Essential Elements That Contribute to the Recovery of Persons With Severe Mental Illness: A Systematic Scoping Study

Abstract

Introduction: There is an increasing emphasis on recovery-oriented care in the design and delivery of mental health services. Research has demonstrated that recovery-oriented services are understood differently depending on the stakeholders involved. Variations in interpretations of recovery lead to challenges in creating systematically organized environments that deliver a consistent recovery-oriented approach to care. The existing evidence on recovery-oriented practice is scattered and difficult to apply. Through this systematic scoping study, we aim to identify and map the essential elements that contribute to recovery outcomes for persons living with severe mental illness. Methods: We used the Arksey & O'Malley framework as our guiding approach. Seven key databases (MEDLINE, PubMed, CINAHL/EBSCO, EMBASE, ProQuest, PsycINFO, and Google Scholar) were searched using index terms and keywords relating to recovery and severe mental illness. To be included, studies had to be peer-reviewed, published after 1988, had persons with severe mental illness as the focal population, and have used recovery in the context of mental health. The search was conducted in August 2018 and last updated in February 2020. Results: Out of 4,496 sources identified, sixty (n = 60) sources were included that met all of the selection criteria. Three major elements of recovery that emerged from the synthesis (n = 60) include relationships, sense of meaning, and participation. Some sources (n = 20) highlighted specific elements such as hope, resilience, self-efficacy, spirituality, social support, empowerment, race/ethnicity etc. and their association with the processes underpinning recovery. Discussion: The findings of this study enable mental health professionals to incorporate the identified key elements into strategic interventions to facilitate recovery for clients with severe mental illness, and thereby facilitate recovery-oriented practice. The review also documents important gaps in knowledge related to the elements of recovery and identifies a critical need for future studies to address this issue.

Suffering and Salutogenesis: A Conceptual Analysis of Lessons for Psychiatry From Existential Positive Psychology (PP2.0) in the Setting of the COVID-19 Pandemic

“…Integrating PP2.0 Into a Salutogenic Framework for Psychological Distress in the Context of the COVID-19 Pandemic From the perspective of IMT, or of PP2.0 in general, humans are not purely material beings-rather, they are in a certain sense "hard-wired" for the transcendent and spiritual (Wong, 2020). This perspective is supported by empirical evidence suggesting that spirituality and religion are linked to positive outcomes in terms of physical and mental health and well-being (Braam and Koenig, 2019;Jaiswal et al, 2020;Moreira et al, 2020). Thus, attempting to address the problem of suffering during the COVID-19 pandemic in purely medical terms may be ineffective or even harmful.…”

Part II: Living Life: A Meta-Synthesis Exploring Recovery as Processual Experiences

“…Recovery as a process addresses the importance of expanding a focus solely on the individual to a focus on social and material conditions and on environments supportive of recovery [ 17 , 28 , 29 ]. In addition to direct work with clients, recovery-oriented practices should encompass collaboration with families, systems, and communities [ 30 , 31 ]. Tew highlighted the need to mobilize different forms of capital to promote recovery, i.e., economic, social, relational, identity, and personal capital [ 32 ].…”

Recovery-oriented psychotherapy: Practical recommendations for psychologists in organized care settings.

“…The practical recommendations presented in this article extend research that demonstrates linkages between psychotherapy process and recovery outcomes of individuals living with mental health conditions and receiving psychological services (e.g., Mallonee et al, 2022;Neale & Rosenheck, 1995) by providing psychologists and other mental health providers with specific clinical recommendations. In doing so, this article helps to resolve practical confusion and misuses of recovery in practice that others have previously identified (Jaiswal et al, 2020;Slade et al, 2014). Moreover, while some have debated about the relevance of symptom-focused treatment in recovery-based models of care (see Bellack, 2006), a focus on the process of psychotherapy may resolve this debate.…”

“…Moreover, questions have been raised about whether or not evidence-based practices (EBPs) fit within a recovery model of mental health care (Bellack, 2006). As a result of confusion regarding the integration of recovery into clinical settings, the concept of recovery can often be “misused” or “abused” in practice (Slade et al, 2014), and “has allowed providers to advertise recovery-oriented services without necessarily describing what such services entail” (Jaiswal et al, 2020, p. 2). Indeed, further guidance on how to practice recovery-oriented psychotherapy is needed.…”