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

Abstract

Research considering the basis for mental health nurses wanting to enable recovery among people who suffer from suicidal behavior is sparse. The aim of this study is to explore and evaluate how a new recovery-oriented caring approach (ROCA) was experienced by a suicidal patient in a context of close relatives and nurses. A single-case study with a qual-quan mixed-method design was chosen. Participants were recruited from a psychiatric clinic in Sweden and consisted of one patient, one close relative to the patient, and three nurses. The results reveal that the ROCA enabled the patient to narrate, bear experiences of hopelessness, and ask for support, rather than view suicide as the only possible solution. ROCA has the potential to support patients, relatives, and nurses to develop a common language, considering the patient’s life situation and struggles and to use this as a source for the patient’s individual care planning.

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

“…Five studies implemented models of care to support recovery within hospital‐based mental health services (see Table 1). The approaches employed in these studies were diverse, including ethnographic field research (Dawson et al, 2019); action research using a file audit to assess change (Hinton et al, 2014); quasi‐experimental pre/posttest design (Kalisova et al, 2018); a double‐blind RCT (Gandi & Wai, 2010) and a single case study (Sellin et al, 2019). Limitations in quantitative designs included having no pre‐intervention measures and small sample size (Gandi & Wai, 2010), no control group (Kalisova et al, 2018), and a file audit which may have been limited by the quality of records (Hinton et al, 2014).…”

“…The characteristics of the models of care implemented varied across studies. 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).…”

“…The duration of models of care targeting individual services users was three months (Gandi & Wai, 2010; Sellin et al, 2019). Service‐wide models of care took place over a longer duration, from 18 months to 4 years (Dawson et al, 2019; Hinton et al, 2014; Kalisova et al, 2018).…”

“…Likewise, Sellin et al . (2019) found that ROCA enabled a suicidal service user to talk about his experience and to ask for support as required. However, this approach is radically different from the current practice of regularly checking on service users who are at risk and would be challenging to implement in a culture where safety is paramount.…”

“…A final barrier was the embedded, biomedical model, and organizational prioritizes focused on maintaining safety and clinical treatment, over person‐centred, recovery‐oriented practice. Several studies facilitated the implementation of relational approaches to recovery‐oriented care (Dawson et al, 2019; Gandi & Wai, 2010; Sellin et al, 2019), including active collaboration between the service user and their support network. Unlike the biomedical model, they advocate for a flat, relational structure where all stakeholders have a voice, rather than a hierarchical structure where professionals are the experts and service users are recipients of care.…”