Recovery-oriented practice in a hospital mental health service.

As part of mental health reform in Australia, new policies were introduced to support recovery-oriented practice; however, little has changed in hospital settings focused on managing risk and remediating acute symptoms. Previous studies have indicated that patients' experiences of personal recovery, during a hospital admission, may not mirror that of people living in the community, with patients being more likely to experience disconnection, hopelessness and disempowerment. Using a Participatory Health Research approach, eight mental health professionals, a patient advocate and an external researcher formed a research partnership to answer the question: How can staff enhance recovery-oriented practice in a hospital-based mental health service? The COREQ checklist was used for reporting the methods, analysis and findings. The methods comprised patient focus groups (n = 16 participants), interviews with managers (n = 7) and an online survey for staff (n = 17). Researchers analysed the feedback from the consultations using inductive thematic analysis, identifying two themes: relational recovery and recovery interventions. The findings indicate that relational recovery is key to recovery during a hospital admission and interventions that increase connectedness or reduce the impact of symptoms enhance personal recovery.

Conceptualisation of personal recovery in a private hospital mental health service.

There has been limited research on personal recovery during a hospital admission. However, studies in this setting indicate that consumers' experiences of personal recovery, during an inpatient admission, may not mirror the experiences of consumers living in the community, which has been conceptualised by the CHIME processes of Connectedness, Hope, Identity, Meaning and Empowerment. Findings to date posit that inpatients may be more likely to experience disconnection and hopelessness. To investigate this further, staff working in a private hospital mental health service designed and implemented a research project to understand personal recovery from patients' perspectives. The method comprised four consumer focus groups (n = 16 participants). Researchers analysed the data using inductive thematic analysis, identifying three themes: different pathways reflecting each patient's individual journey to personal recovery; challenges including experiencing hopelessness and distress, ups and downs, it not being easy, isolation and lack of support; and living well including wanting to return to everyday living, hope and acceptance, and feeling empowered. The findings suggest that the CHIME conceptualisation of recovery may need to be revised to include the experiences of hospital patients. The conceptualisation of recovery as a dynamic spectrum, with recovery moving up and down between challenges and living well may better represent hospital patient experiences. Patients also talked about a process not included in CHIME, of returning to 'everyday living' which was about getting back to doing everyday activities that most of us take for granted.