Psychosocial and functional contributors to personal recovery in serious mental illness

Abstract

Background: Although recovery-oriented services have been conceptualized to improve personal recovery, related research often focuses on measures of clinical recovery. Identifying the relationships between personal recovery, clinical recovery, and psychosocial variables will inform service components and outcome measurement in recovery-oriented services.

Aims: This study sought to determine the connection between personal recovery and two sets of potential contributors: psychosocial variables (i.e., empowerment, resilience, and consumer involvement) and functional indicators of clinical recovery.

Method: These relationships were examined by analyzing survey data collected from 266 consumers who are receiving public mental health services in the United States.

Results: Empowerment, resilience and psychological involvement were associated with personal recovery. Clinical recovery did not uniquely contribute to personal recovery once psychosocial factors were accounted for. Interactions revealed that the relationship between psychological involvement and personal recovery was stronger for those who had been recently hospitalized, and for those with relatively greater resilience.

Conclusions: Results indicate that personal recovery is an essential outcome measure for recovery-oriented services that cannot be replaced by clinical recovery outcome measurement. Additionally, empowerment, resilience, and consumer involvement are key components of recovery, which suggests that services and outcome measures should prioritize incorporation of these constructs.

Keywords:

• Serious mental illness
• personal recovery
• functioning
• empowerment
• resilience
• outcome measurement

Acknowledgements

We gratefully acknowledge the contributions of Disability Right Nebraska, Jennifer Monjaras, the consumer advisory board, and the consumer research assistants: Tracey Daley, Kathleen Hansen, George Odoo, Larry Ruback, Jim Sanks, and Kenneth Wolfe. 

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Although residential psychiatric rehabilitation may seem the inverse of independent living, individuals in residential programs may achieve levels of independence, even while in the program, that exceeds that of individuals in assisted or supported living, at least in some domains. Also, the recovery orientation of a residential rehabilitation program is expected to be more intensive than that of assisted, supported or independent living, due to the explicit expectation that the person will progress to a more independent level. Therefore both items were included, because it is expected that they reflect separable factors.

Additional information

Funding

This research was supported in part by grant CDFA 93-138 (Protection and Advocacy for Individuals with Mental Illnesses grant) from the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, and the US Department of Health and Human Services.  This study was additionally supported in part by Office of Academic Affiliations in the United States Department of Veteran’s Affairs.