Purpose In 2020, the significance of “lived experience” and “service user” accounts of recovery has become central to the delivery of mental health policy and practice. Reflecting on the first known account of personal recovery in the late-20th century provided new hope and encouragement that those living with mental illness could live a fulfilling life. Taking this into consideration, the purpose of this paper is to explore the relevance to this experience of those using services today. Design/methodology/approach The authors present a critical literature review, which is underpinned by a systematic approach adopted from Higgins and Pinkerton (1998). This involved a six-step approach seeking to answer the question – What are the service users’ views on the recovery concept within mental health services? Findings The conceptualisation of recovery continues to focus on biomedical parameters. A new interpretation of recovery is beginning to materialise: social recovery. This new interpretation appears to be achievable through six key influencers: health, economics, social interaction/connection, housing, personal relationships and support. Originality/value Building on Ramon’s (2018) argument regarding the need for mental health policy to focus on the concept of social recovery, this study extends on this proposition by providing a foundational evidence base. More specifically, it not only supports the need for this shift in policy but also identifies a new interpretation building in practice. Furthermore, the authors highlight six key pillars that could potentially shape such provisions for policy.
Background: Mental health services are currently experiencing much systemic and organisational change. Many countries have adopted a recovery approach to service provision through the development of national policies and frameworks. Within an Irish context, co-production has been identified as one of the four pillars required for services to become recovery orientated. However, there is a paucity of literature relating to the concept within child and adolescent mental health services. This paper aims to synthesise the peer-reviewed evidence on co-production within such services. Methods: A PRISMA compliant systematic review was undertaken. This includes how the reviewer retrieved, shortlisted, and selected studies for inclusion in the review. It outlines the inclusion/exclusion criteria and how these were further developed through the PICO framework. Finally, the methods also outline how the reviewer assessed bias and quality, as well as the process of data synthesis. Results: Two studies were included in this review, both focusing on co-production, but in different contexts within child and adolescent mental health. Two themes were identified: ‘road less travelled’ and ‘co-producing equality’. These themes and the associated sub-themes describe how co-production works in these services. Discussion: These results highlight the paucity of quality literature in co-production within child and adolescent mental health. Both studies scored poorly in terms of quality. Resulting from this review, a number of actions relating to the therapeutic environment need to be taken into account for co-production to be further implemented. Other: The reviewer has not received any funding for this paper. A protocol was not created or registered for this review.
Since the publication of A Vision for Change (Department of Health and Children 2006), which sets out the direction for mental health services in Ireland, new approaches to interacting with people who have lived experience of mental ill health have emerged. Co-production is one such approach. Co-production is a word used to describe the creation of a dialogical space where the service user, family members, carers and service providers enter a collaborative medical partnership to improve their own care and also service provision. Co-production is a cornerstone in the delivery of a recovery-oriented service and when implemented correctly it has the power to achieve positive change. The aim of this article is to provide background information and guidance on how to implement co-production in traditional mental health services.
Introduction: Recovery has become a catalyst for much organisational and cultural change within mental health services. Recovery involves the service user living the best life of their choice despite the presence of mental health challenges. In contrast, recovery of families remains under-developed with minimal attention given to the unique support families may require in their own recovery journeys. This paper aims to place focus on the topic through a systematic review of the literature into family recovery interventions in mental health; Method and Analysis: A PRISMA compliant systematic review was initiated. It included how the reviewers retrieved and selected studies for the systematic review. It outlined the inclusion/exclusion criteria and how these were further developed through the PICO framework. It also outlined how the reviewers assessed issues of bias and quality, as well as the process of data synthesis; Results: Three studies were included in this review. Each focusing on family recovery interventions across the lifespan: Kidstime to family toolkits to family psychoeducation. The benefits and challenges of each intervention to the family were synthesised along with a list of four family recovery enablers that are vital for the implementation of such family recovery interventions; Discussion/Implications for Practice: The results highlight the paucity of quality literature available for family recovery interventions. All three studies scored poorly in terms of quality, with one particular study (Nagi and Davies 2015) lacking quotations from participants to back up their claims. From this study, a number of actions need to be implemented, specifically around the enablers needed to allow for family recovery interventions to be fully implemented.
Mental health services are currently undergoing immense cultural, philosophical, and organisational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right. Within five Community Health Care Organisations [CHOs] in the Irish mental health services, 2017 marked a new era as the traditional statutory mental health service hired a total of 30 Peer Support Workers. Since then, additional Peer Support Workers were recruited along with the added addition of Family Peer Support Work. The purpose of such positions is to use their lived experiences and the knowledge subset within it to normalise experiences, break down hierarchical barriers and facilitate candid conversations that will allow the service user to progress on their own, self-defined recovery journey. Since it's inception into Irish mental health services, peer support has been line managed by a non-peer discipline. It is this where this paper highlights a potential problem. The paper raises concerns that the supervision conducted by these non-peer professionals could tamper, mutate and destroy the essence of peer support—the transfer and use of lived experience between service users. As such, a recommendation is suggested that the literature pauses discussions as to the mechanism by which lived experience is delivered and instead focus energies on identifying the ontological and epistemological position that underpins the experiences.One potential position to examine is that of constructionism as such knowledge is created or constructed through the fusion of life experiences and sub-concious thoughts and emotions experienced at a particular moment in time which are then entangled together with current information to create a narrative or story that can be therapeutic. It is through this philosophical exercise involviong/including existential themes that the essence of lived experience can be identified, protected, and nourished within mental health discourse.
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