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This report summarises the finding from the REFOCUS programme, which took place in England from 2009 to 2014. The document is written for the general public, and describes what the study involved and what we found.
The REFOCUS programme was a 5 year research study which aimed to understand what is meant by personal recovery and to find effective wa...
Context in source publication
Context 1
... Processes -recovery seems to involve five main recovery processes, which we called the CHIME Framework: Connectedness, Hope and optimism, Identity, Meaning and purpose in life and Empowerment. This framework is shown in Figure 2, and has becoming a widely-used approach to understanding recovery. Do other countries have similar understandings of ...
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Background
The boundary between services for children and adolescents and adults has been identified as problematic for young people with mental health problems.
Aims
To examine the use and cost of healthcare for young people engaged in mental healthcare before and after the child/adolescent and adult service boundary.
Method
Data from 772 young...
Background:
Psychopathology manifests itself primarily in late adolescence and continues into adulthood. Continuity of care is essential during this phase of life. The current care service distinguishes between child/adolescent (CAMHS) and adult mental health services (AMHS). The separation of services can interfere with the continuity of care.
AI...
Citations
... In recent decades, recovery has taken a prominent position within the field of mental health. In this sense, the term recovery is defined as an ongoing, personal journey, experienced and worked towards by the individual with mental illness (Slade et al., 2014;Ralph andCorrigan, 2005, Perkins et al., 2012;Fortune et al., 2015). Driven largely by users of mental health services requesting more information, control and choice regarding illness management, this redefining of recovery has seen a shift in mental health policies and services from a "symptom-illness-treatment" type medical model towards one which aims to empower individuals through recovery and the promotion of subjective and functional wellbeing (Meddings et al., 2015;Slade, 2013;Zucchelli and Skinner, 2013). ...
Purpose
The purpose of this paper is to understand and inform the development and implementation of a newly established Discovery College (a youth-focused Recovery College). It also aims to contribute to a broader understanding of the benefits and barriers to establishing Recovery Colleges.
Design/methodology/approach
The overall study took a mixed-methods approach to the evaluation of Discovery College, including a qualitative process evaluation component as well as a mixed-methods outcomes evaluation. This paper reports on the findings of the process evaluation, which undertook key informant interviews with a range of stakeholders in the implementation process.
Findings
A total of 16 themes emerged from the qualitative data, which were then clustered into four main areas: establishing Discovery College, organisational context, nature of Discovery College and service transformation. Implementation was reported as both feasible and effective. Initial tension between fidelity to the model and a pragmatic approach to action was negotiated during implementation and through an ability of staff to tolerate uncertainty, enabled by the efforts and support of senior service management and college staff.
Originality/value
Recovery Colleges co-designed and implemented in youth mental health services are a recent development in the field of mental health care and very little has previously been published regarding the feasibility, effectiveness and acceptability of youth-focused Recovery Colleges. This paper is one of the first to assess the barriers and enablers to the implementation of Discovery College within a clinical youth mental health service.
... This manual addresses the implementation of pro-recovery interventions by staff and these interventions impact in two ways; Recovery promoting relationships, and Pro-recovery working practices (Bird et al, 2014). A summary of findings from the REFOCUS programme was published by Fortune et al (2015) and this offers a clear demarcation between clinical recovery (emerging from mental health professionals) and personal recovery (emerging from people with lived experience). Importantly, there is clear reference made by Bird et al (2014, p8) that "… recovery can take place within, partly outside or wholly outside the mental health service". ...
Remission is synonymous within cancer care and with other physical disorders, but less known and utilised in relation to people with a diagnosis of schizophrenia. Following work by Andreasen et al (2005) the idea of remission in schizophrenia became more widely utilised as symptomatic remission and was employed as an outcome measure primarily addressing medication efficacy. Whilst remission may or may not be a useful concept, the language, perception and social construction of remission for people with a diagnosis of schizophrenia is also of high importance. To date, there has not been any published material with respect to consultation with service users who have a diagnosis of schizophrenia regarding their personal interpretations and possible concern of the concept of remission. This study explores and conceptualises the possible introduction of the concept of remission into the process of recovery for people with a diagnosis of schizophrenia. Therefore raising the question; “Is remission a useful concept to facilitate transition back into primary care for people with a diagnosis of schizophrenia?”
Recovery Colleges are an innovative education-based approach to support mental health recovery that, following the recent Royal Commission, will have to be established in every area mental health service within the state of Victoria. This paper describes the rationale, benefits and some of the key considerations to successfully establish Recovery Colleges. The establishment of Recovery Colleges has the potential to drive culture change within mental health services and embed recovery orientation within service provision as well as engaging service users in their own recovery journey. There are significant challenges, however, in implementing the collaborative, co-produced model within the constraints of a publicly funded mental health clinical service. This paper considers some of the practice implications for public mental health services in developing and integrating Recovery Colleges. The paper, like everything we do at the Recovery College, is co-produced and co-authored – in this case, by a lived experience expert, a medically trained expert and a research/writing expert.
Hintergrund: Recovery spielt in der psychiatrischen Versorgung von Menschen mit einer schweren psychischen Erkrankungen eine zunehmend größere Rolle. Recovery fordert allerdings von psychiatrisch Tätigen eine Neuausrichtung ihrer bisherigen wohlwollenden und fürsorglichen Haltung hin zur Förderung der Selbstbestimmung, der Autonomisierung und des Empowerment der Nutzerinnen und Nutzer des psychiatrischen Versorgungssystems. Während international in den gesteuerten Gesundheitssystemen Recovery eine zentrale Rolle in den Gesundheitsrichtlinien der Gesundheitssysteme eingenommen hat, findet Recovery in Deutschland zwar in Leitlinien und Empfehlungen Beachtung, aber weniger in der praktischen Umsetzung. Im Aufrage des britischen Gesundheitssystem (NHS) wurde die REFOCUS Intervention zur Förderung einer Recovery-Orientierung evidenzbasiert erarbeitet. Durch die kulturelle Adaption der REFOCUS Intervention zur Förderung und Schulung von Recovery-Gesprächen soll dieser Prozess unter den psychiatrisch Fachpflegediensten vorangetrieben werden.
Methode: Da sich die Gesundheitssysteme in Großbritannien und Deutschland in Form und Ausgestaltung unterscheiden, soll durch eine qualitative Forschungsarbeit mit Experten eine Adaption erarbeitet werden. Als Methoden wurden drei Fokusgruppen-Interviews mit insgesamt 16 Teilnehmern geführt, die als fachliche Leitungen von psychiatrisch häuslichen Fachpflegediensten ihr Expertenwissen zur Reflektion der REFOCUS Materialen zur Verfügung stellten. Das Datenmaterial wurde qualitativ mit Hilfe der inhaltlichen strukturierenden Inhaltsanalyse bearbeitet und analysiert.
Ergebnisse: Die Umsetzung einer Recovery-Orientierung in der Versorgung wurde generell als sehr positiv empfunden. Auch dass dies zu einer Veränderung der Grundhaltung gegenüber den Nutzern und zu einer Veränderung der Arbeitsweise führen wird, wurde größtenteils begrüßt, da es als Weiterentwicklung der in Deutschland verbreiteten Sozialpsychiatrie gesehen wurde. Dafür sei ein umfangreiches Changemanagement sinnvoll. Auch die Inhalte der REFOCUS Intervention und des Trainer-und Teilnehmer-Manuals wurden als sinnvoll und umsetzbar angesehen. Unterschiedlich wurde das Bildungsniveau der Pflegekräfte in Deutschland betrachtet. Zusammenfassung: Die Studienteilnehmer war sich darüber einig, dass die REFOCUS Intervention auch in Deutschland modifiziert Anwendung finden kann.
