Article type
Year
Abstract
Background: Recovery is a worldwide paradigm in mental health. Emerging from the consumer survivor movement personal recovery is described as “a way of living a satisfying, hopeful, contributing life, despite the psychiatry disability or symptoms”. While traditional services focus on professional control, patient dependency, self-stigma and hopelessness, the focus of recovery-oriented services is on client empowerment, collaborative professional/client relationships, and community integration.
Objectives: We conducted a mixed studies review on the operationalization of recovery into services for adults. The review questions were: How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services?
Methods: Ovid- MEDLINE, Ovid-EMBASE, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus were searched from 1998 to July 2018. We included peer-reviewed studies on implementation process, factors and experience when implementing new efforts to transform services for adults with mental illness towards a recovery-orientation. All studies were independently screened over two stages for inclusion by two reviewers using Distiller SR software. We applied Best-Fit Framework Synthesis approach to synthesis and used the Consolidated Framework for Implementation Research (CFIR). The Mixed-Methods Appraisal Tool (MMAT) was used to appraise all included studies. We used both the PRISMA and ENTREQ reporting guidelines. NVivo12 was used for data synthesis.
Results: Of the 70 included studies, 54 were qualitative, 7 mixed-methods, 6 quantitative, 2 (quantitative and qualitative) and 1 RCT. Studies were from: Hong Kong (1), Denmark (1), Japan (1), Republic of Ireland (1), Norway (2), Germany (2), Canada (4), UK (15), USA (19), and Australia (24). Sixty-eight were in English, and 2 in German. Two sets of findings will be presented: (1) distribution of data extracted across CFIR domains and constructs and (2) conceptualization of studies into similar types of innovations and common issues effecting implementation. Seven recovery innovations: (1) E-Innovations; (2) Family-Focused Innovations; (3) Peer Workers; (4) Personal Recovery Planning; (5) Recovery Colleges; (6) Service Navigation and Co-ordination and (7) Staff Training. Common implementation issues are: flexibility, relationship building, inclusion of lived experience, challenges with medical model, risk management, embedding innovations in wider organization, and early engagement with stakeholders.
Conclusions: To date reviews in mental health recovery have been on conceptualizing personal recovery, measure instruments and intervention effectiveness. This is the first review on the implementation of recovery-oriented services and the factors known to effect implementation, and common factors that influence implementation.
Objectives: We conducted a mixed studies review on the operationalization of recovery into services for adults. The review questions were: How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services?
Methods: Ovid- MEDLINE, Ovid-EMBASE, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus were searched from 1998 to July 2018. We included peer-reviewed studies on implementation process, factors and experience when implementing new efforts to transform services for adults with mental illness towards a recovery-orientation. All studies were independently screened over two stages for inclusion by two reviewers using Distiller SR software. We applied Best-Fit Framework Synthesis approach to synthesis and used the Consolidated Framework for Implementation Research (CFIR). The Mixed-Methods Appraisal Tool (MMAT) was used to appraise all included studies. We used both the PRISMA and ENTREQ reporting guidelines. NVivo12 was used for data synthesis.
Results: Of the 70 included studies, 54 were qualitative, 7 mixed-methods, 6 quantitative, 2 (quantitative and qualitative) and 1 RCT. Studies were from: Hong Kong (1), Denmark (1), Japan (1), Republic of Ireland (1), Norway (2), Germany (2), Canada (4), UK (15), USA (19), and Australia (24). Sixty-eight were in English, and 2 in German. Two sets of findings will be presented: (1) distribution of data extracted across CFIR domains and constructs and (2) conceptualization of studies into similar types of innovations and common issues effecting implementation. Seven recovery innovations: (1) E-Innovations; (2) Family-Focused Innovations; (3) Peer Workers; (4) Personal Recovery Planning; (5) Recovery Colleges; (6) Service Navigation and Co-ordination and (7) Staff Training. Common implementation issues are: flexibility, relationship building, inclusion of lived experience, challenges with medical model, risk management, embedding innovations in wider organization, and early engagement with stakeholders.
Conclusions: To date reviews in mental health recovery have been on conceptualizing personal recovery, measure instruments and intervention effectiveness. This is the first review on the implementation of recovery-oriented services and the factors known to effect implementation, and common factors that influence implementation.