The experience of healthcare professionals implementing recovery-oriented practice in mental health inpatient units: A qualitative evidence synthesis.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery-based community programs supporting consumers' recovery journey. A range of healthcare professionals are involved in the care of people within mental health in-patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers. The integration of recovery-oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Developing hope and a safe place is an integral part of recovery-oriented practice within mental health inpatient units. Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours. Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery-oriented care in everyday practice. Using strength-based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person-centred care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of recovery-oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families. Empowering mental health professionals to believe that recovery-oriented practice is possible in mental health inpatient units is crucial. Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. ABSTRACT: Introduction Recovery-oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery-oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery-oriented practice in mental health inpatient units. Aim The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery-oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery-oriented care. Discussion Mental healthcare professionals perceived the principles of recovery-oriented care to be positive and include: therapeutic space, holistic care and person-centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice Recovery-oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery.