety of societal aspects greatly influence perceptions of mental health recovery in Singapore, as participants often shared their desire to live a meaningful life within society but could only do so if they found a way to manage their symptoms more effectively., (© 2023. The Author(s).)

Introduction: Self-determination is a core component of mental health recovery and a predictor of positive outcomes. The literature calls for occupational therapists to lead practice change to greater recovery-orientation, including facilitating people's self-determination. However, systemic challenges thwart translation of policy into practice and therapists report a lack of confidence in implementing recovery-oriented principles. This study aimed to understand the strategies that mental health occupational therapists employ to support people's self-determination., Methods: Data were collected through an international on-line questionnaire principally comprising two open-ended questions designed to elicit deep reflective personal accounts. Participants were asked about an experience in which they supported a person's self-determination and the factors that either facilitated or hindered this experience. Qualitative data were analysed using inductive thematic analysis, guided by constant comparative methods., Findings: Thirty-four therapists, predominantly from Australia (n = 30), participated. Therapists described supporting self-determination as a multifaceted process that involved: (1) working on myself, (2) working with the person, and (3) working with others. They emphasised that the combined use of various strategies across these three areas of work was important to support people's self-determination. Further, awareness of and addressing issues of power in their practice was key., Conclusion: This study supports the translation of recovery-oriented principles into practice by revealing the nuanced strategies implemented by occupational therapists striving to support self-determination. Participants employed diverse strategies to empower people to take the 'driver's seat' in their mental health recovery journey. Insights from this study will support other occupational therapists to actualise recovery-oriented principles and better support self-determination in their practice. To effectively implement self-determination strategies, therapists must reflect on and address existing power differentials within mental health services, particularly between themselves and the people they support., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Background: The optimal duration of antipsychotic treatment following remission of first-episode psychosis (FEP) is uncertain, considering potential adverse effects and individual variability in relapse rates. This study aimed to investigate the effect of antipsychotic discontinuation compared to continuation on recovery in remitted FEP patients., Methods: CENTRAL, MEDLINE (Ovid), Embase, and PsycINFO databases were searched on November 2, 2023, with no language restrictions. RCTs evaluating antipsychotic discontinuation in remitted FEP patients were selected. The primary outcome was personal recovery, and secondary outcomes included functional recovery, global functioning, hospital admission, symptom severity, quality of life, side effects, and employment. Risk of bias was assessed using the Cochrane risk-of-bias tool 2, and the certainty of evidence was evaluated with GRADE. Meta-analysis used a random-effect model with an inverse-variance approach., Results: Among 2185 screened studies, 8 RCTs (560 participants) were included. No RCTs reported personal recovery as an outcome. Two studies measured functional recovery, and discontinuation group patients were more likely to achieve functional recovery (RR 2.19; 95% CIs: 1.13, 4.22; I 2  = 0%; n = 128), although evidence certainty was very low. No significant differences were found in hospital admission, symptom severity, quality of life, global functioning, or employment between the discontinuation and continuation groups., Conclusions: Personal recovery was not reported in any antipsychotic discontinuation trial in remitted FEP. The observed positive effect of discontinuation on functional recovery came from an early terminated trial and an RCT followed by an uncontrolled period. These findings should be interpreted cautiously due to very low certainty of evidence.

In response to the rise in mental disorders, psychosocial and community approaches have been proposed, complementing traditional clinical services. The present research aimed to understand the perception of individuals attending community-based strategies regarding mental health services as part of the approach to mental disorders in Colombia. Two workshops were conducted with 30 individuals with mental disorders (depression, anxiety and bipolar disorder), who were members of community strategies. A thematic analysis was conducted. The theme resulting from the analysis shows Community mental health within the healthcare system , which consisted of categories such as Group Amplifying Actions for Health and Groups as Complementary to Other Forms of Care . It is emphasized that the healthcare system should establish bridges with community mental health strategies and actively engage in their strengthening processes to enhance the outcomes of pharmacological interventions and even psychotherapeutic interventions. Bidirectional learning approach is proposed between community-based mental health services and clinical settings within the healthcare system. Community strategies can make an important contribution to complex processes in the health system., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction: Currently, there is no scientific consensus on the concept of alcohol addiction recovery beyond substance use control. This conceptual issue challenges the implementation of therapeutic strategies and mental health policies that are unrestricted to symptomatic remission. Aiming to contribute to its definition, this study aimed to examine the recovery experience of individuals with alcohol addiction using dialectical phenomenological psychopathology (DPP) as a theoretical and methodological framework., Methods: A dialectical phenomenological analysis was conducted through an examination of online interviews with eight Brazilian, São Paulo state citizens who were self-declared to be undergoing alcohol addiction recovery (or who declared that they had completely recovered)., Results: Participants' reports generated eight categories that were subdivided into two groups. The first group indicated experiential elements of recovery, such as changes in self-relation, changes in interpersonal relations, and changes in time relations, giving new meanings to suffering and alcohol use, and recovery as a continuous process. The second group referred to how the participants interpreted recovery according to their worldviews: as a spiritual experience, moral reformation, and mentality change., Conclusion: These categories can be understood through the lens of DPP as a process of change in the subjects' being in the world, characterized by the continued management of their existential imbalances in the dimensions of spatiality, temporality, selfhood, and intersubjectivity. The results are preliminary when it comes to conceptualizing recovery but may help future studies to develop recovery-oriented therapeutic strategies., (© 2024 S. Karger AG, Basel.)

Recovery-orientated practice is crucial to mental health care services-consistently identified in policy, service delivery guidelines and national mental health action plans. An essential component to systems reform and the adoption of recovery-orientated practice is the inclusion of peer support workers as practice leaders to support shifting culture in mental health service delivery. Designated peer support roles operate as healthcare professionals who utilise their lived and living experience of mental health difficulty to support those on their recovery journey through mutual understanding of shared experience. This research sought to explore the experiences of peer support workers integrating into mental health teams and identify organisational actions to facilitate successful recognition, integration and acceptance by colleagues; therefore, promoting sustainability of the peer support role. Qualitative interviews were undertaken with 18 peer support workers employed across four Australian states within 12 different government and non-government organisations. Study findings reveal three key areas for organisational change with seven main themes to assist organisations to better facilitate the successful integration of peer support workers into mental health service teams. These included robust induction, training for existing staff, clear referral pathways into the service, consistent supervision and debriefing, leadership support, professional development pathways and involving peer workers through change processes. These themes were grouped into three key areas for change including preparation, process and structural changes, and cultural change actions for sustainability. This article makes recommendations for organisations to consider when implementing peer support roles into mental health services., (© 2023. The Author(s).)

Purpose: Psychiatric disorders may have a negative effect on individuals' living, forming intimate relationships, education, and employment. The aim of psychiatric rehabilitation is to promote recovery - finding ways to cope with mental disorders despite debilitating symptoms. This study aimed to explore the outcomes of accommodation, social inclusion, psychiatric symptoms, substance and service use, quality of life and subjective recovery of young adults with severe mental illness after psychiatric rehabilitation., Materials and Methods: The study population consisted of individuals who had been in residential psychiatric rehabilitation between the ages of 18-29 years. Data on outcomes were collected using a questionnaire after a flexible follow-up period (mean 29 months). The questionnaire was answered by 32 eligible persons. We analysed multiple outcomes and compared the proportion of persons living independently at the start, after psychiatric rehabilitation, and at the follow-up point., Results: At the start of the rehabilitation, 33%, at the end, 69%, and at follow-up, 78% lived independently. However, most had not reached competitive employment nor were studying. Cognitive symptoms were the most common psychiatric symptoms, followed by depressive symptoms. More than 80% of the sample felt that they had partly recovered from their severe mental illness., Conclusion: According to the results of this study residential psychiatric rehabilitation may have positive effects on functioning and independent living at follow-up. Reaching competitive employment is difficult for persons with severe mental disorders and effective rehabilitation interventions need to be implemented. However, this study had limitations, and these results should be considered preliminary.

Purpose: The WHOQOL tools are widely used, multi-faceted, patient-rated, quality of life (QoL) measures, developed by the World Health Organization. The WHOQOL questionnaires are used to assess generic quality of life issues affected by all health problems. This study developed a module to use with the WHOQOL tools to improve their sensitivity to Health Related QoL issues relevant to mental health recovery.Methods: Using a sequential mixed-methods approach, two research stages occurred. A qualitative stage invited 88 participants with experience of mental health recovery, into focus groups and importance rating activities, to identify candidate items for the new module. Following this, a quantitative stage involved 667 participants with, and without, mental health/addiction issues completing online or paper-based questionnaires to analyze which candidate items differentiated between those with and without mental health/addiction issues. Classical test theory and iterative Partial Credit Rasch Analysis were used to identify the most suitable candidate items for a reliable and valid mental health recovery module to be used with the WHOQOL tools.Results: Seventeen candidate items captured important HRQoL facets relevant to mental health recovery. Rasch analysis removed 10 misfitting items. The final 7-item module, which demonstrated the best Rasch model fit, enquires about recovery beliefs, identifying strengths, self-awareness, acceptance, capacity to relate, feeling understood, and recovery progress. Ordinal-to-interval conversion tables have been developed to optimize measurement precision when using the module.Conclusions: Important HRQoL issues central to mental health recovery can be reliably evaluated by using the recovery module with the WHOQOL tools. [ABSTRACT FROM AUTHOR]

The history of mental health care has been marked by various struggles in maintaining the dignity of service users. Some reform movements have started to use educational strategies aimed at the beliefs and attitudes of professionals, as well as changing the way that practice is carried out. This paper intends to systematically review and synthesize studies assessing awareness and training activities for mental health professionals covering aspects related to recovery, empowerment, and in general, rights-based care to achieve full citizenship of mental health services users. We reviewed 26 articles and were able to include 14 of them in meta-analytic calculations. Our results at the qualitative level show an evolution of the literature towards better quality designs and focus on aspects related to the impact and maintenance of the effects of these training activities. Meta-analytic calculations found high heterogeneity but no risk of biases and low-to moderate effect sizes with a statistically significant impact on beliefs and attitudes but not on practices. The importance of this information in improving and advancing these educational activities is addressed. [ABSTRACT FROM AUTHOR]

Objective: The HospitalitY (HY) intervention is a novel recovery oriented intervention for people with psychotic disorders in which peer support and home-based skill training are combined in an eating club. A feasibility study was conducted to inform a subsequent randomised trial.Methods: This study evaluated three eating clubs consisting of nine participants and three nurses. Semi-structured interviews and pre- and post-intervention measures (18 weeks) of personal recovery, quality of life and functioning were used to evaluate the intervention. Participants received individual skills training, guided by self-identified goals, while organising a dinner at their home. During each dinner, participants engaged in peer support, led by a nurse.Results: In personal interviews participants reported positive effects on social support, loneliness, and self-esteem. Nurses reported that participants became more independent during the intervention. Participants were satisfied with the HY-intervention (attendance rate = 93%). All were able to organise a dinner for their peers with practical support from a nurse. Pre- and post -intervention measures did not show important improvements.Limitations: Outcome measures were not sensitive to change, likely due to a short intervention period (5 months) and a limited number of participants (N = 9). Using Goal Attainment Scaling to evaluate personal goals turned out to be unfeasible.Conclusions: The HY-intervention is feasible for participants with psychotic disorders. This study refined intervention and research design for the upcoming multicentre randomised controlled trial. We expect that the Experience Sampling Method will be more sensitive to changes in recovery outcomes than regular pre-post intervention measures. [ABSTRACT FROM AUTHOR]

Some suggest the ethos of the Tree of Life (ToL) group aligns with the concept of "personal-recovery" promoted in mental health policy. Thus, it is claimed that the group could be a useful approach within UK mental health services. This review collated 14 papers to explore whether existing literature regarding the ToL group supports this assertion. The papers were synthesized using the thematic analysis method and three broad themes were identified, which support the argument for its utility within services. These were recovery-aligned themes, the inclusivity of the model, and group processes relevant to mental health contexts. The papers are critically appraised, key concerns regarding the wider literature discussed, and clinical implications summarized. [ABSTRACT FROM AUTHOR]

Background: Mood and anxiety disorders are associated with growing burden of disease. Recent evidence shows that monitoring and enhancing positive mental health might be one direction to reduce this burden. The aim was to determine whether positive mental health predict recovery from mental disorders.Methods: The study population consisted of 414 participants with a 12-month disorder from the representative general population Netherlands Mental Health Survey and Incidence Study-2. Independent positive mental health indicators were mental well-being, its subscales emotional, social and psychological well-being and the category flourishing mental health. Recovery was defined as no longer fulfilling DSM-IV criteria of the index disorder 3 years later.Results: Despite meeting the criteria of a 12-month mental disorder, 19% with anxiety disorder were flourishing and 14% with mood disorder. Logistic regression analyses controlled for sociodemographics, physical health, life-events, service use, psychotropic medication, comorbidity and clinical severity showed that positive mental health positively influenced recovery from anxiety disorder (mainly by emotional and psychological well-being) and did not influence recovery from mood disorder.Limitations: The results are not generalizable to psychiatric patients in treatment settings and might differ for specific disorders within each DSM-IV category.Conclusions: Clinicians are encouraged to measure positive mental health in their patients and to improve positive mental health particularly in people with an anxiety disorder. The non-significant relation between positive mental health and recovery from mood disorder warrants further research, for example through using more in-depth assessment of positive mental health components and by investigating recovery from less severe mood disorders. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to construct a conceptual framework for investigating the reconstruction of narrative identity in mental health recovery from a complexity perspective. This conceptual framework provides the foundation for developing a health boardgame to facilitate narrative identity reconstruction. Methods: A selective integrative review of the theoretical and empirical literature relevant to narrative identity reconstruction in recovery was conducted. Sources included books, dissertations, internet resources, and professional journals. Findings: The reviewed material provides a conceptual framework that offers an enriched understanding of narrative identity reconstruction in recovery as a process of adaptive growth. It identifies the Hero's Journey, the life story model of identity (LSMI), and intentional change theory (ITC) as particularly relevant in informing strategies for narrative identity reconstruction. The conceptual framework can be operationalized in a narrative coaching treatment approach using a boardgame. Conclusion and Implications for Practice: In practice, mental health professionals could use the narrative coaching boardgame to facilitate people's adaptive change with a focus on building skills to reconstruct their preferred narrative identity and foster hope. Future research should explore what aspects of narrative identity and non-linear dynamic processes of change are most important in people's recovery narratives and in particular these processes can be assessed in response to the use of the boardgame. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders have a negative impact on the individual, society and global economy. The prevalence of mental disorders is increasing in young people, if unaddressed, they may develop into severe and chronic illnesses. Despite this, research into youth mental health recovery is limited. The current study aims to develop a theoretical framework of recovery in youth mental health and identify what facilitates this process. Methods: Fourteen parents of children engaged with the Child and Adolescent Mental Health Service were interviewed in relation to their understanding of youth mental health recovery. The transcripts of these interviews were analysed using the constructivist grounded theory approach. Results: A theoretical model of youth mental health was developed. The model provides an understanding of (a) the characteristics of youth mental health recovery, (b) the facilitators of recovery and (c) the barriers to recovery. The theory suggests that due to developmental factors youth mental health recovery occurs within the ecological context of complex social systems. Conclusions: The theory reflects elements of existing developmental and recovery research and provides a novel understanding of youth mental health recovery. This model may inform social, government and service attitudes and policy, and highlights areas for future research. [ABSTRACT FROM AUTHOR]

Background: Personal resources have been identified as important factors in predicting patient healing or symptoms control in schizophrenia. This observational retrospective study aims to explore the influence of resilience and recovery style on the modalities of clinical presentation of the disease, as well as individual functioning and quality of life. Methods: Participants were patients affected by schizophrenia spectrum disorders assessed at different mental health facilities. The rating scales considered are the following: Resilience Scale 10-items (RS); Recovery Style Questionnaire (RSQ); Montreal Cognitive Assessment (MoCA); Schizophrenia Quality of Life Scale (SQLS); Life Skills Profile (LSP); Positive and Negative Syndrome Scale (PANSS). Results: Forty-four patients fulfilled the inclusion criteria. The mean age was 46 years; the average length of the history of the disease at recruitment was 23 years with an average age at first episode of psychosis (FEP) of 23 years. General psychopathology, neurocognition, and integration recovery style can predict psychosocial functioning and explain ∼54% of the LSP variance; RS total score and PANSS general psychopathology score can predict and explain ∼29% of the LSP variance. A negative association between PANSS general psychopathology and LSP total score supports the need to reduce first the symptomatology, and then successfully apply other types of interventions. A strong positive association between neurocognition and life functioning was detected, showing that deficits in neurocognition have proved to be important predictors of the functional outcome. Integration was also proven to be significantly associated with a good functional outcome. Psychotic symptoms turn out to be a negative predictive factor, whereas resilience can be hypothesized as a protective factor. Conclusions: Resilience and recovery style "integration" can be considered as two complementary predictive resources for a good outcome; this result supports the need to set up personalized treatments, based on the characteristics of the patients. [ABSTRACT FROM AUTHOR]

The clubhouse model is a community psychiatric rehabilitation program aiming to provide a restorative environment for people with severe mental health problems. These clubhouses provide their members with opportunities for friendship, employment, and education, which help them on their paths towards mental health recovery. Towards that end, the model features clubhouse members and staff working side by side to execute clubhouse activities. That is, unlike most of the community mental health programs where staff provide services to their clients, clubhouse staff are required to partner with members in their work. The aim of this qualitative study was to understand how the clubhouse staff elicited member participation and facilitate recovery. The research was conducted between Year 2013 and Year 2014 at the world's first clubhouse: Fountain House in New York City. The first author conducted 262 hr of active participant observation in 41 visits to Fountain House, and in‐depth interviews with 38 staff members who had worked at Fountain House for at least 1 month during the study period. The dimensional analysis procedure was used to analyse the observation notes and interview transcripts. Results showed that participation was a key to rebuilding members' self‐confidence, which further encouraged members to seek more opportunities for self‐enhancement and personal growth. Specific organisational policies, programming, practical considerations, and other strategies shaped a positive environment for members to exercise autonomy, experience self‐efficacy, and model behaviours after others who have succeeded. Findings of this research support the egalitarian staff–member relationships and the maintenance of an open and transparent atmosphere of the clubhouse, as observational learning enables members to move forward with their journeys to recovery. Findings also may inform efforts to shift traditional psychiatric services towards recovery‐oriented care. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The Freedom Commission's recommendations, Substance Abuse and Mental Health Services Administration's framework, and policy directives on recovery-oriented services have fueled the recovery transformation. Mental health recovery services have been implemented in a broad range of outpatient settings. However, psychiatric inpatient units remained embedded in the traditional model of care. AIMS: The purpose of this article is to describe an ongoing quality improvement implementation of recovery services in a Veterans Health Administration acute psychiatric inpatient unit. METHOD: An interprofessional Partnership for Wellness delivered 4 to 6 hours per day of evidence-based recovery and holistic population-specific health programs. Veteran, system, and program indicators were measured. RESULTS: Preliminary indicators over a 2-year period suggest that Veterans rated group content and relevance high, pre–post psychiatric rehospitalization rates decreased by 46%, and fidelity to recommended strategies was high. CONCLUSIONS: The project success reflects strong leadership, a partnership of committed staff, effective training, and an organizational culture exemplifying excellence in Veteran services and innovation. [ABSTRACT FROM AUTHOR]

Many people with a psychotic disorder are coping with severe psychosocial limitations related to their illness. The current randomized controlled trial (RCT) investigates the effects of an eating club intervention (HospitalitY (HY)) aimed to improve personal and societal recovery. In 15 biweekly sessions participants received individual home-based skill training and guided peer support sessions in groups of three participants from a trained nurse. A multi-center RCT was conducted (intended sample size: n = 84; n = 7 per block) in patients with a diagnosis of schizophrenia spectrum receiving community treatment. HospitalitY was compared to a Waiting List Control (WLC) condition at three time points (baseline, end-of-treatment (8 months) and follow-up (12 months)) using personal recovery as primary outcome and loneliness, social support, self-stigma, self-esteem, social skills, (social) functioning, independency competence, and psychopathology as secondary outcomes. Outcomes were evaluated with a mixed modeling statistical procedure. The HY-intervention had no significant effects on personal recovery or secondary outcomes. More attendance was associated with higher scores on social functioning. With N = 43 participants included, power was insufficient. Seven HY-groups were started, from which three discontinued before the sixth meeting, one HY group stopped due the start of the COVID-19 pandemic. Despite a promising pilot study on feasibility, the current RCT did not show any effects of the HY intervention. A mixed qualitative-quantitative research methods might be more appropriate for researching the HospitalitY-intervention to investigate what social and cognitive processes are at play in this peer guided social intervention. • Eating clubs are a novel intervention in combining societal and personal recovery. • Eating clubs have not been researched before in an RCT. • Researching eating clubs in an RCT showed to be challenging. • Personal recovery interventions might benefit from qualitative evaluations. [ABSTRACT FROM AUTHOR]