From Recovery in Mental Health to Recovery in General Practice: Contribution of Service Users and their Relatives to the Revision of the WHO International Classification of Diseases

Abstract

The purpose of this study was to contribute to the revision of the International Classification of Diseases (ICD-10) by exploring how mental health service users and their relatives conceive the influence of the contextual factors, as described in Chap. 21 of the ICD-10, on a) the onset of a mental or behavioral disorder; b) the resurgence of such a disorder; and c) the recovery process. In individual and group interviews, the 18 main categories of contextual factors proposed by the ICD-11 (beta draft) were discussed through the Contextual Factors Questionnaire (CFQ). Participants in individual interviews (N=28) completed the CFQ. Among the three dimensions, it was for the recovery process that the contextual factors were considered to be the most influential, followed by their influence on the resurgence of a mental or behavioral disorder and then by the influence on the onset of that disorder. The most influential factor for a single dimension was that of 'interventions' on the recovery process, whereas the 'social or cultural factors' are the most influential ones for all dimensions combined, closely followed, at par, by 'risk factors' and 'interpersonal relations'. As recovery is also dependent upon health services and interventions globally, this paper suggests that these could be more effective if they were recovery-oriented and with recovery as a common overarching goal for mental as well as for physical healthcare provision and thus for global recovery. However, further work is needed to validate its reliability for enhanced mental and physical health parity in general practice.