Service providers' experiences and perspectives on recovery-oriented mental health system reform.

Abstract

Objective-With the use of a qualitative approach, this study focuses on service providers' experiences and perspectives on recovery-oriented reform.Methods-Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites.Results-Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses.Conclusions and Implications for Practice-The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice.

Mental Health Reform at a Systems Level: Widening the Lens on Recovery-Oriented Care

“…20,22 Other problems noted in these studies included highly variable and difficult-to-monitor nursing practices, 23 very limited individualized care planning, patient engagement, and shared decision making, all within the context of increasingly shorter stay and high-acuity settings that emphasize risk management and stabilization. 12,24 These challenges are exacerbated by the low morale observed on wards, with up to 40% of psychiatric nurses dissatisfied with their jobs 25 and, compared with community mental health workers, evidence of generally greater pessimism and less optimism about the potential for recovery of their clients.…”

“…11 There remains considerable ambiguity around how recovery-oriented mental health systems can successfully move from promotion of principles to the implementation of integrated practices. 1,[12][13][14] Arguably, the most obvious impediment to the implementation of mental health reform at a systems level is the lack of clear, evidence-based, and practical direction for hospitals. Despite its accounting for about one-half of all mental health and addictions expenditures in Canada, 15 the literature provides little guidance on how inpatient care could be improved, with no systematic reviews and few randomized trials.…”

Promoting Consumer Choice and Empowerment through Tenant Choice of Supportive Housing Case Manager

“…Self-help, self-advocacy, and peer support have also been cited as essential components of consumer choice (Curtis & Hodge, 1995), and, since its beginning in the late 1980s (Barton, 1998) and with increasing influence over the past decade (Piat & Lal, 2012), the mental health recovery movement has promoted a shift from a provider-driven emphasis on treatment adherence to a consumer-driven focus on treatment choice and self-determination (Laugharne, Priebe, McCabe, Garland, & Clifford, 1998). With this growing emphasis on consumer choice have come issues regarding personal autonomy and the difficulty of balancing the wishes and judgment of clients of mental health services against those of mental health professionals.…”

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program

“…There is an increasing body of research on the implementation and evaluation of Recovery-oriented mental health services worldwide (Hungerford et al, 2016;Piat & Lal, 2012;Williams et al, 2015).…”