Health Recovery Research Articles

Experiences of caregivers of patients with traumatic brain injury during hospitalization in western China: A qualitative study

ABSTRACT Family members frequently provide both physical and emotional support to patients. Previous studies have focused primarily on the experiences of patients with traumatic brain injury (TBI) and their caregivers during home care and the transition from hospital care to the community, with less emphasis on their experiences during acute hospital care immediately after TBI. This study aimed to explore the experiences of caregivers of patients with TBI during acute hospitalizations. A qualitative descriptive study using individual semistructured interviews was conducted at the trauma center of a tertiary hospital in western China. A purposive sample of 21 caregivers of patients with TBI were recruited. The interviews were conducted face to face in the inpatient ward from July to September 2023. Conventional content analysis was used to conduct the framework analysis. The experiences of caregivers were identified within three key themes: TBI consequences in patients (physical impairments, psychological distress, and cognitive dysfunctions), challenges of caregivers (physiological/emotional/economic burdens, conflicts, and concerns regarding recovery), and needs of caregivers (health information, medical services, and recovery expectations). This study highlights the experiences of caregivers of patients with TBI during hospital stays in western China. The challenges faced by caregivers and the needs of caregivers are multidimensional. Appropriate support should be provided to alleviate the burden of caregiving.

Archetypes and change in wildfire risk perceptions, behaviours and intentions among adults in Tasmania, Australia

Background Anthropogenic climate change globally increases wildfire risk. Understanding how wildfire threats impact community-wide risk perceptions and response options will critically inform resilience education strategies. Aim To gain an increased understanding of wildfire risk perceptions and self-evacuation intentions among residents in the wildfire-prone state of Tasmania, Australia. Methods We co-designed survey questions with stakeholders from emergency management, health and community recovery, using a computer-aided telephone interview to survey residents over 18 years of age. Numerical classification analysis, linear regression and descriptive statistics were used to analyse survey data. Results We identified four archetypes – the ‘immediate leaver’, ‘prepared stayer’, ‘unprepared leaver’ and ‘informed leaver’, each with distinct sociodemographic characteristics. Key variables were gender, age, location and income, with women most likely to leave and lower-income householders from rural areas most likely to stay. Previous wildfire experience and owning a home were significantly associated with increased preparedness actions. Compared to 2016, we found a significant increase in the proportion of residents intending to leave their property, with rural men least likely and urban women most likely to leave. Implications Recent education campaigns have likely driven increases in wildfire threat-related self-evacuation, yet the existence of distinct archetypes argues for more tailored messaging and education programs.

Public health resilience and recovery in Ukraine: Academic partnerships to improve population health

Abstract Background Strengthening the public health workforce is among top priorities for the transformation of Ukraine’s public health system. As part of the USAID Public Health System Recovery and Resilience Activity, an Academic Partnership Collaborative brought together three Ukrainian universities (National University Kyiv-Mohyla Academy, I. Horbachevsky Ternopil National Medical University, Sumy State University), two American universities (Temple University and Drexel University), and the All-Ukrainian Association of Public Health Specialists (UPHA) to enhance the competencies of public health graduates in Ukraine. Objectives The collaborative focuses on strengthening the Ukrainian universities’ public health curricula and the teaching and research competencies of the Ukrainian faculty, making the curricular changes in Ukraine better aligned with US and European academic standards. The university partners are collaborating with the newly established UPHA in building partnerships with peer organizations in the US (American Public Health Association) and Europe (EuPHA) and sharing advancements in public health education with the broader community of public health practitioners in Ukraine to enhance their competencies to improve population health and align with European systems of public health. Results We have established linkages among all partners via an initial meeting in Uzhhorod, Ukraine in April 2024. We anticipate results by November 2024 to include curriculum review recommendations, coaching on prioritized topics for the Ukrainian partners, faculty development plans, and the establishment of continuing professional development programs in collaboration with UPHA. Conclusions Through this partnership, selected Ukrainian universities will have an enhanced and sustainable capacity to train the public health workforce and will become leading examples for other public health programs to simulate and collaborate with beyond the project. Key messages • Ukraine’s resilience and recovery relies upon the strength of the current and future public health workforce; mechanisms for building public health training are essential to a healthy population. • A collaborative process of strategic activities among American and Ukrainian universities and professional associations can be effective in building a resilient public health system in Ukraine.

Flooding and Mental Health interventions for vulnerable groups

Abstract Issue/Problem The UK is increasingly vulnerable to flooding due to climate change, which significantly affects mental health. Vulnerable populations are disproportionately impacted, experiencing stress, anxiety, and other severe mental health issues, requiring effective intervention strategies. Description of the problem The UK’s third Climate Change Risk Assessment (CCRA) highlights flooding as a key challenge, with mental health impacts representing a major health burden. Effective interventions are crucial for these communities. Results UKHSA’s flooding and mental health guidance is incorporated into flooding and health advice documents for the public and frontline responders. It includes assessment and support strategies for health and social care staff, emergency responders, and local authorities. It focuses on those most at risk and promotes a phased approach to care-from immediate safety and shelter to long-term psychological support. This strategy accommodates the prolonged nature of mental health recovery, requiring adaptable and sustained interventions. Lessons Addressing the mental health impacts of flooding demands a comprehensive, multi-phase strategy that adapts to the evolving needs of affected populations. Early intervention and long-term support are vital to mitigate the extensive psychosocial damage. Key messages • Flooding severely affects mental health, necessitating structured, long-term interventions. • Flexible support strategies that evolve over time are crucial for effective recovery, ensuring that interventions meet the changing needs of those impacted by flooding.

Innovations in residential treatment that promote multi-drug addiction recovery

Abstract Background As the drug addiction crisis deepens in many countries across the globe, governments are rapidly expanding publicly funded treatment facilities. At the same time, the illicit drug market has evolved with many substances now containing multiple addictive drugs that complicate recovery. The evidence base for treatment remains primarily focused on single substances. The purpose of this study was to examine the lived experience of adults who attended in-patient treatment centres for multi-drug addiction in Canada. Methods This qualitative study was conducted in 2022 with 32 adults who voluntarily attended an in-patient treatment centre for drug addiction (44% female, 23-53 years). All had been addicted to multiple substances including opioids, crack and methamphetamines. Most (70%) were homeless before treatment. In 1-hour semi-structured interviews adults described the structures and programming that helped them recover in these facilities. Many tried multiple facilities and thus had a rich history of lived experience to draw from. Narrative inquiry was used to characterize qualitative themes across interviews using a phenomenological lens. Results Seven qualitative themes emerged from the data. Residential treatment centres that were effective at helping adults recover from multi-drug addiction: (1) provided flexible stays up to 100 days; (2) felt like a home not a prison; (3) permitted opioid replacement therapies; (4) provided a variety of recovery tools (e.g., cognitive behavioural therapy, Narcotics Anonymous, cultural supports); (5) helped adults reunite with family, find a safe place to stay, and find work before discharge; (6) provided transitional housing after discharge if needed; and (7) provided free long-term recovery support and check-ins after discharge. Conclusions The findings of this study highlight 7 actions that treatment facilities can adopt and test with their own clients in an effort to better support multi-drug addiction recovery. Key messages • A stronger evidence base is needed to inform in-patient multi-drug addiction treatment. • Findings underline 7 actions treatment facilities can take to promote multi-drug addiction recovery.

“One can’t Occur without the Other”: How Men Describe the Connection Between Healing from Childhood Sexual Abuse and Addiction Recovery

ABSTRACT The role that healing from childhood sexual abuse (CSA) plays in the context of substance use disorder (SUD) recovery is not well understood, particularly in male survivors. Building on interviews with 25 men and using grounded theory, this qualitative study explored the connection between healing from CSA and SUD recovery among male survivors. The findings reveal a cyclical nature in the connection between healing from CSA and addiction recovery, where sobriety enables healing and healing from CSA enables long-term recovery. This study highlights the importance of acknowledging and addressing sexual trauma in the treatment of SUD, particularly in male survivors.

Choice Matters: The Moderating Effect of Choice on the Relationship Between Mental Health Personal Recovery and Symptomatology

PurposeLimited research examines how choice surrounding treatment impacts mental health recovery among young adults with serious mental illness (SMI) who are navigating symptom management, complex mental health systems, and developmental expectations of increased independence. This study examines whether perceived choice related to mental health treatment impacts the relationship between symptomatology and personal recovery among Black, Latino/e, and multiracial young adults with SMI. MethodsSurveys were conducted with 121 young adults with SMI attending a community-based personal recovery-oriented program. Data included covariates (demographics and social support), psychiatric symptomatology, personal recovery, and choice. Ordinary least squares regressions tested whether choice predicts symptomatology and personal recovery, and whether choice moderates the relationship between symptomatology and personal recovery. ResultsMost participants were Black, Latino/e, or multiracial (96%) and male (67%) with an SMI diagnosis receiving services through Medicaid. Holding demographics and social support constant, a strong sense of choice was positively associated with personal recovery, (χ2 (7, N = 112) = 17.5, p = .01), but not symptomatology (χ2 (7, N = 112) = 12.5, p = .09). Furthermore, perceived choice moderated the relationship between symptomatology and personal recovery (β = −0.48, 95% CI [-0.79, −0.17], p = .012), where the association between symptomatology and personal recovery ceased to exist at lower levels of perceived choice in treatment. DiscussionThis study suggests perceived choice can influence the relationship between symptomatology and personal recovery among Black, Latino/e, and multiracial young adults with SMI. Implications for clinical practice include further evidence for enhancing shared decision-making and transition-focused care for young adults of color.

Coffee in mutual aid for the recovery of mental health in rural settings

Los trastornos mentales tienen un impacto significativo en las personas, las familias, las comunidades y los países con consecuencias económicas evidentes, incluidos los costos directos, la pérdida de productividad y otros costos indirectos. Cada vez se reconoce más el papel de las comunidades en la gestión de su recuperación en términos de salud mental. Desde la Declaración de Caracas de 1990 se establece la responsabilidad de los Estados de promover y acompañar las acciones comunitarias. Por otro lado, el fortalecimiento de la cultura es reconocido como un factor protector de la salud mental y debe ser un componente de cualquier intervención comunitaria. A través de un método argumentativo como razón práctica y lógica inductiva, el objetivo de este estudio es analizar las estrategias de recuperación psicosocial surgidas de las comunidades. El cooperativismo, la ayuda mutua y el café se proponen como elementos orientadores de este enfoque epistemológico, este último como elemento cultural en la recuperación de la salud mental rural. La medicina, la psicología social y comunitaria y la rehabilitación de base comunitaria son movimientos no hegemónicos que pretenden fortalecer la autonomía y el empoderamiento de individuos y grupos. Esto sugiere que, con una mayor inversión en servicios comunitarios, una mayor recuperación en el entorno mismo y menos hospitalizaciones psiquiátricas, finalmente habrá un impacto positivo. Su objetivo es garantizar condiciones de vida dignas y de calidad, entre otros fines. Se concluye la importancia de orientar estas iniciativas a mejorar los problemas de implementación de las políticas públicas sociales y de Salud.

'My Journey': A Qualitative Study of Recovery From the Perspective of Individuals With Chronic Mental Illness.

Due to the humanistic paradigm shift in recent years, mental health recovery has been approached through personal recovery beyond the limits of the biomedical perspective, emphasising the subjective perception and uniqueness of the individual. Therefore, approaching recovery perceptions from patients' perspectives has gained importance. This study aimed to examine in depth the recovery perceptions of individuals with chronic mental illness. It is a qualitative study conducted using a phenomenological design. The study group consisted of 12 patients who had been undergoing treatment for mental illness for at least 1 year and were selected by purposive sampling method. Data were collected face-to-face using a semi-structured interview form and analysed using the content analysis technique. The content analysis revealed three main themes and seven sub-themes. The themes were journey (a meaningful life, optimal functioning, new identity), journey ticket (resilience, support systems) and stones on the road (traditional perspective, barriers). In conclusion, the study results revealed that individuals in the recovery process required support and counselling to make sense of the process and adapt their identity. Employment should be used more effectively in the recovery process of individuals with chronic mental illness. Recovery can only be achieved by breaking away from the traditional perspective of healing and combating the perception of society towards patients. Accordingly, psychiatric nurses should provide effective guidance and counselling to show that individuals can create and live a meaningful life alongside their illnesses.

Spatio-Temporal Analysis of Urban Emergency Response Resilience During Public Health Crises: A Case Study of Wuhan

In recent years, public health emergencies have severely disrupted city functions and endangered residents’ health and lives, enhancing the emergency response capacity, a crucial aspect of building resilient cities. Based on the Wuhan Statistical Yearbook and local economic and social big data, this study constructed a resilience assessment system that covers resistance, adaptability, and resilience. Evaluate the resilience level of each region and analyze its spatiotemporal characteristics using the entropy weight method, Theil index, and natural breakpoint method. The central area exhibited higher resilience levels, while peripheral areas showed lower resilience, owing to location advantage and developmental disparities. The obstacle degree model revealed that scientific and technological innovation, social rescue capabilities, and population size are the primary weak links in building urban emergency response capacity. Based on these findings, this study aims to provide policy recommendations and improvement measures for multiple stakeholders, guide the construction of resilient cities, enhance the ability to respond to public health crises and recovery speed, and ensure urban functions and residents’ well-being.

A Mixed Methods Study of Ethnic Identity and Mental Health Recovery Processes in Minoritized Young Adults.

Ethnic identity development is associated with positive mental health in young adults from ethnic minority groups. How a sense of belonging and attachment to one's ethnic culture is related to personal mental health recovery remains unexplained. This study examines the experiences of ethnic minority young adults in the U.S. to understand the aspects of culture and identity development that are relevant to their recovery processes. Young adults who were living with chronic mental disorders were recruited from four rehabilitation programs. Interviews produced quantitative and qualitative data. An explanatory sequential mixed methods design was used to integrate the qualitative findings from a sub-group of young adults (n = 44) with the results from the quantitative study. Directed content analysis was used to analyze the qualitative data, and the integrated data were analyzed in joint displays. The prominent themes characterizing ethnic identity development in personal recovery were (a) cultural history, traditions, and values; (b) mental illness stigma within the ethnic community; and (c) bias and discrimination in mental health services. Young adults with high ethnic identity development reported having more support from family, but they also described experiences with stigma and racism. The integrated results suggest that ethnic identity development promotes mental health recovery in minoritized young adults through social support and improved well-being and resilience. Experiences of intersectional stigma and structural racism associated with ethnic identity can interfere with self-determination and access to care among minoritized Hispanic/Latine, Black, and multiracial young adults in the U.S.

The Role of Social Support in Substance Addiction Recovery: A Systematic Review

Recovery from substance addiction is a complex process that requires continuous physical and psychological support. Social support plays a crucial role in assisting individuals through the process of substance addiction recovery. This article presents a systematic review of the role of social support in substance addiction recovery by analyzing relevant studies from various academic sources. The findings indicate that social support, whether from family, friends, or community, significantly enhances individuals' motivation, resilience, and success in maintaining long-term recovery. Various forms of support, such as emotional, instrumental, and informational support, help individuals cope with the challenges of recovery. Additionally, participation in support groups and positive interpersonal relationships have been shown to accelerate the recovery process and prevent relapse. Therefore, social support is a key element not only in facilitating recovery but also in improving the quality of life for individuals dealing with substance addiction.

Impact of family engagement on client participation in coordinated specialty care for first episodes of psychosis

BackgroundCoordinated specialty care (CSC) programs for first episodes of psychosis are increasingly offered in the United States. A component of CSC programs is active family engagement in treatment, though research on the impact of this engagement is limited. This study examined the characteristics of families engaged compared to families not engaged in treatment, and the impact of family engagement on client participation and medication adherence over the first 6 months of treatment.MethodsUsing data from the Early Psychosis Intervention Network (EPINET) research hub in Minnesota (EPI-MINN), we compared two groups of individuals: clients who had a family member(s) engaged in their treatment vs. clients who did not. Family engagement was defined as any treatment services provided to a family member(s) by CSC clinical staff. The groups were compared on intake demographic variables, duration of untreated psychosis (DUP), hospitalizations, symptom severity, and functioning. A comparison of the total number of treatment visits during the first 6 months of treatment was tested using both nonparametric (Mann Whitney U) and parametric (ANCOVA) tests. Group comparisons on self ratings of “intent to attend visits,” “intent to complete the program,” and medication adherence were tested with ANCOVA and Chi-Square.ResultsFamily-engaged clients were younger, with less years of education, and more often White; clients without family engagement were more often Black. Family engagement was positively associated with increased total number of visits for all interventions with the exceptions of client peer support and case management visits. Family engagement increased clients’ self-reported intent to attend visits, though not intention to complete the program, which was moderately to markedly high in both groups. No differences were noted with medication adherence, with high rates of adherence across the entire study sample.ConclusionsOverall, results of the study support the benefits of family engagement in CSC on client participation, though future research is needed to understand why Black families are less engaged and what treatment adaptations are needed to reduce these racial differences. The results also support the value of CSC programs for medication adherence, a critical factor in symptom reduction and mental health recovery.

Thermal Comfort and Restorative Benefits of Waterfront Green Spaces for College Students in Hot and Humid Regions

Global climate change presents a serious threat to the sustainable development of human society, highlighting the urgent need to develop effective adaptation strategies to mitigate the impact of climate-related disasters. Campus waterfront green spaces, integral to the blue-green infrastructure, have been demonstrated to facilitate stress recovery. However, in hot and humid regions, severe outdoor thermal conditions may impair students’ mental and physical health and cognitive function, leading to symptoms such as increased stress, anxiety, and depression. This study examined the influence of outdoor thermal environments on health recovery by selecting three different waterfront green spaces in this climate: Space A (medium water body, sky view factor (SVF) = 0.228), Space B (large water body, SVF = 0.808), and Space C (small water body, SVF = 0.292). The volunteers’ thermal comfort and the restorative benefits of these spaces were evaluated via the perceived restorativeness scale (PRS), heart rate (HR), and electrodermal activity (EDA). We found variations in the neutral physiological equivalent temperature (PET) across the spaces, with values of 28.1 °C (A), 28.9 °C (B), and 29.1 °C (C). The lowest skin conductance recovery rate (RSC) at 0.8811 was observed in Space B, suggesting suboptimal physiological recovery, despite higher scores in psychological recovery (fascination) at 15.23. The level of thermal comfort in this hot and humid region showed a negative correlation with the overall PRS score, the “being away” dimension, and heart rate recovery (RHR). At a lightly warm stress level, where PET increased from 31.0 to 35.7 °C, RSC peaked between 1.45 and 1.53 across all spaces. These insights provide guidance for urban designers and planners in creating waterfront green space designs that can improve the urban microclimate and promote thermal health, achieving sustainable health.

‘Two sides of the one coin’: using reflection to examine co-production of human rights education within higher institutions in Ireland

ABSTRACT Encompassing human rights-based approaches within mental health service delivery is essential to supporting the recovery of service users, their family members/carers/supporters. This is being increasingly led by social workers due to their role in responding to psychosocial challenges. This is seen in today’s mental health services through their work in safeguarding service users and addressing familial concerns regarding all aspects of life. It is also evidenced in their openness to the concept of personal recovery—a movement aimed at defending and improving human rights for service users and their family members/carers/supporters through the recognition of international legislation. Recent debates within social work education have explored whether our critical and radical roots are declining or absent in practice. One argument for this has been the increasing pressures coming from neoliberal policies. This paper describes how both authors approached several co-produced sessions with social work students at an Irish university regarding mental health recovery and social work. The authors provide insight into this approach, including a description and exploration of a model of reflexivity used during this process which can be used by other educators, students, and practitioners [CS is an Assistant Professor of Social Work,MJN is a Consumer Academic].

The Different Faces of Religion in Therapy: An Exploratory Qualitative Study of a Religion-Based Therapeutic Community for Addiction Recovery in Israel.

This article examines the impact of the integration of religion and psychological treatment in a religion-based therapeutic community for persons in recovery from addiction in Israel. Based on an exploratory qualitative study that includes participant observation in a Jewish forgiveness therapy training course and in-depth interviews with counselors working in the community, we identify three themes that characterize the therapeutic process. First, religion emerges as a challenge in therapy, one that should be addressed with sensitivity. Second, religion can be turned into a spiritual and cultural resource in the recovery process, with a cautious and sensitive approach. Third, religion can offer a remedial experience, without necessarily involving an intensification of faith. We offer principles that can help guide decisions regarding the integration of religion into therapy, with a focus on addiction treatment oriented to clients with a religious background.

Development of a culturally safe recovery-oriented mental health practice

ABSTRACT This paper provides a comprehensive perspective on recovery, highlighting the significance of cultural awareness and the use of intersectionality theory to further the understanding of the influence of diverse identities on the recovery journey. A conceptual model is being introduced for culturally safe recovery-oriented practices, encompassing key domains: ways of knowing, presence, doing, and operating. Social workers are urged to lead the adoption of these practices, addressing service delivery gaps and promoting cultural safety for mental health service users. The model encourages mental health practitioners to engage in self-reflexivity, challenge power structures, and dismantle social inequities that hinder mental health recovery. The holistic embrace of all four practice domains can enhance service delivery and foster cultural safety for service users in recovery.

28-country global study on associations between cultural characteristics and Recovery College fidelity.

Recovery Colleges (RCs) are learning-based mental health recovery communities, located globally. However, evidence on RC effectiveness outside Western, educated, industrialised, rich, and democratic (WEIRD) countries is limited. This study aimed to evaluate associations between cultural characteristics and RC fidelity, to understand how culture impacts RC operation. Service managers from 169 RCs spanning 28 WEIRD and non-WEIRD countries assessed the fidelity using the RECOLLECT Fidelity Measure, developed based upon key RC operation components. Hofstede's cultural dimension scores were entered as predictors in linear mixed-effects regression models, controlling for GDP spent on healthcare and Gini coefficient. Higher Individualism and Indulgence, and lower Uncertainty Avoidance were associated with higher fidelity, while Long-Term Orientation was a borderline negative predictor. RC operations were predominantly aligned with WEIRD cultures, highlighting the need to incorporate non-WEIRD cultural perspectives to enhance RCs' global impact. Findings can inform the refinement and evaluation of mental health recovery interventions worldwide.

Financial Lifelines: Cash Transfer Programs as a Tool for Mental Health Recovery in Sudan's War Zones

Financial Lifelines: Cash Transfer Programs as a Tool for Mental Health Recovery in Sudan's War Zones

Guided Slow Looking for Young Psychiatric Service Users: A phenomenological approach to arts and mental health recovery

Guided Slow Looking for Young Psychiatric Service Users: A phenomenological approach to arts and mental health recovery