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No occupational therapy outcome measures have been designed specifically for recovery-orientated services.This paper aims to identify occupational therapy outcome measures relevant to mental health practice and assess them against recovery principles adopted by Irish Mental Health Services.

A narrative review methodology was used to appraise outcome measures against CHIME recovery principles.

A systematic search across 13 databases identified eight well-established outcome measures commonly used within occupational therapy mental health literature. The included outcome measures were appraised using a recovery alignment tool.

All outcome measures connected to some recovery processes. Those using semi-structured interview formats and notably the Canadian Occupational Performance Measure (COPM) had the strongest alignment to recovery processes.

This is the first known review which provides some validation that the included outcome measures support recovery processes, yet the measures rely heavily on therapist’s skills for processes to be facilitated. It recommends that ways to better support the process of partnership in occupational therapy mental health outcome measures be explored and further research be undertaken.

Recovery has been debated in mental health for some time. Attempts to clarify and make recovery operational have served to add confusion and uncertainty. This has failed to unite service users and service providers due to differing approaches, despite the rhetoric. The purpose of this paper is to offer an overview and to position the context from a humanistic and salutogenic perspective appreciating new approaches and influences for people in their journey of recovery having been given a diagnosis of schizophrenia.

All literature available could not be included and therefore the author did not select papers purely demonstrating outcome statistics. The preference was to address papers looking at the connections people have and the important factors they feel contribute towards recovery.

An agreed definition of recovery cannot be established, but differing perspectives need to be appreciated and considered if recovery is to be successfully achieved. Some mental health practitioners may feel they have an understanding of recovery, yet evidence continues to point to the uncertainty in practice and delivery of services. Newer incentives and recovery networks are establishing themselves to meet areas missed by traditional approaches.

The value of this literature review is to highlight some of the areas already observed and to provoke the potential for fresh thinking in relation to a salutogenic approach taking into account the perceptions of the stakeholder groups. This would enable people to re-evaluate their thoughts and practice and contextualise where we are in relation to recovery for people diagnosed with schizophrenia.

Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision.

This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings.

Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3.

This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts.

On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity.

Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care.

This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.

The purpose of this paper to contribute to discussions on improvements to acute mental health services by increasing the awareness of the experience of being compulsorily detained.

A thematic analysis of a literature review was undertaken, exploring patients’ experiences of compulsory detention, and is presented here alongside a lived-experience commentary. This leads into a discussion of the implications for practice.

There are three key themes identified: people’s views on the justification of their compulsory detention; the power imbalance between patients and staff; and the lack of information or choice. The lived-experience commentary adds weight to these findings by citing personal examples and making suggestions for improving services. The discussion centres on the potential of co-production between people who access services, their supporters, and professionals to improve treatment for people who may need compulsory detention. The paper also raises questions on whether current legislation and service provision can effectively deliver recovery-orientated practice.

Through bringing together research evidence and personal perspectives this paper contributes to the discussion on how services for people in crisis can be improved and raises important questions about current service provision and the legislation that underpins it.

The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice.

Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts.

Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults.

Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood.

Being excluded blights the lives of the mentally ill. Exclusion is both cause and consequence of mental ill‐health and extends beyond material deprivation to exclusion from the activities which give meaning to life. Promoting inclusion is central to the work of all mental health practitioners and the purpose of this paper is to advance the practices which support this.

The literature on what supports social inclusion and the related concept of recovery is reviewed. The working practices and prevailing theoretical models in psychiatry are also considered in the context of understanding how these practices and models can support socially inclusive and recovery‐orientated ways of working.

Social inclusion and recovery interact dynamically. Central to being “in recovery” is the experience of being included. Social inclusion is also a platform on which to participate in life's activities and to learn to “live well” again. The practices which support these approaches are consistent with medical models of care, with the bio‐psychosocial model that prevails in psychiatric practice and with existing guidelines on the nature and purpose of the therapeutic relationship.

Obstacles are described that impede adopting new practices and these include creating additional work, increased risk in a risk averse environment, and incompatibility with current models of medical practice. This paper seeks to describe the cost of exclusion, the value of inclusion, the practices which support recovery and social inclusion and to refute the arguments for not adopting these ways of working.

In 2020, the significance of “lived experience” and “service user” accounts of recovery has become central to the delivery of mental health policy and practice. Reflecting on the first known account of personal recovery in the late-20th century provided new hope and encouragement that those living with mental illness could live a fulfilling life. Taking this into consideration, the purpose of this paper is to explore the relevance to this experience of those using services today.

The authors present a critical literature review, which is underpinned by a systematic approach adopted from Higgins and Pinkerton (1998). This involved a six-step approach seeking to answer the question – What are the service users’ views on the recovery concept within mental health services?

The conceptualisation of recovery continues to focus on biomedical parameters. A new interpretation of recovery is beginning to materialise: social recovery. This new interpretation appears to be achievable through six key influencers: health, economics, social interaction/connection, housing, personal relationships and support.

Building on Ramon’s (2018) argument regarding the need for mental health policy to focus on the concept of social recovery, this study extends on this proposition by providing a foundational evidence base. More specifically, it not only supports the need for this shift in policy but also identifies a new interpretation building in practice. Furthermore, the authors highlight six key pillars that could potentially shape such provisions for policy.

The lived experience of individuals who experience mental illness should be at the heart of recovery-orientated practice and research. The purpose of this paper is to outline key ethical and practical issues that both respect principles of recovery and are fundamental to establishing and maintaining a research relationship with people with severe mental illness (SMI).

Theoretical frameworks of recovery, discourse ethics and critical reflexivity were used in a 12-month longitudinal community study to construct and build methodology to inform the collection of rich descriptive data through informal discussions, observations and interviews. Detailed field notes and a reflective journal were used to enable critical reflexivity and challenge normative assumptions based on clinical and lay views of SMI.

The paper provides an analysis through three vignettes which demonstrate how the principles of recovery were incorporated in an ethically grounded research relationship.

The study may have been limited by the small sample size of participants.

Aspects of the research methodology may potentially be adopted by researchers working with people who experience SMI or with other hard-to-reach groups.

As more research is undertaken with individuals who experience SMI, stigma around understandings of mental illness can be broken down by supporting individuals to find their voice through recovery orientated discourse ethics.

Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists.

It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes.

This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

The purpose of this paper is to stimulate discussion within mental health and psychiatric nursing as to how the open dialogue approach can contribute to their work. The paper is mainly theoretical, though relates to practical examples of open dialogue in mental health care research and practice to illustrate the actual potential in practice.

First the authors raise issue with the narrow lens of psychiatric diagnosis and question its usefulness against a contemporary backdrop of personalised care and recovery orientated practice. Open dialogue as a way of being and as a process are explored as they relate to people interaction and contribute to therapeutic interaction, organisational and community development. The authors reflect on how open dialogue can be and is practiced in different ways and at different levels.

The authors consider open dialogue as a suitable approach for working with people who have mental health and/or psychiatric problems. The approach is also recommended for working in larger circumstances as families and social network, on organisational and community levels in different ways. Open dialogue should be considered not as a method or technique but as a process of interaction which can be applied to different conditions and circumstances.

Within mental health discourse open dialogue is increasingly evident and filtering into the broader discussion on increasing effectiveness of mental health interventions. Perfectly suited to mental health and psychiatric nursing as a way of being with service user, this reflection on open dialogue offers further thoughts on how as a process it has already filtered into nursing practice and how as nurses we can easily accommodate it within the therapeutic approach.