Recovery and care continuity experiences of people in mental health care: A conciliatory approach to the challenge of implementing recovery‐based services

Abstract

This study investigates recovery and care continuity experiences of people with serious mental illness negotiating transforming services in the wake of recovery-based policy implementation. Data were collected in two phases involving (n = 16) service users who had transited from secondary to primary care and (n = 16) supporting workers. A qualitative methodology employed semi-structured interviews and thematic discourse analysis generating three themes. First, participants' expectations were misaligned with transforming services. Second, participants constructed competing versions of recovery in their talk. Third, analysis revealed care discontinuities concentrated at the primary care level. A singular notion of top-down recovery, a proliferation of bottom-up, competing recovery versions, and misaligned expectations of transforming services are closely allied with escalating service system complexity and fragmentation. This has detrimental implications for care continuity. Top-down, policy-based recovery implementation is viewed as a neoliberalist colonization of the recovery concept, understood in the Habermasian sense of colonization of the lifeworld. The detrimental effects of recovery colonization should not lead to repudiation of the concept altogether. Rather, the original | 1997 RECOVERY IN SERVICES: A CONCILIATORY APPROACH How to cite this article: Weaver, N. Recovery and care continuity experiences of people in mental health care: A conciliatory approach to the challenge of implementing recovery-based services.

MOSAIC, an example of comprehensive and integrated social and health care: care and practices oriented towards personal recovery

“…There are two recent systematic reviews (2017 and 2022) that address the challenge. The first one (19) highlighted the efficacy demonstrated in the 172 experiences analyzed. However, it concluded with the need to obtain quality indicators, aimed at improving implementation.…”

Por Uma Psiquiatria Paliativa: Aplicação De Cuidados Paliativos a Usuários Da Rede De Atenção Psicossocial (Raps)

“…Um dos motivos que podem ter mantido os cuidados paliativos fora do manto da atenção psicossocial é o conceito, vago, ambíguo e impreciso, de cura em saúde mental [16][17] , de onde se deduz que, Artigo Original DOI: 10.36489/saudecoletiva.2024v14i89p13278-13287 Todo o conteúdo desse periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons no modelo pré-reformista e no âmbito da ciência teórica e das leis, a ideia de cura se vincularia ao restabelecimento de condutas e valores socialmente aceitos. Hoje, priorizam-se, entre outros, termos como remissão de episódios agudos, controle de sintomas, estabilidade, recovery e transtorno com episódio único, sendo raras as referências a distúrbios passíveis de remissão completa e permanente [3][4][17][18] .…”

“…Uma explicação para a lacuna seria a dificuldade em estabelecer, em relação às doenças psiquiátricas, o que significa estar "fora da possibilidade de cura", ou ainda o caráter de "ameaça à vida", critérios historicamente associados à ideia de paliatividade. A definição atual de cuidados paliativos os estende a situações outras que não apenas as doenças ameaçadoras ou incuráveis [1] , restando nebuloso o conceito de cura em saúde mental bem como flexível a noção de cuidado [2][3][4][5][6] .…”

Toward a theory of multifunctional liberalism: Systems‐theoretical reflections on the nature of statehood

“…To the individual person, this ecosystem would then appear as a multifunctional decision-making infrastructure rather than an institutional cage without exit option. Though the function systems of modern society do feature an expansionist drift and claim for total inclusion of every individual person (Teubner, 2021;Verschraegen, 2011;Weaver, 2021Weaver, , 2022, the universal organized access to the function systems via procedures such as health treatments or universal suffrage typically remains an option rather than obligation in a liberal society. This lack of an imperative for total inclusion precisely is the difference between a liberal society of organizations and an organized society of any kind.…”