Conceptualizations, assessments, and implications of personal recovery in mental illness: A scoping review of systematic reviews and meta-analyses.

Abstract

Recovery, defined as a personal process of living with mental illness, has become a prominent concept in mental health care. We aimed to map the state of the art of conceptualizing recovery, its promoting and impeding factors, recovery-oriented practice, and the assessment of recovery. A scoping review of systematic reviews and meta-analyses was performed. Systematic searches were conducted, supplemented with hand-searching in reference lists. Of 228 articles that were identified and 33 that were reviewed, a total of 25 were included. This review showed that the CHIME conceptual framework for personal recovery is widely endorsed, containing the elements of connectedness, hope and optimism, identity, meaning in life, and empowerment. Although personal recovery first and foremost starts from individual preferences, the CHIME framework should be adapted according to culture and unique population characteristics. "Difficulties and trauma" should be added, and the person's choice, risk taking, and coping with challenges should be emphasized. Barriers to recovery are stigma and negative effects of mental health services and medication. Facilitators of recovery include spirituality, personal agency, and social support. Recovery-focused interventions, in which peer providers are involved, enhance recovery, hope, and empowerment. For assessing recovery outcomes, multiple instruments are accepted as methodologically sound. Personal recovery is conceptualized as complementary to clinical recovery and represents processes rather than outcomes. Additional work is needed to bridge the gap between the concept of recovery-oriented practice and routinely provided interventions. A broad framework of recovery is needed, and more research is needed into the working mechanisms of personal recovery processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).