Cross-cultural conceptualization and implementation of recovery in mental health: a literature review

Abstract

Purpose This paper aims to review how the recovery concept among cultural and ethnic minorities has been conceptualized within extant literature. Drawing on the Connectedness; Hope and optimism about the future; Identity; Meaning in life; and Empowerment (CHIME) framework, this paper highlights the cultural adaptations of supported housing – a prominent recovery-oriented intervention – as it has been implemented in a multicultural western country and delineates the future implications for research, policy and practice in regard to mental health recovery interventions for cultural and ethnic minorities. Design/methodology/approach An online search was performed to identify recent empirical studies published in English in peer-reviewed journals. Findings The reviewed studies confirmed what Leamy et al. (2011) had initially reported: spirituality and support networks can act as enablers or inhibitors in the recovery process of mental health services users with diverse cultural backgrounds. The stigma surrounding mental illness is a key challenge that skews the recovery experience among minority groups. Other cultural-specific factors influencing recovery include linguistic peculiarities of the maternal language and gender. The cultural adaptation of a recovery-oriented intervention is not only feasible and effective but also challenging. Originality/value By studying the cultural variations of mental health recovery, the intention is to inform mental health practitioners and other key stakeholders of the distinct cultural components that influence the recovery process, thereby promoting the development of culturally sensitive, accessible and effective recovery-oriented interventions. It is worth noting that providing culturally appropriate mental health services could be viewed as a human right issue for minority groups.

Ethnic identity, stress, and personal recovery outcomes among young adults with serious mental health conditions.

“…Research and practice initiatives that have been designed to engage young people within communities of color (Breland-Noble, 2020; Sanchez et al, 2021) or those that have been designed to promote positive ethnic identity development in youth (Meca et al, 2014; Umaña-Taylor et al, 2018) could be instructive for creating innovative recovery services. Research on implementing culturally adapted recovery services has noted the considerable challenge of trying to offer services that accommodate the preferences of a culturally heterogeneous client population (Sofouli, 2021; Stergiopoulos et al, 2012). Person-centered approaches that focus on aspects of an individual young person’s ethnic identity could present a more feasible alternative for addressing such barriers.…”

“…Understanding an individual’s ethnic identity and culture has become a critical aspect of recovery-oriented psychiatric assessment and treatment planning (Dixon et al, 2016; Lewis-Fernández et al, 2014). Ethnic identity, as an aspect of cultural identity, can shape an individual’s experiences of mental illness (Lewis-Fernández & Kirmayer, 2019), as well as perceptions of which services are acceptable and helpful for their recovery (Lewis-Fernández et al, 2014; Sofouli, 2021). This seems to be of particular importance for services provided to young adults whose ethnic identities and experiences with marginalization can affect their experiences of mental health care.…”

“…In addition, young people with marginalized ethnic identities often report distrust of mental health services, stigma, and feeling misunderstood by their providers as barriers to help-seeking and ongoing participation in mental health services (Moore et al, 2021; Munson et al, 2012). However, relatively few evidence-based, recovery-oriented practices have been adapted to address the needs of ethnically diverse individuals living with mental illness (Slade et al, 2014; Sofouli, 2021). There have been some recent promising developmentally and culturally adapted interventions to promote recovery among diverse young adults with SMI (Dixon et al, 2015; Habib et al, 2015; Moore, 2018; Munson et al, 2021), but ethnic–racial disparities in unmet need persist (Jones et al, 2021; Oluwoye et al, 2018; Substance Abuse and Mental Health Services Administration, 2015).…”

Nurses’ Perceptions on How Recovery-Oriented Mental Health Care Can Be Developed and Implemented

“…Brooke-Sumner et al [ 30 ] from South Africa have attributed the failure of health workers to implement recovery-oriented mental health services to a lack of understanding and involvement of mental healthcare personnel. In addition, a review of how recovery is understood among ethnic minorities by Sofouli [ 37 ] concluded that more work should be carried out on the policy so that cultural minorities can access culturally tailored interventions to address their needs. Therefore, this calls for developing interventions informed by findings from the localised data context to accommodate the uniqueness of different communities.…”

Identifying and Exploring Sustainability Determinants of Mental Health Recovery-Oriented Interventions: A Mixed Methods Study Protocol

“…Over the past two decades, there has been a growing research literature on the conceptualization, effectiveness, and operationalization of mental health recovery into services (Canacott et al, 2020 ; Le Boutillier et al, 2011 , 2015 ; Leamy et al, 2011 ; Piat et al, 2021 ; Sreeram et al, 2021 ; van Weeghel et al, 2019 ). Studies on the different facets of mental health recovery were conducted initially in high-income Western countries and then expanded to other regions (e.g., Asia, Africa, Middle-East) (Sofouli, 2020 ). However, less attention has been given to the sustainability of recovery-oriented interventions and practices over time.…”