1. A multi-site study: What do people say helps their recovery?
Marked difference between people with lived experience and professionals make sense of recovery
People use very personal constructs – about themselves, their hopes, loves, dreams etc
Professionals use very clinical constructs – about symptom reduction, functionality, vocational outcomes etc
Having said this I think that Recovery is poor term because it has many different interpretations for people. It is both a process that occurs in people’s lives and a movement towards a new paradigm. It is loosing its meaning because it is becoming a buzz word.
Dr Barbara Tooth
NSW Institute of Psychiatry
Dr Kalyanasudnaram & Helen Glover
Australia

2. Rationale for the research
Simply, for the original study, no-one in Australia had conducted research asking people to tell their story of what helps
To test the assumptions of MH professionals about what helps by asking people
add to the growing literature on what people say helps their recover and
thereby starting to build the evidence base for the emerging recovery paradigm.
It has long been argued that comprehensive service provision is necessary to provide people with a range of choices/ options for treatment
To begin to fill the gap in the literature regarding the impact of comprehensive MHS on people’s recovery
Provide additional information on the recovery process from people who have received such services
Discuss the implications of the research findings for service provision

3. Methodology Two Independent Studies – Queensland (1997) USA (2003)
Italy ( current)
60 People in Qld, 20 in Boulder, 20 Madison, 20 Italy
Questions developed by focus groups

4. Methodology Part 1 Open ended question Part 2
Specific questions developed from focus groups, literature & experience
Part 3
Questions about the role of the MHS
Part 4 Demographic data
In Australia people self selected, In US chosen by services (not desired)
Held focus groups in both Australia US & Italy to develo

5. QUESTIONS 1. Can you tell me about your journey of recovery? 2.
What do you understand by the term recovery?
What is it about you that has helped?
How and when did you know that you were in recovery?
Other factors : what was helpful, what was not, spiritual aspect; understanding the illness; health professionals; medications; stigma; adjustments
What was it about your services that specifically contributed to your recovery (USA and Italy only)

6. Part 3 Questions What is it about the MHS that has been most helpful?
Have you been able to participate in your treatment?
Have you been able to participate in your medications?
Did the MHS help you connect to the wider community?
Did the MHS help you with your relationships with your family?
How could the service be improved?

7. Demographics Queensland USA Age range 21-60 mean 36 GAF 80-89 62%%
<70 11%
Admissions range 0-30
mean 6
Work F/T 14% P/T 21%
Voluntary 7% Unemployed 58%
Medication Yes 82%
USA
Age range 35-67
mean 51
GAF % %
<70 65%
Admissions range 1-24
mean 7
Work F/T 7% P/T 28%
Voluntary 29% Unemployed 36%
Medication Yes 100%
Shows that there is a vast variation in the way professionals understand and make sense of what constitutes recovery. GAF doesn’t indicate that people living a life.
Qld self selection
US professional selection
US hard to exit services due to insurance issues, have to take meds to receive services

8. Overall results USA Determination 95% Spirituality 86%
Medication important 81%
Therapist helpful 81%
Self-help/responsibility 76%
Medication side effects 76%
*Being occupied % (B)
Psychiatrist helpful 71%
MHP unhelpful 71%

9. Overall findings USA *Struggle to recover 67% (B)
*Stigma hindered 67% (B)
*Consumers helpful 66% (M)
Family important 57%
*Friends important 57%
Managing illness 57%
Understanding illness 57%
Work important 57%
Boulder a university town

10. Similarities with Qld Queensland USA Determination 82%
Responsibility 68%
Manage illness 67%
Medication SE’s 65%
MHP unhelpful 61%
Friends 58%
Stigma hindered 53%
Work important -
USA
Determination 95%
Responsibility 76%
Manage illness 57%
Medication SE’s 76%
MHP unhelpful 71%
Friends 57%
Stigma hindered 67%
Work important 57%

11. Differences Queensland Understand illness 81% Being occupied 32%
Spirituality 49%
Helpful MHP 56%
Psychiatrist helpful -
Accept medication 54%
Struggle to recover 42%
USA
Understand illness 57%
Being occupied 76%
Spirituality %
Therapist helpful 81%
Psychiatrist helpful 71%
Meds important 81%
Struggle to recover 67%

12. Additional questions Turning point: (Qld in brackets)
Internal 48% (44%)
External 57%* (25%)
* 19% identified an external event that triggered internal awareness
Internal something within themselves,
External some event eg work, study, just doing it made people realise they were getting on with life.

13. What is it about the MHS that has been most helpful?
Trends suggest:
Respectful 50%
Practical help 48%
Available 40%
Yet:
Unsolicited negative comments 45%
Validation

14. What is interesting?
Significant similarity across both studies that reinforces the internal and external conditions that help or hinder people in their ongoing recovery:
Internal conditions that supports people in their ongoing recovery
AN ACTIVE SENSE OF SELF

15. What is interesting?
External conditions that support self-directed recovery
Family / friends
Medication
Being occupied
MHP’s – use their humanity
(respect, dignity, listen, equality, tried to understand what is important for person)
Relationships – dilemma when saying it is just the relationship that workers interpret that they don’t have to do anything but have a good relationship “coffee and cake”, so need to start to name and focus on the processes that facilitate the internal efforts

16. What is interesting?
External conditions that hinder self-directed recovery:
Medications – side effects
MHP – don’t use their humanity
(use covert threats, try to put their ideas onto the person “you should”, perceived power imbalance, hide behind professional barrier)
Get in the road of people’s self directed recovery

17. What is interesting?
Over 100 factors reinforcing the complex, diverse and individual nature of the recovery process
Implications for services
Implications for professionals
– MHP can both help or hinder a person’s self-directed recovery and it is becoming clearer about what helps and what does not
From this study it is curious that the most important thing was practical help and being available. No particular service was named as useful. People tend to take from the service what they need. There is evidence to suggest that in the US service systems can inadvertantly trap people and create what they are trying to prevent, chronicity
For professionals the pursuit of science appears to have moved us further and further away from our basic humanity. We need to reconceptualise what we are doing when we work with people

18. Some parting comments
We need to remember the messages of over a decade ago from Deegan, Fisher and others.
MHS and MHP cannot put their values onto recovery, take it over or own it.
Recovery is something people do and it is their job to recover in their own unique and personal way.
It is services and professionals task to understand what each person wants from us, and understand how we can help facilitate their self-directed journey or recovery