The objective of this study was to explore the meaning of recovery from the perspectives of consumers receiving mental health services in Canada. Methods: Sixty semi-structured interviews were conducted with 54 mental health consumers in Montreal, Québec City and Waterloo-Guelph, Ontario. Results: Two contrasting meanings of recovery emerged. The first definition strongly attached recovery to illness while the second definition linked recovery to self-determination and taking responsibility for life. Conclusions: The prominence of biomedical definitions of recovery suggests the need to find common ground between these two perspectives, if conceptualizations of recovery are to include the views of consumers who routinely experience the mental health system.

Background-Recovery is emerging as a worldwide paradigm in mental health. There is increasing recognition that the transformation of mental health systems to a recovery perspective requires collaboration among all stakeholders. Research to date has focused on the perspectives of service users and providers. The role and influence of organizational decision makers in the transformation process has been less studied.

Purpose The purpose of the present study was to advance a theoretical understanding of the mechanisms by which WISEs can influence the stigma associated with mental illness. Many people with serious mental illnesses want to work, but despite much attention to work entry strategies, unemployment rates remain exceptionally high among this population. Stigma has been identified as a particularly pernicious barrier to the full community participation of people with mental illnesses. If work integration social enterprises (WISE) are to positively impact the full community participation of people with mental illnesses, then addressing stigma will be integral to their operation. Design/methodology/approach A comparative case study approach was used to address the following research questions: “How is the stigma of mental illness experienced in the everyday operations of WISE?” and “What influence do WISEs have on the stigma of mental illness within the workplace and beyond?” Five established WISEs that pay workers at minimum wage or better were selected for inclusion. The maximum variation sample included WISEs that varied in terms of geographical location, form of commerce, business size, revenues and degree of connection with mental health systems and local communities. Data analysis was conducted in four stages using qualitative methods. Findings The study findings suggest processes by which WISEs can positively impact the stigma of mental illness. Three social processes are associated with the potential of WISE to contribute to stigma reduction: perception of legitimacy, perception of value and perception of competence. Each of these social processes is fueled by underlying tensions in practice that arise in the context of negotiating the dual goals of the business. Research limitations/implications This study advances theoretical understanding of the ways in which stigma may be perpetuated or reduced in WISE by revealing the social processes and practice tensions that may be associated with operation choices made by WISEs and their partners. Further research would be required to determine if the processes described actually lead to reduced stigma. Although efforts were made to select WISEs that demonstrate a variety of features, it is likely that some important features were absent. Additional research could further explore the findings identified here with WISEs from other sectors, including youth and workers with transient or less severe forms of illness. This work should be replicated internationally to explore how contextual factors may influence individual and public perceptions. Practical implications The findings provide guidance for WISE developers in the mental health sector concerning strategies that may help mitigate the development of stigmatizing features within a social enterprise and by extension improve the work experience and workforce integration of employees. The identification of these processes and tensions can be used to advance the development of consensus principles and standards in the WISE field and contribute to ongoing evaluation and research. Social implications WISEs have the potential to reduce stigma, an important goal to support their efforts to improve employment and integration outcomes for people with mental illnesses. Through their business structures and operations they may be able to impact stigma by positively influencing perceptions of legitimacy, value and competence – all issues that have been associated with public assumptions about mental illness that sustain stigma. Originality/value To the best of the authors’ knowledge, this study is one of the first to specifically focus on stigma in the WISE sector, particularly as it relates to the work integration of persons with mental illnesses. The findings provide a range of theoretical and practical implications for future development in the field and highlight factors that merit consideration more broadly in the sector.

This article examines how the recovery

Purpose The purpose of this paper is to understand how daily life reflects the recovery journeys of individuals with serious mental illness (SMI) living independently in the community. Design/methodology/approach The go-along technique, which blends participant observation and interviewing, was used to gather data from 19 individuals with SMI living in supported housing. Data were analyzed through the CHIME framework of personal recovery, which includes social connectedness, hope and optimism, identity, meaning in life, and empowerment. Findings Applying the CHIME framework to qualitative data reveals the multiple ways in which everyday experiences, within and beyond formal mental healthcare environments, shapes personal recovery processes. Research limitations/implications Combining novel methods and conceptual frameworks to lived experiences sharpens extant knowledge of the active and non-linear aspects to personal recovery. The role of the researcher must be critically considered when using go-along methods. Practical implications Practitioners working with this population should account for the role of socially supportive and financially accessible spaces and activities that support the daily work of recovery beyond the context of formal care and services. Originality/value This study utilizes an innovative method to illustrate the crucial role of daily and seemingly banal experiences in fostering or hindering personal recovery processes. It is also the one of the first studies to comprehensively apply the CHIME framework to qualitative data in order to understand the recovery journeys of individuals with SMI living in supported housing.

The role of medication in the recovery of mental health consumers is important. In the context of a multi-site Canadian study on the meaning of recovery, five themes related to medication and recovery emerged from qualitative interviews with 60 consumers. For these consumers, recovery meant: finding a medication that works; taking medication in combination with services and supports; complying with medication; having a say about medication; and living without medication. Findings underlined consumers' need to communicate their concerns around medication and be supported in developing self-management strategies and more collaborative relationships with providers. The study suggests an expanded role for nursing practice in these areas.Recovery from serious mental illness has emerged over the past two decades as a worldwide paradigm in mental health, challenging traditional biomedical models of care. Longitudinal studies have challenged century-long beliefs aboutmental illness as an inevitably deteriorative condition, establishing that the course of mental illness is heterogeneous and that recovery often occurs spontaneously

This study used photo-elicitation methodology to explore how the move from supervised to supported housing affects recovery and community connections for individuals living with serious mental illness (SMI) in four Canadian cities. Qualitative interviews conducted in 2015 revealed five themes: (1) the characteristics distinguishing home from housing; (2) the importance of amenities offered by supported housing; (3) the connections between accessibility, mobility, and wellbeing; (4) the role of certain places in facilitating aspects of recovery such as offering hope or facilitating social connectedness; and (5) the concrete and metaphorical impact of changing vantage points on identity (re)construction. Utilizing therapeutic landscapes as an analytical framework, and combining insights from the health geography, and mental health (MH) housing and recovery literatures, this study deepens current understanding of how everyday places-conceptualized as therapeutic landscapes-directly and indirectly support MH recovery for individuals with SMI. Implications for research on housing, and on the spatial aspects of recovery processes are discussed.

BackgroundProvider working conditions are important in mental health service delivery.AimsTo identify variables associated with perceived recovery-oriented care among mental health professionals.MethodA total of 315 mental health professionals and 41 managers across four Quebec service networks completed questionnaires. Univariate and multilevel mixed-effects linear regressions for bivariate and multivariate analyses were performed using independent variables from the input–mediator–output–input model and recovery-oriented care.ResultsRecovery-oriented care related to: working in primary care or out-patient mental health services, team support, team interdependence, prevalence of individuals with suicide ideation, knowledge-sharing, team reflexivity, trust, vision (a subset of team climate), belief in multidisciplinary collaboration and frequency of interaction with other organisations.ConclusionsOptimising team processes (for example knowledge-sharing) and emergent states (for example trust) may enhance recovery-oriented care. Adequate financial and other resources, stable team composition, training on recovery best practices and use of standardised assessment tools should be promoted, while strengthening primary care and interactions with other organisations.Declaration of interestNone.