Assessing Diversity and Inclusivity is the Next Frontier in Mental Health Recovery Narrative Research and Practice (Preprint)

Abstract

UNSTRUCTURED Demand for digital health interventions is increasing in many countries. The use of recorded mental health recovery narratives in digital health interventions is becoming more widespread in clinical practice. Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, including struggles and successes over time. Helpful impacts of recorded mental health recovery narratives include connectedness with the narrative and validation of experiences. Possible harms include feeling disconnected and excluded from others. Diverse narrative collections from many types of narrators and describing multiple ways to recover are important, to maximize the opportunity for service users to benefit through connection, and to minimize the likelihood of harm. Mental health clinicians need to know whether narrative collections are sufficiently diverse to recommend to service users. However, no method exists for assessing diversity and inclusivity of existing or new narrative collections. We argue assessing diversity and inclusivity is the next frontier in mental health recovery narrative research and practice. This is important but methodologically and ethically complex. In this viewpoint article, we evaluated one diversity and two inclusivity assessment methods. The diversity assessment method used Simpson’s Diversity Index. The two inclusivity assessment methods were based on comparator demographic rates and arbitrary thresholds. These methods were applied to four narrative collections as a case study. Refinement needs to be made regarding a narrative assessment tool, practicality and cultural adaptation.