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Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
Article number712026
JournalFrontiers in Psychiatry
Volume12
DOIs
Published1 Sep 2021

Bibliographical note

Funding Information: This study was part of NV’s PhD supported by National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London (NIHR CLAHRC South London) at King’s College Hospital NHS Foundation Trust. PG was supported by the UK Medical Research Council (UKRI) in relation the Indigo Partnership (MR/R023697/1) award. Publisher Copyright: © Copyright © 2021 Vera San Juan, Gronholm, Heslin, Lawrence, Bain, Okuma and Evans-Lacko. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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  • Vera San Juan 2021

    Vera_San_Juan_2021.pdf, 824 KB, application/pdf

    Uploaded date:01 Sep 2021

    Version:Final published version

King's Authors

Abstract

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised. Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems. Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods. Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence. Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention. Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.

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