Mental Health Recovery Narratives and Their Impact on Recipients: Systematic Review and Narrative Synthesis

Abstract

Objective: Mental health recovery narratives are often shared in peer support work and antistigma campaigns. Internet technology provides access to an almost unlimited number of narratives, and yet little is known about how they affect recipients. The aim of this study was to develop a conceptual framework characterizing the impact of recovery narratives on recipients. Method: A systematic review of evidence about the impact of mental health recovery narratives was conducted. Searches used electronic databases (n ¼ 9), reference tracking, hand-searching of selected journals (n ¼ 2), grey literature searching, and expert consultation (n ¼ 7). A conceptual framework was generated through a thematic analysis of included articles, augmented by consultation with a Lived Experience Advisory Panel. Results: In total, 8137 articles were screened. Five articles were included. Forms of impact were connectedness, understanding of recovery, reduction in stigma, validation of personal experience, affective responses, and behavioural responses. Impact was moderated by characteristics of the recipient, context, and narrative. Increases in eating disorder behaviours were identified as a harmful response specific to recipients with eating disorders. Conclusions: Mental health recovery narratives can promote recovery. Recovery narratives might be useful for clients with limited access to peers and in online interventions targeted at reducing social isolation in rural or remote locations, but support is needed for the processing of the strong emotions that can arise. Caution is needed for use with specific clinical populations. Protocol registration: Prospero-CRD42018090923. Abré gé Objectif : Les récits de rétablissement de la santé mentale sont souvent partagés dans les groupes de soutien et les campagnes d'anti-stigmatisation. La technologie d'Internet offre un accès à un nombre presque illimité de récits, et pourtant, nous en

The mechanisms and processes of connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives

“…A preliminary coding framework, used as part of the deductive approach in objective 1, was developed through the synthesis of existing research on the impact of receiving recovery narratives [27,28]. This is shown as Additional file 2.…”

“…To accommodate, a mixture of text, audio and video-based narrative modalities were chosen. The selected narratives were diverse in narrator age, gender and ethnicity, given preliminary evidence that sociodemographic characteristics can influence connection [27]. Finally, to vary cognitive demands on participants, the chosen narratives were different in length.…”

“…We have undertaken a series of studies to understand the impact of recorded recovery narratives on recipients, of which the current paper is the third study. First, we conducted a systematic review and narrative synthesis to develop a conceptual framework to characterise the impact of live or recorded recovery narratives on recipients [27]. Five publications were included, and the synthesis identified six broad potential impacts of narratives: connectedness; understanding recovery; reduction in stigma; validation of personal experiences; emotional response; and behavioural responses.…”

“…A knowledge gap exists in relation to understanding the immediate impact of recorded recovery narratives across different modalities. The aim of this study is to refine preliminary change models presented through previous studies [27,28] in order to produce a testable causal chain model characterising how receiving a recorded mental health recovery narrative impacts on connection. The objectives are to understand the mechanisms by which connection with narrative and narrator characteristics occurs (Objective 1) and to characterise the processes by which these mechanisms of connection lead to outcomes (Objective 2).…”

Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives

“…The presence of 'downbeat' and 'neutral' tones support the inclusion of stories which may not conform to a "genre of inspiration", required to be emotionally uplifting [40], but which may be experienced as more authentic, a key moderator for positive impact on a recipient [14]. As evidence of both benefits and harms of stories emerges [43] it becomes increasingly important that individuals are offered a variety of examples, to maximise their chances of experiencing connection and hope [44].…”