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Mental health service users' aspirations for recovery: examining the gaps between what policy promises and practice delivers
- Authors:
- DAVIES Kate, GRAY Mel
- Journal article citation:
- British Journal of Social Work, 45(S1), 2015, pp.i45-i61.
- Publisher:
- Oxford University Press
This paper draws on findings from an Australian study of mental health service users' perspectives on service user participation to examine the challenges for translating recovery policy into practice. It considers the ways in which national mental health policies and developing welfare reforms reflect and/or contradict the highly personal mode of recovery important to service users; though they seemingly signal potential wins for service user empowerment, they are accompanied by losses for those who do not fit neatly into clinical categorisations. The service users (n = 11) and service providers (n = 6) interviewed for this exploratory qualitative study revealed that recovery was a lifelong process of fluctuating capacity and described a system poorly equipped and often unwilling to move beyond tokenistic modes of participation. The analysis of service user perspectives against the backdrop of policy reform reveals the ongoing tensions between personal and clinical definitions of recovery. (Publisher abstract)
Physical health decision making and decision aid preferences of individuals with severe mental illness
- Authors:
- WRIGHT-BERRYMAN Jennifer L., CREMERING Allison
- Journal article citation:
- Social Work in Mental Health, 15(6), 2017, pp.651-662.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Individuals with severe mental illness (SMI) often suffer from comorbid physical health conditions that reduce quality of life and longevity. The integrated care movement has improved access to primary care services, but system change does not necessarily impact health behaviours. In an effort to better understand health behaviours of persons with SMI in integrated care, the authors explored physical health decision making and decision aid preferences. Three focus groups were conducted, including two consumer groups and one mental health staff group. Data were analysed using a grounded theory approach, employing independent coding, thematic analysis, and meaning-making processes. Data suggest that overall, the consumer groups preferred a shared decision making process, with the doctor making the final treatment decision. Staff indicated that decision making depended on a consumer’s functioning level. Consumers liked the idea of using a decision aid, and reported preferring the computerised aid. Staff felt that decision aids were dependent on consumer level of functioning. Consumers generally view primary care doctors as experts, but like the idea of using decision aids to assist in making medical decisions. Staff feel that consumers may need help in both decision making and decision aid use in primary care. (Publisher abstract)
Living a meaningful life with serious mental illness: defining and understanding personal medicine
- Author:
- RADOHL Tamara
- Journal article citation:
- Journal of the Society for Social Work and Research, 7(2), 2016, p.345–369.
- Publisher:
- Society for Social Work and Research
Objective: Shared decision making (SDM) is an approach adapted from the health care field for use in mental health treatment because SDM promotes collaborative decision making of providers and consumers regarding treatment options and goals. Personal medicine, defined as “self-initiated, non-pharmaceutical self-care activities that serve to decrease symptoms, avoid undesirable outcomes such as hospitalisation, and improve mood, thoughts, behaviours, and overall sense of well-being” (Deegan, 2005, p. 31), has been incorporated into SDM when applied in mental health settings. This exploratory, qualitative study investigates how mental health consumers define and use personal medicine. Method: A sample of 14 consumers with severe and persistent mental illness were selected from a local community mental health agency using purposeful sampling. Participants used Common Ground, a software programme that formalises SDM and uses the concept of personal medicine. Participants were interviewed using a naturalistic inquiry approach and a semi-structured interview protocol of open-ended questions. Interviews were transcribed and coded, and findings were corroborated with consultant panels. Comprehensive member checks ensured trustworthiness. Results: Personal medicine might be a larger concept than can be explained by any single modality. Several factors contribute to the use of personal medicine, including the individualisation of personal medicine by consumers, how consumers define the concept of personal medicine, and the purposes and benefits of personal medicine. Conclusions: Participants report personal medicine to have benefit, value, and purpose that impact recovery. These findings support current literature and practical implications that might inform the ways in which professionals use personal medicine. (Edited publisher abstract)
Recovery versus risk? from managing risk to the co-production of safety and opportunity
- Authors:
- PERKINS Rachel, REPPER Julie
- Journal article citation:
- Mental Health and Social Inclusion, 20(2), 2016, pp.101-109.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to propose a recovery-focused approach to risk and safety and what this might look like in practice. Design/methodology/approach: Review of recovery approaches and the ways in which traditional approaches to risk might hinder people in their recovery journey. Consideration of the principles of a recovery-focused approach to safety. Findings: A recovery-focused approach to risk based on co-produced safety plans that enable people to do the things they value as safely as possible and shared responsibility for safety. Four key principles of a recovery-focused approach to promoting safety, autonomy and opportunity are proposed. Originality/value: A recovery-focused approach to risk and safety is central to the development of recovery-focused practice within services. This paper outlines such an approach. (Publisher abstract)