The notion of recovery has become a dominant force in mental health policy, evident in reports of the Surgeon General and President's New Freedom Commission. In both reports, recovery is stipulated as the overarching goal of care and foundation for reforms at state and local levels. Little consensus exists regarding the nature of recovery in mental illness, however, or about the most effective ways to promote it. The authors offer a conceptual framework for distinguishing between various uses of the term, provide a definition of recovery in mental health, and conclude with a discussion of the implications of this concept for meaningful reform.
Despite the study's limitations, findings suggest that use of peer mentors is a promising intervention for reducing recurrent psychiatric hospitalizations for patients at risk of readmission.
Little is known about the experiences of peer support providers. This report describes a qualitative study of such experiences drawn from a project offering peer support to persons with mental illnesses who had multiple inpatient admissions within an 18-month period. Interviews focused on peer staff's relationships with participants; identifying and exploring participant interests, strengths, and aspirations; use of self-disclosure; and connecting participants to other services. Interviews were transcribed and analyzed using established phenomenological data analytic strategies. Peer staff described a tension between pushing and patience and the need for gentle persistence, the art and value of adopting an accepting and nonjudgmental attitude, and the process of identifying and building on strengths in pursuit of personal goals. The mutual identification between peer supporters and clients represented both an advantage and a potential liability, in that peer staff tied their own feelings of self-worth to the outcomes of their clients' struggles. Rather than viewing the deeply personal nature of peer support as posing risks due to a perceived vulnerability on the part of peer support providers, these findings suggest the need for ways to train peer staff in managing safely the vicarious trauma, frustrations, and inevitable setbacks involved in this work.
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