“Is There a Getting Better From This, or Not?” Examining the Meaning and Possibility of Recovery From Mental Disorder

Hess, Jacob Z.; Lacasse, Jeffrey R.; Harmon, Jordan; Williams, Daniel C.; Vierling-Claassen, Nathan

doi:10.1080/0145935x.2014.924344

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…In the literature, two representations of recovery are commonly found: a way to restore functioning or a process to deepen wellness. 50,51 The first representation relies on a clinical model of care, whereas the second focuses on a citizenship model that derives from the mental health user movement that claims users have a right to self-determination and inclusion in the community. 51 Our study also confirmed that fully and systematically engaged mental health users can be challenging for providers with regard to their care.…”

Section: Main Contributions Of This Papermentioning

confidence: 99%

Clinical Governance to Enhance User Involvement in Care: A Canadian Multiple Case Study in Mental Health

Clavel

Pomey

2020

Int J Health Policy Manag

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Background: Individuals with serious mental illness face challenges in managing their health, leading to the need for integrating their needs and preferences in care decisions. One way to enhance collaboration between users and providers is to improve clinical governance; a shared responsibility between managers and providers, supported by healthcare organizations (HCOs), policies, and standards. We applied the concept of clinical governance to understand (1) how managers and providers can enhance the involvement of users in mental health, (2) the contextual and organizational factors that facilitate user involvement in care, and (3) the users’ perceptions of their involvement in care. Methods: We conducted two, in-depth case studies from two clinical teams in Canada offering outpatient care for users with acute mental illness. A total of 25 interviews were carried out with managers, and four focus groups were held with providers. A measure of patient-reported experience was used to evaluate the users’ perceptions of their involvement in care. Results: The providers used two methods to involve users in the care planning process: encouraging users to identify their life goals and supporting them to define recovery-oriented objectives. To encourage the adoption of collaborative practices, the managers used various practices such as revising care protocols, strengthening providers’ knowledge of best practices and integrating peer-support workers (PSWs) in the team. Compliance with organizational and external commitments/requirements for user involvement, access to specific training and the institutionalization of a culture promoting user involvement facilitated the adoption of collaborative practices. We found that mental health teams that adopt recovery and collaborative practices with users show a high degree of user-perceived involvement in care. Conclusion: This is the first study to apply the concept of clinical governance to understand how managerial and clinical practices, and other organizational and contextual factors, can enhance the involvement of mental healthcare users.

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Section: Main Contributions Of This Papermentioning

confidence: 99%

Clinical Governance to Enhance User Involvement in Care: A Canadian Multiple Case Study in Mental Health

Clavel

Pomey

2020

Int J Health Policy Manag

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“…Yet, tensions persist about the meaning and ownership of recovery [16,17]. Generally speaking, there are two major portrayals of recovery [18,19]. One is akin to the notion of cure in the field of physical health; clinical recovery refers primarily to the reduction of psychiatric symptoms through a curative approach to the disease using psychopharmacology and psychotherapy.…”

Section: A Problem To Be Addressed: Measuring the Effects Of Psws On mentioning

confidence: 99%

Online and Recovery-Oriented Support Groups Facilitated by Peer Support Workers in Times of COVID-19: Protocol for a Feasibility Pre-Post Study

Pelletier¹,

Houle²,

Goulet³

et al. 2020

JMIR Res Protoc

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Background In times of pandemics, social distancing, isolation, and quarantine have precipitated depression, anxiety, and substance misuse. Scientific literature suggests that patients living with mental health problems or illnesses (MHPIs) who interact with peer support workers (PSWs) experience not only the empathy and connectedness that comes from similar life experiences but also feel hope in the possibility of recovery. So far, it is the effect of mental health teams or programs with PSWs that has been evaluated. Objective This paper presents the protocol for a web-based intervention facilitated by PSWs. The five principal research questions are whether this intervention will have an impact in terms of (Q1) personal-civic recovery and (Q2) clinical recovery, (Q3) how these recovery potentials can be impacted by the COVID-19 pandemic, (Q4) how the lived experience of persons in recovery can be mobilized to cope with such a situation, and (Q5) how sex and gender considerations can be taken into account for the pairing of PSWs with service users beyond considerations based solely on psychiatric diagnoses or specific MHPIs. This will help us assess the impact of PSWs in this setting. Methods PSWs will lead a typical informal peer support group within the larger context of online peer support groups, focusing on personal-civic recovery. They will be scripted with a fixed, predetermined duration (a series of 10 weekly 90-minute online workshops). There will be 2 experimental subgroups—patients diagnosed with (1) psychotic disorders (n=10) and (2) anxiety or mood disorders (n=10)—compared to a control group (n=10). Random assignment to the intervention and control arms will be conducted using a 2:1 ratio. Several instruments will be used to assess clinical recovery (eg, the Recovery Assessment Scale, the Citizenship Measure questionnaire). The COVID-19 Stress Scales will be used to assess effects in terms of clinical recovery and stress- or anxiety-related responses to COVID-19. Changes will be compared between groups from baseline to endpoint in the intervention and control groups using the Student paired sample t test. Results This pilot study was funded in March 2020. The protocol was approved on June 16, 2020, by the Research Ethics Committees of the Montreal Mental Health University Institute. Recruitment took place during the months of July and August, and results are expected in December 2020. Conclusions Study results will provide reliable evidence on the effectiveness of a web-based intervention provided by PSWs. The investigators, alongside key decision makers and patient partners, will ensure knowledge translation throughout, and our massive open online course (MOOC), The Fundamentals of Recovery, will be updated with the evidence and new knowledge generated by this feasibility study. Trial Registration ClinicalTrials.gov NCT04445324; https://clinicaltrials.gov/ct2/show/NCT04445324 International Registered Report Identifier (IRRID) PRR1-10.2196/22500

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“…En effet, on peut succinctement distinguer au moins deux représentations principales du rétablissement 19 . Lorsque le rétablissement réfère au contrôle des symptômes, s'apparentant aux notions de guérison, l'objectif principal pour la personne est alors de se conformer aux traitements.…”

Section: Cadre Conceptuel Du Rétablissement Civiqueunclassified

Évaluation d’une intervention de promotion de la citoyenneté : le Projet citoyen de l’Université du rétablissement

Pelletier

Pouliot-Morneau

Houle

et al. 2017

smq

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Le Plan d’action en santé mentale 2015-2020, du ministère de la Santé et des services sociaux du Québec, comprend des mesures « favorisant le plein exercice de la citoyenneté ». Il mise sur la mobilisation de tous les partenaires. Participation aux instances et citoyenneté vont de pair, mais jusqu’à récemment il n’existait pas de mesure de la citoyenneté qui aurait permis d’observer empiriquement d’éventuelles avancées en cette matière. Nous avons utilisé les résultats d’une nouvelle mesure de la citoyenneté validée pour structurer des groupes de discussion avec 18 usagers de services de santé mentale québécois ; ils ont ainsi commenté les résultats à la mesure administrée auprès de 800 autres répondants. Pour mener l’évaluation, deux types de données ont été mis à contribution de manière croisée, soit dans le cadre d’une méthode mixte. En effet, des données quantitatives ont été générées à partir des résultats à la mesure de la citoyenneté, tandis que des entrevues de groupe ont permis de produire des données qualitatives ici présentées sous forme d’extraits de ces entrevues. Avec 57,9 %, c’est pour la dimension « implication dans la communauté » que le résultat est le plus faible. Les participants aux entrevues de groupe ont commenté ce résultat en suggérant que l’implication dans la communauté se manifeste souvent d’abord par l’exercice d’un travail ; c’est d’ailleurs pour la question « Vous avez accès à du travail » que le score est le plus faible d’entre tous les 23 items, à égalité avec la possibilité d’influencer la communauté (50,3 %). D’autre part, le fait que ce soit pour l’item « Vous êtes traités avec dignité et respect » que le résultat soit le plus élevé s’explique peut-être par la possibilité que, en prenant davantage conscience de l’influence des déterminants sociaux (ce n’est donc pas volontairement que nous serions malades ou sans-emploi), les participants se regardent eux-mêmes avec plus de dignité et de respect. Ils sentent que le système public les considère davantage comme citoyens à part entière puisqu’il sollicite leur participation. La mesure de la citoyenneté s’est avérée pertinente pour soulever de tels enjeux.Objectives The Global Model of Public Mental Health is “global” not only in the sense of having an international perspective, but in regarding service users as actors at all levels of public mental health exerting collective and organized influence on the social determinants of health, in addition to being recipients of care. Having access to appropriate health and mental health care when needed is a fundamental human right. Having a say over the manner in which care is provided, including partnership in decision making in care planning and ongoing care, has gained increasing support among recipients and providers of care. Over the past ...

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“Is There a Getting Better From This, or Not?” Examining the Meaning and Possibility of Recovery From Mental Disorder

Cited by 14 publications

References 28 publications

Clinical Governance to Enhance User Involvement in Care: A Canadian Multiple Case Study in Mental Health

Clinical Governance to Enhance User Involvement in Care: A Canadian Multiple Case Study in Mental Health

Online and Recovery-Oriented Support Groups Facilitated by Peer Support Workers in Times of COVID-19: Protocol for a Feasibility Pre-Post Study

Évaluation d’une intervention de promotion de la citoyenneté : le Projet citoyen de l’Université du rétablissement

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