Abstract
Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education.Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education.Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted.Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements).Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress.Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.
Highlights
Mental health recovery narratives have been defined as firstperson lived experience accounts of recovery from mental health problems, which refer to events or actions over a period of time, and which include elements of adversity or struggle, and of self-defined strengths, successes or survival [1, 2]
Whilst the focus in the remainder of this paper is on clinical perspectives on Recovery Narratives (RRNs), it is fully acknowledged that the concept of recovery emerged from the survivor movement
Three themes emerged from the analysis of the data relating to opportunities for use of RRNs
Summary
Mental health recovery narratives have been defined as firstperson lived experience accounts of recovery from mental health problems, which refer to events or actions over a period of time, and which include elements of adversity or struggle, and of self-defined strengths, successes or survival [1, 2]. Recovery has been taken up as a guiding value in mental health systems internationally [4] This implementation of recovery in services has been criticized for several reasons, including that it is a professional co-optation which occludes issues of social justice [5], that it commodifies experiences in systems that sustain subjugation [6], and that it is a cover for neoliberalism [7]. These issues have led some groups, such as the critical theorist and activist collective Recovery in the Bin, to call for the replacement of recovery with “unrecovery” [8]. Little is known about how RRNs can be used in clinical practice and clinical education
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