What Are the Personal Recovery Needs of Community-Dwelling Individuals with Mental Illness? Preliminary Findings from the Canadian Personal Recovery Outcome Measurement (C-PROM) Study
Publication: Canadian Journal of Community Mental Health
30 October 2018
Abstract
Personal recovery is an overarching goal that underpins mental health community support and clinical services in Canada. Surprisingly, little information is available about the personal recovery needs of community-dwelling Canadians with mental illness. The purpose of this study is to describe these needs in a sample of adults living in a large urban centre. We performed a multi-site cross-sectional survey of adults who receive community-based mental health services in an urban setting. Participants were asked to complete six patient-reported outcome (PRO) measures about personal recovery, hope, mastery, and depression. We used descriptive and correlational analyses to summarize the data according to an established evidence-based theoretical conceptualization of recovery. Two hundred and twenty-eight individuals participated in the study. Participants indicated high levels of self-reported empowerment and hope and optimism about the future. In contrast, participants reported low levels of perceived connectedness, identity, and meaning in life. In conclusion, this study identified that recovery-oriented PRO measures can improve our understanding of the needs and goals of individuals with mental illness and highlight the ways in which individuals can achieve a sense of meaning in life. Understanding the recovery needs of Canadians with mental illness may help foster recovery-oriented healthcare by bringing person-centred approaches to the point of treatment, so as to ensure greater quality and accountability of mental health services.
Résumé
Le rétablissement personnel est un objectif prioritaire qui sous-tend les services communautaires de soutien en santé mentale et les services cliniques au Canada. Étonnamment, on dispose de peu d’information sur les besoins en matière de rétablissement personnel des Canadiens atteints de troubles mentaux qui vivent dans la collectivité. L’objectif de la présente étude est de décrire ces besoins à l’aide d’une enquête réalisée auprès d’un échantillon d’adultes vivant dans une grande agglomération urbaine. Nous avons réalisé une enquête transversale multisite auprès d’adultes recevant des services communautaires de santé mentale en milieu urbain. On a demandé aux participants de remplir six rapports d’état de santé évaluant le rétablissement personnel, l’espoir, la maîtrise de soi et la dépression. Nous avons eu recours à des analyses descriptives et corrélationnelles pour résumer les données recueillies, et ce, suivant une conceptualisation théorique fondée sur des données factuelles de rétablissement. Deux cent ving-huit individus ont participé à l’étude. Les participants ont fait état de niveaux élevés d’autonomisation autodéclarée et exprimé de l’espoir et de l’optimisme pour l’avenir. À l’inverse, les participants ont fait état de faibles niveaux de perception d’affiliation, d’identité et du sens de la vie. En conclusion, la présente étude a permis de révéler que les rapports d’état de santé spécifiquement axés sur le rétablissement du patient peuvent améliorer notre compréhension des besoins et des aspirations des personnes atteintes de troubles mentaux et mettre en lumière les façons pour les individus de donner un sens à leur vie. La compréhension des besoins de rétablissement des Canadiens atteints de troubles mentaux peut contribuer à la mise en place de services en santé orientés vers le rétablissement du patient en favorisant l’adoption d’approches centrées sur la personne dans les lieux de traitement dans le but d’assurer une meilleure qualité et une plus grande responsabilité dans les services de santé mentale couramment prodigués.
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References
Ahmed S., Berzon R. A., Revicki D. A., Lenderking W. R., Moinpour C. M., Basch E., and Wu A. W. 2012 The use of patient-reported outcomes (PRO) within comparative effectiveness research: Implications for clinical practice and health care policy Medical Care 50 12 1060 -1070
Andrade L. H., Alonso J., Mneimneh Z., Wells J. E., Al-Hamzawi A., Borges G., and Kessler R. C. 2014 Barriers to mental health treatment: Results from the WHO World Mental Health surveys Psychological Medicine 44 6 1303 -1317
Anthony W. A. 1993 Recovery from mental illness: The guiding vision of the mental health service system in the 1990’s Psychosocial Rehabilitation Journal 16 4 11 -23
Barbic, S., Kidd, S. A., & McKenzie, K. (Under Review). Development and testing of the Personal Recovery Outcome Measure.
Barbic S. P., Cano S. C., and Mathias S. 2018 The problem of patient-centred outcome measurement in psychiatry: Why metrology hasn’t mattered and why it should Journal of Physics: Conference Series 1044 1 1 -6
Barbic S. P. and Cano S. J. 2016 The application of Rasch measurement theory to psychiatric clinical outcomes research: Commentary on … Screening for depression in primary care British Journal of Psychiatry Bulletin 40 5 243 -244
Barbic S. P., Jones A. A., Woodward M., Piercy M., Mathias S., Vila-Rodriguez F., and Honer W. G. 2018 Clinical and functional characteristics of young adults living in single room occupancy housing: Preliminary findings from a 10-year longitudinal study Canadian Journal of Public Health 109 2 204 -214
Barbic S. P., Kidd S. A., Davidson L., McKenzie K., and O’Connell M. J. 2015 Validation of the Brief Version of the Recovery Self-Assessment (RSA-B) using Rasch Measurement Theory Psychiatric Rehabilitation Journal
Barbic S. P., Krupa T., and Armstrong I. 2009 A randomized controlled trial of the effectiveness of a modified recovery workbook program: Preliminary findings Psychiatric Services 60 491 -497
Bird V., Leamy M., Tew J., Le Boutillier C., Williams J., and Slade M. 2014 Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers Australian and New Zealand Journal of Psychiatry 48 7 644 -653
Brijnath B. 2015 Applying the CHIME recovery framework in two culturally diverse Australian communities: Qualitative results International Journal of Social Psychiatry 61 7 660 -667
Brosnan S., Barron E., and Sahm L. J. 2012 Health literacy and the clozapine patient Perspectives in Public Health 132 1 39 -42
Browne J. P., Cano S. J., and Smith S. 2017 Using patient-reported outcome measures to improve health care: Time for a new approach Medical Care
Brundage, M., Blazeby, J., & Revicki, D. (2012). Patient-reported outcomes in randomized clinical trials: development of ISOQOL reporting standards. Quality of Life Research.
Canadian Institutes for Health Research. (2015). Canada’s strategy for patient-oriented research—Patient engagement framework. Retrieved from http://www.cihr-irsc.gc.ca/e/49232.html
Canadian Institutes for Health Research. (2016). Strategy for patient-oriented research. Retrieved from http://www.cihr-irsc.gc.ca/e/41204.html
Cano S., Vosk T., Pendrill L., and Stenner A. J. 2016 On trial: the compatibility of measurement in the physical and social sciences Journal of Physics Conference Series 772 1 1
Cano S. J., Barrrett L. E., Zajicek J. P., and Hobart J. C. 2011 Beyond the reach of traditional analyses: Using Rasch to evaluate the DASH in people with multiple sclerosis Multiple Sclerosis Journal 17 214 -222
Cano S. J., Pendrill L. R., Barbic S. P., and Fisher W. Jr. 2018 Patient-centred outcome metrology for healthcare decision-making Journal of Physics: Conference Series 1044 1
Carr S. 2017 Lonely in a crowd: Invited commentary on Webber and Frendt-Newlin (2017). A review of social participation interventions for people with mental health problems Social Psychiatry Psychiatric Epidemiology 52 7 781 -783
Colton C. W. and Manderscheid R. W. 2006 Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states Preventing Chronic Disease 3 2 A42
Cook J. A., Copeland M. E., Corey L., Buffington E., Jonikas J. A., Curtis L. C., and Nichols W. H. 2010 Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives Psychiatric Rehabilitation Journal 34 2 113 -120
Corrigan P. W., Salzer M., and Ralph R. O. 2004 Examining the factor structure of the recovery assessment scale Schizophrenia Bulletin 30 4 1035 -1041
Coulter A. 2017 Measuring what matters to patients British Medical Journal 356 j816
Davidson L. J., Schmutte T., Dinezeo T., and Andres-Hyman R. 2008 Remission and recovery in schizophrenia: Practitioner and patient perspectives Schizophrenia Bulletin 34 5 -8
Davidson, L. J., Sells, D., Songster, S., & O’Connell, M. (2005). Qualitative studies of recovery: What can we learn from the person?. In R. O. Ralph & P. W. Corrigan (Eds.), Recovery in mental illness: Broadening our understanding of wellness (pp. 147–170). Washington, DC, US: American Psychological Association.
Department of Health and Human Services. (2003). Achieving the promise: Transforming mental health care in America. Retrieved from Rockville, MD.
Edgelow M. and Krupa T. 2011 Randomized controlled pilot study of an occupational time-use intervention for people with serious mental illness American Journal of Occupational Therapy 65 3 267 -276
Epstein R. M. and Street R. L. Jr. 2011 The values and value of patient-centered care Annals Family Medicine 9 2 100 -103
Firth J., Cotter J., Elliott R., French P., and Yung A. R. 2015 A systematic review and meta-analysis of exercise interventions in schizophrenia patients Psychological Medine 45 7 1343 -1361
Forchuk C., Dickins K., and Corring D. J. 2016 Social determinants of health: Housing and income Health Quarterly 18 Suppl 27 -31
Gnanasakthy A., Mordin M., Clark M., DeMuro C., Fehnel S., and Copley-Merriman C. 2012 A review of patient-reported outcome labels in the United States: 2006 to 2010 Value in Health 15 3 437 -442
Hobart J. C., Cano S. J., Zajicek J. P., and Thompson A. A. 2007 Rating scales as outcome measures for clinical trials in neurology: Problems, solutions, and recommendations Lancet Neurology 6 1094 -1105
Honer W. G., Cervantes-Larios A., Jones A. A., Vila-Rodriguez F., Montaner J. S., Tran H., and Schultz K. 2017 The hotel study—Clinical and health service effectiveness in a cohort of homeless or marginally housed persons Canadian Journal of Psychiatry 706743717693781
Hunt M. G. and Resnick S. G. 2015 Two birds, one stone: Unintended consequences and a potential solution for problems with recovery in mental health Psychiatric Services 66 11 1235 -1237
Jones A. A., Vila-Rodriguez F., Leonova O., Langheimer V., Lang D. J., Barr A. M., and Honer W. G. 2015 Mortality from treatable illnesses in marginally housed adults: A prospective cohort study British Medical Journal Open 5 8 e008876
Keetharuth A. D., Brazier J., Connell J., Bjorner J. B., Carlton J., Taylor Buck E., and Barkham M. 2018 Recovering quality of life (ReQoL): A new generic self-reported outcome measure for use with people experiencing mental health difficulties British Journal of Psychiatry 212 1 42 -49
Kelly E., Duan L., Cohen H., Kiger H., Pancake L., and Brekke J. 2017 Integrating behavioral healthcare for individuals with serious mental illness: A randomized controlled trial of a peer health navigator intervention Schizophrenia Research 182 135 -141
Kidd S. A., George L., O’Connell M., Sylvestre J., Kirkpatrick H., Browne G., and Thabane L. 2010 Fidelity and recovery orientation in Assertive Community Treatment Community Mental Health Journal 46 342 -250
Kidd S. A., McKenzie K. J., and Virdee G. 2014 Mental health reform at a systems level: Widening the lens on recovery-orientated care Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie 59 5 243 -249
Kirwan J. R., Bartlett S. J., Beaton D. E., Boers M., Bosworth A., Brooks P. M., and Gossec L. 2014 Updating the OMERACT filter: Implications for patient-reported outcomes Journal of Rheumatology 41 5 1011 -1015
Kirwan J. R., de Wit M., Frank L., Haywood K. L., Salek S., Brace-McDonnell S., and Bartlett S. J. 2017 Emerging guidelines for patient engagement in research Value Health 20 3 481 -486
Kisely S., Preston N., Xiao J., Lawrence D., Louise S., and Crowe E. 2013 Reducing all-cause mortality among patients with psychiatric disorders: A population-based study Canadian Medical Association Journal 185 1 E50 -56
Kondo S., Kumakura Y., Kanehara A., Nagato D., Ueda T., Matsuoka T., and Kasai K. 2017 Premature deaths among individuals with severe mental illness after discharge from long-term hospitalization in Japan: A naturalistic observation during a 24-year period British Journal of Psychiatry Open 3 4 193 -195
Krishan S., von Esenwein S. A., and Druss B. G. 2012 The health literacy of adults with severe mental illness Psychiatric Services 63 4 397
Krupa T., McLean H., Eastabrook S., Bonham A., and Baksh L. 2003 Daily time use as a measure of community adjustment for persons served by assertive community treatment teams American Journal of Occupational Therapy 57 5 558 -565
Kulik D. M., Gaetz S., Crowe C., and Ford-Jones E. L. 2011 Homeless youth’s overwhelming health burden: A review of the literature Pediatric Child Health 16 6 e43 -47
Laursen T. M., Nordentoft M., and Mortensen P. B. 2014 Excess early mortality in schizophrenia Annual Review of Clinical Psychology 10 425 -448
Leamy M., Bird V., Le Boutillier C., Williams J., and Slade M. 2011 Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis British Journal of Psychiatry 199 445 -452
MacMillan R. D. 2014 The mainstreaming of recovery Journal of Mental Health 23 5 217 -218
Marshall S., Haywood K., and Fitzpatrick R. 2006 Impact of patient-reported outcome measures on routine practice: A structured review Journal of Evaluation in Clinical Practice 12 5 559 -568
Mechanic D., McAlpine D., Rosenfield S., and Davis D. 1994 Effects of illness attribution and depression on the quality of life among persons with serious mental illness Social Science and Medicine 39 2 155 -164
Mental Health Commission of Canada. (2015). Guidelines for recovery-orientated practice. Retrieved from www.mentalhealthcommission.ca
Mueser K. T., Deavers F., Penn D. L., and Cassisi J. E. 2013 Psychosocial treatments for schizophrenia Annual Review of Clinical Psychology 9 465 -497
Mueser K. T., Meyer P. S., and Penn D. L. 2006 The illness management and recovery program Schizophrenia Bulletin 32 Suppl 1 S32-S43
O’Connell M., Tondora J., Croog G., Evans A., and Davidson L. J. 2005 From rhetoric to routine: Assessing perceptions of recovery-oriented practices in a state mental health and addiction system Psychiatric Rehabilitation Journal 28 378 -386
Pendrill L. 2014 Man as a measurement instrument Journal of Measurement Science 9 4 24 -35
Pentland, W. E., & McColl, M. A. (1999). Application of time use research to the study of life with a disability. In W. E. Pentland, S. Andrew, M. Harvey, P. Lawton, & M. A. McColl (Eds.), Time Use Research in the Social Sciences. New York: Kluwer Academic/Plenum Publishers.
Poremski D., Whitley R., and Latimer E. 2014 Barriers to obtaining employment for people with severe mental illness experiencing homelessness Journal of Mental Health 23 4 181 -185
Proctor E. K., Landsverk J., Aarons G. A., Chambers D., Glisson C., and Mittman B. 2009 Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges Administrative Policy in Mental Health 36 1 1 -17
Public Health Association. (2008). Health literacy in Canada, a healthy understanding. Retrieved from http://www.ccl-cca.ca/CCL/Reports/HealthLiteracy.html
Reeve B. B., Wyrwich K. W., Wu A. W., Velikova G., Terwee C. B., Snyder C. F., and Butt Z. 2013 ISOQOL recommends minimum standards for patient-reported outcome measures used in patient-centered outcomes and comparative effectiveness research Quality of Life Research 22 8 1889 -1905
Rifkin S. B. 2014 Examining the links between community participation and health outcomes: A review of the literature Health Policy Plan 29 Suppl 2 ii98 -106
Salyers M. P., Godfrey J. L., Mueser K. T., and Labriolo S. 2007 Measuring illness management outcomes: A psychometric study of clinician and consumer rating scales for illness self-management and recovery Community Mental Health Journal 43 5 459 -480
Shanks V., Williams J., Leamy M., Bird V. J., Le Boutillier C., and Slade M. 2013 Measures of personal recovery: A systematic review Psychiatric Services 64 10 974 -80
Shor R. and Shalev A. 2014 Barriers to involvement in physical activities of persons with mental illness Health Promotion International
Slade M., Amering M., Farkas M., Hamilton B., O’Hagan M., Panther G., and Whitley R. 2014 Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems World Psychiatry 13 1 1 -12
Spaniol, L., Koehler, M., & Hutchinson, D. (1994). Recovery workbook: Practical coping and empowerment strategies for people with psychiatric disability. Boston: Center for Psychiatric Rehabilitation, Boston University
Stickley T., Wright N., and Slade M. 2018 The art of recovery: Outcomes from participatory arts activities for people using mental health services Journal of Mental Health 1 -7
Stuart S. R., Tansey L., and Quayle E. 2017 What we talk about when we talk about recovery: A systematic review and best-fit framework synthesis of qualitative literature Journal of Mental Health 26 3 291 -304
The Mental Health Commission of Canada. (2012). Changing directions, changing lives:The mental health strategy for Canada. Retrieved from https://www.mentalhealthcommission.ca/sites/default/files/MHStrategy_Strategy_ENG.pdf
Thornicroft G. 2011 Physical health disparities and mental illness: The scandal of premature mortality British Journal of Psychiatry 199 6 441 -442
Thornicroft G. and Slade M. 2014 New trends in assessing the outcomes of mental health interventions World Psychiatry 13 118 -124
Walker E. R., McGee R. E., and Druss B. G. 2015 Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis JAMA Psychiatry 72 4 334 -341
Webber M. and Fendt-Newlin M. 2017 A review of social participation interventions for people with mental health problems Social Psychiatry and Psychiatric Epidemiology 52 4 369 -380
Wiering B., de Boer D., and Delnoij D. 2017 Patient involvement in the development of patient-reported outcome measures: A scoping review Health Expectations 20 1 11 -23
Williams J., Leamy L., Bird V. J., Harding C., Larsen J., Le Boutillier C., and Slade M. 2012 Measures of the recovery orientation of mental health services: Systematic review Social Psychiatry and Psychiatric Epidemiology 47 11 1827 -1835
World Economic Forum: the Harvard School of Public Health. (2011). The global economic burden of non-communicable diseases. Geneva: World Economic Forum.
World Health Organization. (2013). Mental Health Action Plan 2013–2030. Retrieved from http://www.who.int/mental_health/publications/action_plan/en/
Yanos P. T. and Robilotta S. A. 2011 An examination of time-use among adults diagnosed with severe mental illnesses using daily interviews Psychiatric Rehabilitation Journal 34 3 243 -247
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Canadian Journal of Community Mental Health
Volume 37 • Number 1 • May 2018
Pages: 29 - 47
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Version of record online: 30 October 2018
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Skye Pamela Barbic, Sean A. Kidd, Zachary T. Durisko, Rosemary Yachouh, Gausiha Rathitharan, and Kwame McKenzie. 2018. What Are the Personal Recovery Needs of Community-Dwelling Individuals with Mental Illness? Preliminary Findings from the Canadian Personal Recovery Outcome Measurement (C-PROM) Study. Canadian Journal of Community Mental Health.
37(1): 29-47. https://doi.org/10.7870/cjcmh-2018-005
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