Mental health staff perspectives on supporting recovery

• Main Author: Le Boutillier, Clair
• Other Authors: Henderson, Rosalind Claire ; Slade, Mike Dominic ; Lawrence, Vanessa Claire
• Published: King's College London (University of London) 2017
• Subjects: 362.2
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.718552

Background: Recovery has come to mean living a life beyond mental illness, and mental health services are encouraged to consider their role in supporting recovery. Staff perspectives are central to understanding how recovery support can be adopted in mental health care, because staff provide front-line services and are the vehicle bridging the gap between policy rhetoric and clinical practice. Aims: To explore staff perspectives on supporting recovery and to identify factors that help or hinder their efforts to provide support for recovery. Methods: A thematic analysis of 30 international documents offering recovery-orientated practice guidance was conducted. Ten focus groups were then conducted with multidisciplinary clinicians (n=34) and team leaders (n=31) from five NHS Mental Health Trusts across England, followed by individual interviews with clinicians (n=18), team leaders (n=6) and senior managers (n=8) using grounded theory methodology. A systematic review and narrative synthesis of empirical studies (n=22) identifying clinician and manager conceptualisations of recovery-orientated practice was then conducted. Results: The synthesis of existing practice guidance identified four practice domains of recovery support: Promoting Citizenship, Organisational Commitment, Supporting Personally Defined Recovery, and Working Relationship. The grounded theory identified a core category of Competing Priorities, with subcategories Health Process Priorities, Business Priorities and Staff Role Perception. The contextualising systematic review identified three conceptualisations of recovery support: Clinical Recovery, Personal Recovery and Service-defined Recovery. Conclusions: The conceptual framework of recovery-orientated practice contributes to the understanding of recovery-orientation. Competing priorities influence how recovery-orientated practice is understood and supported by staff. Service-defined recovery is a new and un-researched influence in mental health systems. The impact of service-led approaches to operationalising recovery in practice has not been evaluated.