https://www.collegianjournal.com/article/S1322-7696(15)00075-X/pdf

Mental health recovery: A review of the peer-reviewed published literature

Objectives
The recovery movement has generated interest in the concept of personal recovery, but little attention has been paid to it in relation to bipolar disorder (BD). The aim of this study was to examine personal recovery in BD using a staged model, exploring whether different stages are associated with different psychosocial and clinical profiles.

Methods
Adults with BD in remission (n = 75) were recruited from an outpatient psychiatric clinic in Hong Kong. Their average age was 45 years, with 11% and 45% working part time and full time, respectively. The data included stages of recovery, sociodemographic characteristics, clinical information, and perceptions of the importance of recovery factors and the resilience-engendering features of health services. Decision tree analysis was used to identify the predictors of stages of recovery, and receiver operating characteristic curves were employed to detect the rates of correct classification within the staged model.

Results
‘Respect, hope, and self-directed empowerment’, older age, binge drinking history, early first diagnosis, and ‘meaningful role’ were all associated with being in a later stage of personal recovery. The first two variables demonstrated better classification accuracy than the last three. Using these variables, the classification accuracy of Stages 2–4 was adequate.

Conclusions
There are associations between the stage of recovery and psychosocial variables among individuals with BD in remission. Interventions that promote ‘respect, hope, and self-directed empowerment’ have the potential to facilitate personal recovery from BD.

Exploring the recovery concept in bipolar disorder: a decision tree analysis of psychosocial correlates of recovery stages.

This study gathers empirical data to test whether two forms of recovery are related: (1) the traditional outcome-based notion of recovery from a mental illness, which is called "functional recovery," and (2) the more recent, consumer-based concept of recovery in mental illness, which is called "personal recovery." A total of 150 Chinese outpatients were recruited, 75 with bipolar disorder and 75 with schizophrenia, as determined by structured clinical interview. Participants were reported to be in clinical remission for at least the previous 6 months by treating psychiatrists. Personal recovery was measured with the Stages of Recovery Scale, and functional recovery was measured with residential and employment status. In addition to clinical and demographic data, self-report measures included functioning (confirmed through chart review) and a survey of the participant's assessment of the importance of various elements of recovery. Personal recovery was significantly correlated with functional recovery; small effect size suggested that the two domains are far from identical. The strength of this correlation was stronger for participants with schizophrenia than for those with bipolar disorder. A cluster analysis also suggested that residential and employment statuses, along with personal recovery scores, were useful in differentiating participants. Patients were more likely to reach better recovery outcomes if they were female, married, had higher family income, and perceived social roles as less important to their recovery. Consistent with the consumer literature, personal recovery is related but still distinct from functional recovery. Personal recovery has more to do with life circumstances than with functioning status alone.

Differences and similarities Between Functional and Personal recovery in an asian Population: a Cluster analytic approach

The mental health sector across states in Australia is moving to offering individualised funds and shared management, person-centred and self-directed (SPS) services. However, little is known about the recovery experiences of consumers with mental illness who had used a SPS service that was recently introduced in Western Australia. This study explored the recovery experiences of these consumers. Data relating to sixteen consumers’ lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed in the past by consumers, the Guides (staff) and an independent evaluator. Four over-arching categories, and related sub-categories, emerged. These suggested that consumers’ recovery experiences included them gaining: 1) a greater sense of empowerment; 2) expanded connections with the community, others and ‘the self’; 3) an enriched sense of ‘the self’; and 4) an enhanced quality of life. Access to SPS services, including having access to individualised funds, high quality shared management and person-centred relationships with the Guides, and a chance to self-direct services enabled consumers to have control over all aspects of their recovery journey, facilitated change and growth, and improved their capacity to self-direct services. Most consumers encountered a number of positive recovery experiences at varied levels that enhanced their lived experiences.

/pdf/a-qualitative-exploration-of-the-recovery-experiences-of-16nmnid2ww.pdf

A qualitative exploration of the recovery experiences of consumers who had undertaken shared management, person-centred and self-directed services

Providing optimal care to patients with recent-onset psychosis can improve outcomes and reduce relapse. However, there is a lack of consistency of the implementation of guidelines for such patients across the Asia-Pacific region. We determined a pragmatic set of recommendations for use on a day-to-day basis to help provide optimal care at this crucial stage of illness. The recommendations were developed over a series of meetings by an international faculty of 15 experts from the Asia-Pacific region, Europe, and South Africa. A structured search of the PubMed database was conducted. This was further developed based on the faculty's clinical experience and knowledge of the literature into 10 key aspects of optimal care for patients during the first five years of a diagnosis of a psychotic disorder, with particular relevance to the Asia-Pacific region. Several common principles emerged: adherence to antipsychotic medications is crucial; substance abuse, psychiatric and medical comorbidities should be addressed; psychosocial interventions play a pivotal role; and family members can play a vital role in overall patient care. By following these recommendations, clinicians may improve outcomes for patients with recent-onset psychosis.

/pdf/recommendations-for-the-optimal-care-of-patients-with-recent-37epamharz.pdf

Recommendations for the optimal care of patients with recent-onset psychosis in the Asia-Pacific region

OBJECTIVES. To develop a questionnaire for measuring the perceived importance of the elements of mental health recovery in psychiatric inpatients in Hong Kong and to test the psychometric properties of the questionnaire. METHODS. Thematic content analysis of identified literature on mental health recovery was performed to identify the elements related to mental health recovery. A questionnaire was developed to assess the perceived importance of the identified elements. An expert panel was set up to evaluate the content validity and patient focus group's face validity of the questionnaire. Participants were recruited from medium-stay and rehabilitation wards of Castle Peak Hospital. RESULTS. A total of 101 psychiatric inpatients completed the questionnaire, the majority of whom suffered from schizophrenia (75%). Having meaning in life was rated by 91% of the participants as an important element of recovery, followed by hope (86%) and general health and wellness (85%). Cronbach's alpha for internal consistency was 0.91. Explorative factor analysis yielded 7 factors and intraclass correlation coefficients revealed a fair-to-good test-retest reliability. CONCLUSIONS. The results supported the psychometric properties of the questionnaire for measurement of mental health recovery and serve as a basis for the future development of recovery-oriented services in the psychiatric inpatient settings in this locality.

Y M Yeung

Papers

Mental health recovery for psychiatric inpatient services: perceived importance of the elements of recovery.