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A multi-site study: What do people say helps their recovery?. Dr Barbara Tooth NSW Institute of Psychiatry Dr Kalyanasudnaram & Helen Glover Australia. Rationale for the research.

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a multi site study what do people say helps their recovery

A multi-site study: What do people say helps their recovery?

Dr Barbara Tooth

NSW Institute of Psychiatry

Dr Kalyanasudnaram & Helen Glover

Australia

rationale for the research
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

methodology
Methodology

Two Independent Studies –

  • Queensland (1997)
  • USA (2003)
  • Italy ( current)
methodology1
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
questions
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)
part 3 questions
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?
demographics
Queensland

Age range 21-60

mean 36

GAF 80-89 62%

70-79 27%

<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 80-89 15%

70-79 20%

<70 65%

Admissions range 1-24

mean 7

Work F/T 7% P/T 28%

Voluntary 29% Unemployed 36%

Medication Yes 100%

Demographics
overall results usa
Overall results USA

Determination 95%

Spirituality 86%

Medication important 81%

Therapist helpful 81%

Self-help/responsibility 76%

Medication side effects 76%

*Being occupied 76% (B)

Psychiatrist helpful 71%

MHP unhelpful 71%

overall findings usa
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%

similarities with qld
Queensland

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%

Similarities with Qld
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 86%

Therapist helpful 81%

Psychiatrist helpful 71%

Meds important 81%

Struggle to recover 67%

Differences
additional questions
Additional questions
  • Turning point:(Qld in brackets)

Internal 48% (44%)

External 57%* (25%)

* 19% identified an external event that triggered internal awareness

what is it about the mhs that has been most helpful
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%
what is interesting
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

what is interesting1
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)

what is interesting2
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)

what is interesting3
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

some parting comments
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
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