Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting

Abstract

Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.

Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review

“… Relationship building Personal recovery planning involves close relationship building between service providers and service users that entailed a certain amount of complexity around managing the relationship, navigating boundaries, and dealing with a sense of loss when the relationship was required to end at the end of the intervention [ 109 ]. Lived experience Recovery planning interventions designed or co-designed by people with lived experience was seen as an important design feature [ 109 , 115 , 116 ]. Recovery colleges Flexibility Designing the college so that all students could easily join and sign-up for courses without need for referral or prerequisites was highly appreciated, as was being able to make oneʼs own choices of what to take, how much to participate in class, and dropping a course without being penalized [ 125 , 127 , 129 ].…”

“…A common characteristic of recovery-oriented innovations is the appointment of a service provider who takes on a role predicated upon building trusting relationships with service users (e.g. facilitator) [ 85 , 87 , 89 , 90 , 93 , 109 , 116 , 118 , 120 , 122 ]. However, relationship building is also an element of these innovations’ complexity from the point of view of service providers, both in terms of managing relationships with co-workers and service users, and ending relationships with service users [ 99 , 102 , 104 , 105 , 107 , 114 , 118 , 126 , 133 ].…”

“… [ 94 – 104 ], [ 105 – 109 ], [ 110 ], [ 111 – 115 ] 4 Personal recovery planning New approaches to writing plans within service provider–service user encounters. [ 109 , 116 – 121 ], [ 115 , 122 ], [ 123 , 124 ] 5 Recovery colleges Education programs offering courses to service users and service providers on recovery and other topics in mental health. [ 125 – 129 ] 6 Service navigation and coordination Innovations aimed at wraparound care, care coordination, and client access to services across health and social services.…”

The contribution of the voluntary sector to mental health crisis care: a mixed-methods study

“…Given the intensely personal nature of a MH crisis and the conceptualisation of a MH crisis as a 'turning point', 6 there is an opportunity for learning and building resilience if effectively supported. 71 Mind's inquiry into crisis care 1 identified four main themes for what people wanted from a crisis support service:…”

“…For each person, information on their experience of a MH crisis and their crisis care trajectory was gathered through separate narrative interviews 71 with the person (and their carer, if appropriate). Narrative interviews were adopted to enable a rich description of the unfolding of events and actions from the participants' perspectives and to gain insights into their MH crisis experience.…”