“Life is Vanilla”: Reconceptualising recovery and recovery-oriented practice in a hospital-based mental health service

This thesis reconceptualises recovery and recovery-oriented practice in the context of admission to a hospital-based mental health service. While mental health reform in Australia introduced policies to support recovery-oriented practice, little has changed in inpatient settings focused on managing risk and remediating acute symptoms. Previous studies indicated that consumers’ recovery experiences in this context may not mirror that of consumers living in the community. Using a Participatory Health Research approach, eight mental health professionals, a consumer advocate and an academic researcher formed a research partnership to understand recovery better and enhance recovery-oriented practice in a hospital-based mental health service. The methods comprised consumer focus groups (n = 17 participants), an online survey for staff (n = 17), and interviews with managers (n = 7). Co-researchers analysed the feedback from the consultations using inductive thematic analysis, identifying eight themes under three meta-themes: the conceptualisation of recovery, relational recovery, and recovery interventions. Three primary findings reflect the experience of recovery during an inpatient admission: 1) Recovery can be reconceptualised as a spectrum of experience from challenges to living well, including the existing CHIME processes and a new process, everyday living; 2). Relational recovery, encompassing connectedness, empowerment and hope, is key to recovery during a hospital admission; and 3) Interventions that enhance connectedness or reduce symptoms support recovery. Staff co-researchers actioned changes to their practice based on the findings, including introducing activities of everyday living, creating a visitors’ book for consumers to share messages of hope, improved identification and support for carers, and commencing recovery planning earlier in an admission. Further research is required to validate the reconceptualisation of recovery as a spectrum, confirm the vital recovery processes during a hospital admission, and explore how Participatory Health Research can facilitate practice changes.