The Development of Recovery Competencies for In-patient Mental Health Providers Working with People with Serious Mental Illness

Chen, Shu-Ping; Krupa, Terry; Lysaght, Rosemary; McCay, Elizabeth; Piat, Myra

doi:10.1007/s10488-011-0380-x

Cited by 87 publications

(162 citation statements)

References 110 publications

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“…21 Also highlighted was the poor quality of physical space in most inpatient settings, which often limited the ability of staff to implement care in a manner that effectively engaged Mental Health Reform at a Systems Level: Widening the Lens on Recovery-Oriented Care key supports, such as family-and otherwise-provided safe and stimulating environments. 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.…”

Section: Problems and Barriers To Changementioning

confidence: 99%

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

2014

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This paper is an initial attempt to collate the literature on psychiatric inpatient recoverybased care and, more broadly, to situate the inpatient care sector within a mental health reform dialogue that, to date, has focused almost exclusively on outpatient and community practices. We make the argument that until an evidence base is developed for recoveryoriented practices on hospital wards, the effort to advance recovery-oriented systems will stagnate. Our scoping review was conducted in line with the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (commonly referred to as PRISMA) guidelines. Among the 27 papers selected for review, most were descriptive or uncontrolled outcome studies. Studies addressing strategies for improving care quality provide some modest evidence for reflective dialogue with former inpatient clients, role play and mentorship, and pairing general training in recovery oriented care with training in specific interventions, such as Illness Management and Recovery. Relative to some other fields of medicine, evidence surrounding the question of recovery-oriented care on psychiatric wards and how it may be implemented is underdeveloped. Attention to mental health reform in hospitals is critical to the emergence of recovery-oriented systems of care and the realization of the mandate set forward in the Mental Health Strategy for Canada. W W W Réforme de la santé mentale au niveau des systèmes : élargir nos vues sur les soins orientés vers le rétablissementCet article est une première tentative de colliger la littérature sur les soins axés sur le rétablissement de patients psychiatriques hospitalisés et, plus généralement, de situer le secteur des soins des patients hospitalisés dans le dialogue sur la réforme de la santé mentale qui, jusqu'ici, a porté presque exclusivement sur les pratiques ambulatoires et communautaires. Nous alléguons que jusqu'à ce qu'une base de données probantes soit établie pour les pratiques axées sur le rétablissement dans les services d'hospitalisation, les efforts en vue d'améliorer les systèmes axés sur le rétablissement stagneront. Notre étude de portée a été menée conformément aux lignes directrices des éléments de rapport préférentiels pour les revues systématiques et les méta-analyses de 2009 (PRISMA). Sur les 27 articles sélectionnés pour la revue, la plupart étaient des études descriptives ou de résultats non contrôlés. Les études abordant les stratégies d'amélioration de la qualité des soins offrent une évidence modeste pour le dialogue réflectif avec d'anciens patients hospitalisés, le jeu de rôle et le mentorat, et le jumelage de la formation générale en soins axés sur le rétablissement avec la formation en interventions spécifiques, comme le programme de prise en charge de la maladie et de rétablissement. En ce qui concerne d'autres domaines de la médecine, l'évidence à la question des soins axés sur le rétablissement dans les services d'hospitalisation et à la manière de les mettre en oeuvre est sous-développée. L'attention portée à...

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Section: Problems and Barriers To Changementioning

confidence: 99%

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

2014

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“…The purpose of this clinical project was to foster recovery-orientation on an acute psychiatric unit by strengthening the subjective perspective of patients within the working relationship (14)(15)(16). One major part of the project was to successively restructure organizational processes (introduction of treatment conferences and conjoint treatment planning, reduction of the total time of reports on patients in their absence).…”

Section: Aimsmentioning

confidence: 99%

Patients’ subjective perspective on recovery orientation on an acute psychiatric unit

Jaeger¹,

Konrad

Rueegg

et al. 2014

Nordic Journal of Psychiatry

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Background : Evaluations of the recovery orientation of mental health services have focused on outpatient and rehabilitative rather than acute inpatient facilities. Aim : This naturalistic observational study seeks to evaluate the subjective perspective and functional outcome of inpatients before and after structural alterations. The changes made were the introduction of treatment conferences and conjoint treatment planning, reduction of the total time spent on reports about patients (in their absence), and recovery-oriented staff training on an acute psychiatric unit of the University Hospital of Psychiatry, Zurich, Switzerland. Methods : During 1 year (2011/2012) eligible patients on the study unit were interviewed on a voluntary basis using established instruments to assess several recovery-relevant aspects. Two different samples (before and after the project; n 34 and n 29) were compared with regard to subjective parameters (e.g. patients ' attitudes toward recovery, quality of life, perceived coercion, treatment satisfaction, and hope), clinical and socio-demographic basic data, as well as the functional outcome according to the Health of the Nation Outcome Scales (HoNOS). Results: Some patient attitudes towards recovery and their self-assessment of the recovery process improved during the study. Other subjective parameters remained stable between samples. Functional outcome was better in subjects who were treated after the implementation of the new concept. The length of stay remained unchanged. Conclusions: The implementation of recovery-oriented structures and providing the necessary theoretical underpinning on an acute psychiatric unit is feasible and can have an impact on attitudes and knowledge of personal recovery.

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“…While the provision of recovery-oriented care is a guiding principle, implementing recovery-oriented or recovery-enabling [52] practices requires transformations within MH systems [10, 38, 39]. In some sectors, such as MH inpatient settings, there is limited research directly addressing recovery-oriented practice [39, 53].…”

Section: Introductionmentioning

confidence: 99%

An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges

et al. 2017

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BackgroundOver past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered.DiscussionThis descriptive paper outlines a service-wide Integrated Recovery-oriented Model (IRM) for MH services, designed to enhance personally valued health, wellbeing and social inclusion outcomes by increasing access to evidenced-based psychosocial interventions (EBIs) within a service context that supports recovery as both a process and an outcome. Evolution of the IRM is characterised as a series of five broad challenges, which draw together: relevant recovery perspectives; overall service delivery frameworks; psychiatric and psychosocial rehabilitation approaches and literature; our own clinical and service delivery experience; and implementation, evaluation and review strategies. The model revolves around the person's changing recovery needs, focusing on underlying processes and the service frameworks to support and reinforce hope as a primary catalyst for symptomatic and functional recovery. Within the IRM, clinical rehabilitation (CR) practices, processes and partnerships facilitate access to psychosocial EBIs to promote hope, recovery, self-agency and social inclusion. Core IRM components are detailed (remediation of functioning; collaborative restoration of skills and competencies; and active community reconnection), together with associated phases, processes, evaluation strategies, and an illustrative IRM scenario. The achievement of these goals requires ongoing collaboration with community organisations.ConclusionsImproved outcomes are achievable for people with a SMI. It is anticipated that the IRM will afford MH services an opportunity to validate hope, as a critical element for people with SMI in assuming responsibility and developing skills in self-agency and advocacy. Strengthening recovery-oriented practices and policies within MH services needs to occur in tandem with wide-ranging service evaluation strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1164-3) contains supplementary material, which is available to authorized users.

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The Development of Recovery Competencies for In-patient Mental Health Providers Working with People with Serious Mental Illness

Cited by 87 publications

References 110 publications

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

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

Patients’ subjective perspective on recovery orientation on an acute psychiatric unit

An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges

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