Recovery after a suicidal episode: Developing and validating the Recovery Evaluation and Suicide Support Tool (RESST).

Abstract

The personal recovery movement advocates for shifting emphasis from clinical symptom reduction toward reclaiming personal agency and creating meaning-filled lives despite the presence of distressing experiences. Corresponding personal recovery measures have been developed; however, there is no established psychometric assessment of personal recovery following a suicidal episode. This study addressed this gap by developing the Recovery Evaluation and Suicide Support Tool (RESST) and assessing its test score reliability, test score interpretations' validity, and psychometric properties. Throughout RESST's development, input from diverse stakeholders-including clinicians, researchers, and individuals with lived experience-was gathered to ensure a meaningful and useful scale. Exploratory factor analysis techniques were used with adults with a suicidal episode history (N = 502) to select and refine items, culminating in a 21-item scale with four distinct subscales: Self-Worth, Life Worth, Social Worth, and Self-Understanding. Confirmatory factor analysis techniques demonstrated model fit across three samples of adults with a suicidal episode history (combined N = 1,523), and test-retest reliability was obtained (N = 204). The results revealed that RESST scores exhibit an internally consistent and replicable factor structure, consistent with personal recovery theory. Additionally, the interpretation of test scores exhibited both convergent and discriminant validity. Mental health indices related to recovery, negative mood states, suicidality, and meaning in life had significant moderate-to-strong correlations with the RESST, supporting the validity of the test score interpretations and clinical relevance. This measure should aid research into recovery processes and understanding how recovery following a suicidal episode may be enhanced clinically and personally. Public Significance StatementThe study highlights the underexplored area of personal recovery after a suicidal episode. It demonstrates that the Recovery Evaluation and Suicide Support Tool (RESST) offers reliable test scores and valid test score interpretations, effectively aiding in understanding, tracking, and supporting individuals' recovery from suicidal episodes.

Implementation of the Recovery Model and Its Outcomes in Patients with Severe Mental Disorder

“…An alternative perspective, termed personal recovery, sees recovery as a process carried out by a person with a serious mental illness to achieve psychological well-being beyond the limitations of the disease [1]. Recovery is understood from this perspective as a personal and ongoing process involving acceptance of the disability and the development of a new meaning and purpose in life [2][3][4].…”