Caring for the suicidal person: A Delphi study of what characterizes a recovery‐oriented caring approach

Abstract

More research is needed for supporting mental health nurses in their caring for suicidal individuals. This study aimed to describe what characterizes a recovery-oriented caring approach, and how this can be expressed through caring acts involving suicidal patients and their relatives. Delphi methodology was used, and research participants were recruited as experts by experience to explore a recovery-oriented caring approach in a dialogical process between the experts and the researchers. The results highlight that it is important to acknowledge the view of the uniqueness of each person and reflected understanding of each individual person and experience. The results also reveal that a recovery-oriented caring approach is characterized by a 'communicative togetherness'. This communicative togetherness is associated with enabling a nurturing and caring space for suicidal patients to really express themselves and to reach for their own resources. The recovery-oriented caring approach has thereby potential to facilitate a mutual understanding of the complexities of the patient's situation, and supports patients in influencing their care and regaining authority over their own lives. Accordingly, mental health nurses need to listen sensitively to what suicidal patients really say by acknowledging their lifeworlds and being open to individual variations of their recovery processes. This includes recognizing available and supportive relatives as capable of contributing to the patient's life project to continue living.

Implementation of recovery‐oriented practice in hospital‐based mental health services: A systematic review

“…Three studies (Dawson et al, 2019; Gandi & Wai, 2010; Sellin et al, 2019) applied models of care based on a relational conceptualization of recovery: Open Dialogue (Olson et al . 2014), Partnerships‐in‐Coping (Shanley et al, 2003) and Recovery‐Oriented Care Approach (ROCA; Sellin et al, 2018). Relational recovery reflects the ideology that humans are interdependent, and the social context defines the experience (Price‐Robertson et al, 2017).…”

“…Partnership‐in‐Coping combines a recovery‐oriented approach with the use of the therapeutic alliance, to support service users to develop biophysiological, cognitive‐emotional, social, and emotional coping (Shanley et al, 2003). ROCA is an approach to working with people experiencing suicidal ideation, which focuses on their recovery process rather than monitoring behaviour (Sellin et al, 2018).…”

Knowledge and attitudes of mental health professionals and students regarding recovery: A systematic review

“…Alternatively, the external recovery process described how consumers are presented in the external world without being affected by symptoms of mental illness or living life in the community like everyone else (Jacob et al 2015). Six studies classified the external recovery process according to attributes such as social inclusion, relationship, and attaining an optimum level of functioning in the community (Gaffey et al 2016; Gilburt et al 2013; Jackson‐Blott et al 2019; Jacob et al 2015; Karpetis 2018; Parker et al 2017; Sellin et al 2018).…”

“…Five studies described several factors that can expedite the personal recovery process of consumers. These factors include collaborative or multidisciplinary teamwork, therapeutic rapport, good communication skills (Gaffey et al 2016; Karpetis 2018; Sellin et al 2018), showing ‘empathy, the ability to listen’ (Gaffey et al 2016), caring, helping, supporting, being respectful and open (Gilburt et al 2013), assessing risk (Karpetis 2018), and consumer involvement in service utilization (Gilburt et al 2013). In addition, two studies recommended factors such as staff involvement and developing idiosyncratic management strategies in delivering recovery‐oriented services (Gilburt et al 2013; Jackson‐Blott et al 2019).…”

Experiences of a Recovery-Oriented Caring Approach to Suicidal Behavior: A Single-Case Study

“…From the relatives’ perspectives, participation was about being actively involved in a process in which the person regains the desire to live (Sellin, Asp, Kumlin, Wallsten, & Wiklund Gustin, 2017b). The results from these studies (Sellin et al, 2017a, 2017b) were the point of departure when designing a Delphi-study, to which researchers in suicide prevention, registered nurses, and representatives from a Swedish organization working with suicide prevention and support to relatives, were invited to give their perspectives and reflect on what characterizes a recovery-oriented caring approach (ROCA) (Sellin, Kumlin, Wallsten, & Wiklund Gustin, 2018). The Delphi-panel concluded that such a caring approach needs to support patients in giving voice to their perspectives in dialogue with mental health nurses in what can be understood as a “communicative togetherness.” This means that the communication between the patient and the nurse is recognized as essential and needs to take place and evolve in relation to the patient’s lifeworld.…”