Abstract
BackgroundMental health policy is for staff to transform their practice towards a recovery orientation. Staff understanding of recovery-orientated practice will influence the implementation of this policy. The aim of this study was to conduct a systematic review and narrative synthesis of empirical studies identifying clinician and manager conceptualisations of recovery-orientated practice.MethodsA systematic review of empirical primary research was conducted. Data sources were online databases (n = 8), journal table of contents (n = 5), internet, expert consultation (n = 13), reference lists of included studies and references to included studies. Narrative synthesis was used to integrate the findings.ResultsA total of 10,125 studies were screened, 245 full papers were retrieved, and 22 were included (participants, n = 1163). The following three conceptualisations of recovery-orientated practice were identified: clinical recovery, personal recovery and service-defined recovery. Service-defined recovery is a new conceptualisation which translates recovery into practice according to the goals and financial needs of the organisation.ConclusionsOrganisational priorities influence staff understanding of recovery support. This influence is leading to the emergence of an additional meaning of recovery. The impact of service-led approaches to operationalising recovery-orientated practice has not been evaluated.Trial RegistrationThe protocol for the review was pre-registered (PROSPERO 2013: CRD42013005942).Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0275-4) contains supplementary material, which is available to authorized users.
Highlights
Mental health policy is for staff to transform their practice towards a recovery orientation
The principle of evidence-based health care is largely accepted as a quality standard of mental health practice, yet a translational gap between knowledge and routine implementation has been cited as a major challenge to innovation in mental health [5, 6]
National programmes for health service transformation are underway, such as Implementing Recovery through Organisational Change (ImROC) in England [7], but conceptual uncertainty and diverse understandings of recovery-orientated practice present a challenge for mental health professionals and services [8, 9]
Summary
Mental health policy is for staff to transform their practice towards a recovery orientation. Staff understanding of recovery-orientated practice will influence the implementation of this policy. The aim of this study was to conduct a systematic review and narrative synthesis of empirical studies identifying clinician and manager conceptualisations of recovery-orientated practice. National programmes for health service transformation are underway, such as Implementing Recovery through Organisational Change (ImROC) in England [7], but conceptual uncertainty and diverse understandings of recovery-orientated practice present a challenge for mental health professionals and services [8, 9]. The aim of this study was to conduct a systematic review and narrative synthesis of primary research investigating how clinicians and managers understand recoveryorientated practice in mental health services
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