Recovery Attitudes and Recovery Practices Have an Impact on Psychosocial Outreach Interventions in Community Mental Health Care

Abstract

The most recent mental health policies implemented in the province of Québec, Canada, have emphasized recovery-oriented mental health practice. Part of this impetus has resulted in significant importance placed on the development of community mental health models in the public health system. The forms of community mental health programs have evolved considerably over time in Québec but are largely inspired by the evidence-based model of Assertive Community Treatment (ACT). However, if mental health policies and programs in Québec are now emphasizing the role of community mental health, it is also clear that actors on the field are implementing the evolving practice paradigms that dominate our mental health policies, such as recovery, participation, citizenship, in a variable way (1, 2). This article presents an ethnographic inspired research study conducted in 2014 and aims to contribute to the understanding of how recovery-oriented mental health policies are understood and implemented in an ACT team in downtown Montréal, Québec. With the aim of developing integrated knowledge on the issue of recovery in mental health and the conditions it presupposes, this research draws on field experiences from various actors, including service users with severe mental health problems, typically with concomitant disorders and complicated by substance use and/or living in a situation of homelessness. Using a critical constructivist approach, the research sought to a) explore how participants (stakeholders, users, and psychiatrists) achieve their social order; b) understand the meaning of recovery in mental health for participants and the actions associated with recovery as a process or as a practice; c) apprehend the potential of community interventions to connect the individual to the collective. The results indicate that the (over)use of medicolegal tools and the unchanging conception of “madness” represent obstacles to the sustained development of interventions centered on the person, his living conditions, and his recovery. Nevertheless, many interactions between service providers and service users indicate the potential for emerging recovery-oriented practice interventions, particularly when those interactions are based on positive and egalitarian conceptions between service providers and service users that led to the development of spaces for the co-construction innovative practice approaches.

Narrative Matters: Mental health recovery – considerations when working with youth

“…Feelings of hopefulness in the face of the complexity of developmental tasks, identity formation, societal integration, planning for the future and coping with difficult life situations can help buoy youth and support their mental well health. Hope, as a core component of mental health recovery, may be linked to resilience and have a particular impact on the ways both youth and mental health professionals’ conceptions of risk (Khoury, 2019). It is also a factor that can guide professionals in asking children and adolescents about what hope looks like for them and then motivating all actors involved to change psychosocial and socioeconomic conditions to foster hope.…”

“…Finally, it is imperative for adults working with youth to keep in mind that the mental health recovery model emphasises the role of mutual aid and community connection, but also emphasises the unique journey that an individual will take. Mental health recovery understood as an individual process aimed at increasing social functioning (Khoury, 2019). However, with children, adolescents and younger adults, parents and guardians have a more direct role and responsibility in various aspects of their lives.…”

Improving Research Practice for Studying Borderline Personality Disorder: Lessons From the Clinic

“…Meaningful changes for individuals may include psychosocial growth (e.g., in personal relationships or forging new social connections), economic progress (e.g., employment and/or financial independence), and lifestyle improvements (e.g., increased occupational engagement that may begin with volunteering or part-time work in areas of personal interest). 48 Although the recovery model has shown promise and relevance in the clinical setting [49][50][51][52] and was adopted by the United States' President's New Freedom Commission on Mental Health in 2003, 53 identifying research outcomes that reflect recovery principles has been a slower process. This may reflect an apparent conflict between the clinical research focus on group-level analysis and the recovery focus on the individual.…”

“…Although the recovery model has shown promise and relevance in the clinical setting 49–52 and was adopted by the United States' President's New Freedom Commission on Mental Health in 2003, 53 identifying research outcomes that reflect recovery principles has been a slower process. This may reflect an apparent conflict between the clinical research focus on group-level analysis and the recovery focus on the individual.…”

Recovery-oriented practices and role perceptions of healthcare staff providing community-based mental healthcare as team in Central and Eastern Europe: an observational study

“…Although recovery from severe mental illness is an individual journey, professional care and guidance can support recovery outcomes (8,9). A recovery-oriented approach focuses on the person, addresses stigmatisation and facilitates social inclusion, and improves quality of life, citizenship, and participation in society (3,10).…”