Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people\xa0with severe mental disorders

Susana Gorbeña,Mike Slade,María-Concepción Moreno-Calvete,Ioseba Iraurgi,Patricia Penas,Jose-Juan Uriarte

doi:10.1186/s12888-021-03287-y

Abstract

BackgroundPersonal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment.MethodsStandardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program.ResultsUsers valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = −.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma.ConclusionsAn improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.

Highlights

Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and in the orientation of mental health services
Penas et al BMC Psychiatry (2021) 21:277 experience of the users themselves when evaluating both their process of recovery and the assistance they are receiving in mental health services [5]
The conceptualization of personal recovery has been challenging because of the individuality and subjectivity of the process, the CHIME conceptual framework has gained wide international acceptance and validity [6, 7]. This conceptual framework highlights five recovery processes: Connectedness, Hope and optimism, Identity, Meaning and purpose and Empowerment, which in turn are divided into several sub-categories [8]

Summary

Introduction

Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and in the orientation of mental health services. The conceptualization of personal recovery has been challenging because of the individuality and subjectivity of the process, the CHIME conceptual framework has gained wide international acceptance and validity [6, 7]. If the experience of how services support the different components is evaluated, improvements could be made in the different areas, focusing on those that can be considered the most deficient In this sense, it is important that the elements considered significant for recovery process are addressed by services. A moderate distance between the importance attributed and the subjective experience of those elements may facilitate individuals to act and take responsibility for their personal recovery journey This fact could be related with cognitive dissonance theory, which indicates that consistency between beliefs and perception facilitates action, and inconsistency generates discomfort and less probability of engaging in action [9, 10]

Results

Discussion

Conclusion