Operationalising Recovery-oriented services: The challenges for carers

Abstract

Purpose: Recovery approaches to healthcare now feature in the mental health policies and plans of many western countries. However, the operationalisation of these approaches has met with numerous challenges. This paper considers the reasons why, from the point of view of spousal or family carers of people with chronic and severe mental illness. Method: A single-case embedded study was used to analyse the process and outcomes of the implementation of Recovery-oriented services into a public health service organisation located in a major urban centre in south-eastern Australia. The unit of analysis considered in this paper is the experience of carers with the Recovery-oriented services. Findings: Seven of the ten carers who were interviewed had not heard of Recovery or the implementation of Recovery-oriented services. Nine out of the ten carers had noticed no recent improvements in the way services were delivered. Instead, most carers observed a trend to shift the responsibility for overseeing the consumer’s treatment and care from health professionals to carers. The carers went on to describe the limited support and training they receive to undertake their role; and the effects of health professionals with-holding the information required by the carer to provide effective care. Carers also identified solutions to the many service issues they identified, including the development of a designated clinical role, in which a health professional would be available to work with carers who are supporting consumers on their Recovery-journey. Conclusion: Inherent to Recovery approaches is collaboration and partnerships between all key stakeholders, including carers. It is important that mental health services focus on strengthening this aspect of service delivery to address ongoing issues with the operationalisation of Recovery-oriented services.