A narrative study of mental health recovery: exploring unique, open-ended and collective processes (original) (raw)
Related papers
Social Psychiatry and Psychiatric Epidemiology
Purpose Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development. Method 77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives. Results Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology. Conclusion The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction.
Re-storying narrative identity: a dialogical study of mental health recovery and survival
Journal of psychiatric and mental health nursing, 2015
Current UK mental health nursing policy is critiqued for neglecting the storied complexities of recovery-survival. Within a critical framework, creative non-fiction is used in a relational auto-ethnographic design to produce two short stories that demonstrate the utility of narrative re-storying in recovery-survival. New insights emerge for mental health nurse practice and research. These are: that narrative re-storying may help the recovery process for individuals and communities; that hybrid transcultural writing positively undermines barriers between professionals and consumers of mental health; and that all of this constitutes contemporary methodological innovation in narrative inquiry and related practice. Some of the complexities of recovery and survival are arguably relatively neglected in current UK mental health nursing policy and, by association, clinical and research practice. In order to redress this, this paper, part of larger research project, will present two short st...
Narratives of Mental Health Recovery
Brown, W. (2008). Narratives of Mental Health Recovery. [Refereed Journal Article]. Social Alternatives Journal, 27(4), 42-48. This article presents narratives of mental health recovery to investigate and better understand the journey towards recovery for individuals in Scotland. Findings from a research study conducted with this group suggest that recovery is a process – a life journey that has ups and downs. It amounts to much more than an absence of symptoms of illness. Although individual conceptualisations of recovery vary, common themes emerge that link recovery experiences. These include the central role of having hope and being optimistic about their future, having meaning and purpose in one’s life, being valued for social contributions and having trusting, respectful, and reciprocal relationships. Timely access to the right combination of treatment and supports can help individuals better navigate their recovery journeys. Findings provide evidence that people who experience mental health problems can have expertise of their own problems, and many of the most valuable lessons about recovery can be learned from these individuals. Narrators describe recovery as a transformative process sometimes ignited by a turning point, but often acknowledged through refl ection.
Characteristics of mental health recovery narratives: Systematic review and narrative synthesis
PLOS ONE
Background Narratives of recovery from mental health distress have played a central role in the establishment of the recovery paradigm within mental health policy and practice. As use of recovery narratives increases within services, it is critical to understand how they have been characterised, and what may be missing from their characterisation thus far. The aim of this review was to synthesise published typologies in order to develop a conceptual framework characterising mental health recovery narratives. Method A systematic review was conducted of published literature on the characteristics of mental health recovery narratives. Narrative synthesis involved identifying characteristics and organising them into dimensions and types; and subgroup analysis based on study quality, narrator involvement in analysis, diagnosis of psychosis and experience of trauma. The synthesis was informed by consultation with a Lived Experience Advisory Panel and an academic panel. The review protocol was pre-registered (Prospero CRD42018090188). Results 8951 titles, 366 abstracts and 121 full-text articles published January 2000-July 2018 were screened, of which 45 studies analysing 629 recovery narratives were included. A conceptual framework of mental health recovery narratives was developed, comprising nine dimensions (Genre; Positioning; Emotional Tone; Relationship with Recovery; Trajectory; Use of
Recovery conversations provide space for consumers of mental health services to identify how life, post diagnosis, might be lived. Anthony (1993) notes that 'recovery is a simple but powerful vision' (p.13) however there is no universally accepted definition of recovery in a context of mental health. Conceptualising recovery as an individual journey, that has light and shade can provide an expansive view on consumers and their experiences. A recovery narratives study, recently conducted by The University of Sydney, identified that consumers of recovery services believed that their mental health needs were viewed separately, at times, to issues of physical health, culture, addiction issues and relationship stressors. Broad recovery narratives encourage consumers to be active participants in their own journey as 'opposed to passive recipients of their mental health care' (Allott and colleagues, 2002, p.15). Consumers understanding of the role of their physical health, culture and trauma may benefit notions of recovery. This paper identifies how consumers, practitioners and peer-workers, working in a recovery-oriented model, can be guided by participant stories that include factors on the periphery of mental health, and how they may assist in developing a recovery framework that offers both a process and an outcome.
The Centrality of Narratives in the Mental Health Clinic, Care and Research
Philosophy, Psychiatry and Psychology, 2019
In this article, the authors argue that the narrative mode of knowledge represented by narratives in clinical care and research practices in the field of mental health is fundamental. They highlight the different perspectives professionals and patients have regarding the illness phenomenon. While to the professionals, illness is approached in a third-person perspective, to the patients, illness is, first and foremost, a lived experience of complete modification of the being, with the effect of creating distance and suspension and a crisis of signification. Narratives allow us to put both perspectives together by forging bonds between what is common and what is extraordinary, what is expected and what is unexpected, canonical and surprising, concordant and discordant. Illness asks for, prompts, narratives. The narrative provides meaning, context, and perspective to the patients' problems, defining how and why they are ill. Illness narratives express the singularity of the illness experience to each subject. However, this singularity is not solipsistic, as it bears the marks of time, history, culture and of the institutional context in which the subject is immersed. We suggest that within the context of recovery-oriented care practices, methodologies that adopt a relational perspective for the shared production of narratives, such as collaborative writing, should play a key role in the education of professionals, in the recovery clinic and in research.
PLOS ONE
Background Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur. Method Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people's recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts. Results Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy,
2021
In mental health services, recovery constitutes a guiding principle that is endorsed in professional medical guidelines and has become central to mental health policies across the world. However, for many clinicians, it can be a challenge to effectively embed recovery concepts into professionally directed treatment of disease without distortion, and ostensibly away from what matters to those who use the services. We discuss the evolving and multifaceted concept of 'recovery', including illness narratives to frame our discussion. We demonstrate how integration between a person-directed management of illness and a professionally directed treatment of disease can converge, resulting in positive outcomes for people with mental illness.
Narrative and mental health: preserving the emancipatory tradition
Narrative approaches have exercised an emancipatory influence within mental health. In this article, it is suggested that there is a risk that the emancipatory tradition associated with narrative may be co-opted through contemporary mental health strategy by a narrow agenda which promotes a particular Western and neoliberal form of citizenship. This may limit the way recovery can be imagined by equating it solely with the future orientated individual who strives, above all, to be economically independent. To resist this, it is suggested that narrative in mental health should be approached with recourse to therapeutic thinking which promotes a relational ethos of ‘recovery together’. The ‘recovery together’ model is subsequently considered in relation to narrative research on temporal understandings which have been conducted in disability studies and in the area of chronic illness. These studies point towards the value of a relational orientation towards well-being in the present, rather than fixating on future goals. It is suggested that a relational philosophy of the present might be usefully incorporated into narrative approaches when working therapeutically with people suffering from mental distress. It is argued that this might enable users and practitioners to extend the available narrative templates and to imagine recovery in diverse ways which support personal transformation and, ultimately, contribute to social change.
How do recorded mental health recovery narratives create connection and improve hopefulness?
Journal of Mental Health, 2022
Background: Mental health recovery narratives are an active ingredient of recovery-oriented interventions such as peer support. Recovery narratives can create connection and hope, but there is limited evidence on the predictors of impact. Aims: The aim of this study was to identify characteristics of the narrator, narrative content and participant which predict the short-term impact of recovery narratives on participants. Method: Independent studies were conducted in an experimental (n ¼ 40) and a clinical setting (n ¼ 13). In both studies, participants with mental health problems received recorded recovery narratives and rated impact on hopefulness and connection. Predictive characteristics were identified using multi-level modelling. Results: The experimental study found that narratives portraying a narrator as living well with mental health problems that is intermediate between no and full recovery, generated higher self-rated levels of hopefulness. Participants from ethnic minority backgrounds had lower levels of connection with narrators compared to participants from a white background, potentially due to reduced visibility of a narrator's diversity characteristics. Conclusions: Narratives describing partial but not complete recovery and matching on ethnicity may lead to a higher impact. Having access to narratives portraying a range of narrator characteristics to maximise the possibility of a beneficial impact on connection and hopefulness.