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The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap.

This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services.

Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services.

This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.

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.

This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.

A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.

Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.

The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.

This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.

The purpose of this paper is to measure service user and staff views of the recovery orientation of three mental health rehabilitation units; two “open” and one “locked”. It identified elements of recovery that were important to service users. It measured the units’ performance on domains of recovery, attending to differences between staff members’ and service users’ perceptions and between the locked and open units.

A cross-sectional design was used. Staff and service users completed the “Developing Recovery Enhancing Environment Measure (DREEM)”.

Findings revealed some differences between staff and service user views. Service users in the locked unit reported the organisational climate to be more recovery oriented on some domains than those in the open units. Service users’ responses highlighted potential areas for service improvement.

The sample was small but reflected the applied setting. Some service users were not invited to participate because of significant communication or cognitive difficulties and it is recognised that they may have had alternative views that remain unrepresented.

The DREEM provided valuable information about current practice and potential for service development. Both locked and open units can provide recovery-oriented environments. Services should be aware of discrepant views between staff and service users.

To the knowledge, this is the first study to use the DREEM to evaluate the recovery orientation of a locked recovery unit and to compare locked and unlocked units.

The purpose of this paper is to review the literature in terms of the conceptualization of the recovery concept among cultural and ethnic minorities drawing on the connectedness, hope and optimism about the future; Identity, meaning in life, empowerment (CHIME) framework; highlight the cultural adaptations of supported housing – a prominent recovery-oriented intervention, as it was implemented in a multicultural western country; and delineate the future implications for research, policy and practice in regard to mental health recovery interventions for cultural and ethnic minorities.

An online search was performed to identify recent empirical studies published in English in peer-reviewed journals.

Included studies confirmed what the authors of CHIME had initially reported: spirituality and support networks could act as enablers or inhibitors in the recovery process of mental health services users with diverse cultural backgrounds. The stigma surrounding mental illness is a key challenge that skews the recovery experience. Other cultural-specific factors include linguistic peculiarities of the maternal language and gender. The cultural adaptation of a recovery-oriented intervention was feasible and effective but also challenging.

By studying the cultural variations of mental health recovery, the intention is to inform mental health practitioners and other key stakeholders of the distinct cultural components that influence the recovery process, thereby promoting the development of culturally sensitive, accessible and effective recovery-oriented interventions. It is worth noting that providing culturally appropriate mental health services could be viewed as a human right issue for minority groups.

The purpose of this paper is to provide an account of Central and North West London NHS Foundation Trust Mental Health Rehabilitation Services’ experience of utilising Team Recovery Implementation Plan (TRIP) as a framework to embed recovery-focused practice. The paper explores the challenges to creating recovery-focused services in inpatient settings and sets out how using TRIP has enabled frontline staff to work in partnership with people who use services and coproduce changes in practice and service development.

The paper draws on the process of utilising TRIP as a methodology to embed recovery-focused practice.

The account finds that using TRIP as a framework to embed recovery-focused practice supports frontline staff to work in partnership with people who use services and share responsibility for delivering recovery-oriented services, measure progress and drive change.

The paper provides an informative account of implementing TRIP as a framework to embed recovery-focused practice in mental health rehabilitation services. It explores the challenges faced by services in creating recovery-focused services and sets out how the TRIP has been used by teams as a methodology for coproducing, co-delivering and co-reviewing action plans. The paper gives practical examples of keeping the TRIP process alive and identifies several changes to practice and service developments achieved since TRIP’s implementation.

The aim of this study is to explore the characteristics of what is experienced in mental health recovery-oriented places and how these characteristics can facilitate social connections and participation.

This qualitative study has an explorative, interpretive and collaborative design. Dyadic interviews and participatory fieldwork observations were used as methods for data generation. Data were analyzed using a collaborative hermeneutic approach.

Characteristics of recovery-nurturing places involved how concrete and tangible features of place may nurture and enable actions and ways of being with oneself and others. Three broad themes explore the characteristics and how they can enable recovery: nurturing senses, nurturing practical skills and nurturing communication.

This study demonstrates how materiality and recovery are interconnected and expands the understanding of recovery as “in-the-mind processes.” It explores how places and material objects have a recovery-nurturing potential through enabling actions and participation and thereby supporting people in living, storying and restorying their lives.

Recovery approaches to healthcare are now an important feature of the mental health policies and plans of many western countries. However, there are continuing challenges to the operationalisation of these approaches. The purpose of this paper is to consider how to overcome these challenges, using insights gained from health managers and practitioners who have been involved in the process of implementation.

The analysis is undertaken through a descriptive single-case embedded study of the implementation of Recovery into a public mental health service in Australia. The unit of analysis that features in this paper is the perceptions of the implementation of Recovery-oriented services, of health managers and practitioners.

The analysis suggests that although health service managers followed many of the recommendations that can be found in the research literature to support achievement of Recovery-oriented services, there was a need to go further. For example, practitioners in the case study context were educated about the principles of Recovery and provided with new processes of clinical documentation to support their work, however these practitioners felt they were ill-equipped to address complex issues of practice, including the management of clinical risk and professional accountability issues. This raises questions about the content of the education and training provided, and also about the ongoing support provided to practitioners who work within a Recovery-oriented framework.

The descriptive single-case embedded study of the implementation of Recovery is the first of its kind in Australia. Findings of the study provide insight for other health service organisations committed to effectively implementing Recovery-oriented services.

The purpose of this paper is to evaluate how mental health service user involvement in health professional education adds value to student learning about recovery-oriented practice and to determine the quality and suitability of instruments used in studies to evaluate this involvement in terms of their: relationship to recovery-oriented practice; and psychometric properties.

Studies of service user involvement were reviewed to identify their research objectives. These were mapped against an Australian recovery-oriented practice capability framework together with the constructs measured by instruments used in these studies. Psychometric properties for each instrument were evaluated using the COSMIN checklist.

While research objectives are not stated in terms of recovery-oriented practice, they do relate to some elements of a recovery-oriented practice framework. No instrument measures outcomes against all recovery-oriented practice domains. The AQ has the strongest evidence for its psychometric properties. The most commonly used instrument measures only stigma and has poorly validated psychometric properties.

This paper demonstrates that the “value add” of service user involvement in health professional education has been poorly defined and measured to date. Learning from lived experience is central to a recovery-orientation and is an expectation of health professional education programmes. Defining objectives for service user involvement in terms of recovery-oriented practice and developing an instrument which measures student learning against these objectives are important areas for ongoing research supporting improved approaches to supporting people’s recovery.

This study aims to explore and describe staff working in a Norwegian supportive housing site’s experiences with promoting social community participation for residents with co-occurring problems. The research question addressed was: how does residential support staff experience promoting social community participation for residents with co-occurring problems?

Nine residential support staff participated in qualitative interviews. All interviews were recorded and transcribed verbatim. The transcripts were analysed using Braun and Clarke's approach to thematic analysis.

The analysis process resulted in two themes: “It is all about economics” and “Who will pay for it?”

Regarding the Nordic welfare system, the need for a redistribution of financial resources in health services is discussed. The authors recommend that further studies explore people outside the regular health-care system perspectives on how they can contribute to making community inclusion a reality for persons experiencing co-occurring problems.

This study provides a nuanced understanding of how financial resources can impede or support efforts and opportunities to promote community inclusion for residents experiencing co-occurring problems.