The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model.

BACKGROUND: Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur. METHOD: Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people's recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts. RESULTS: Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy, disconnection, pessimism and burden. Impact is positively moderated by the perceived authenticity of the narrative, and can be reduced if the recipient is experiencing a crisis. CONCLUSIONS: Interventions that incorporate the use of recovery narratives, such as peer support, anti-stigma campaigns and bibliotherapy, can use the change model to maximise benefit and minimise harms from narratives. Interventions should incorporate a diverse range of narratives available through different mediums to enable a range of recipients to connect with and benefit from this material. Service providers using recovery narratives should preserve authenticity so as to maximise impact, for example by avoiding excessive editing

Nurse-client processes in mental health: recipients\u27 perspectives.

An ethnonursing method was selected to explore and describe nursing support relationships, from the perspectives of recipients, within the mental health subculture. Data sources consisted of three semi-structured client interviews (n = 14) and field notes. When nurses were described as nice and friendly, and validated the client as a person by listening, three overlapping phases of development emerged from the data. These included: a glimmer of help, exploring and problem solving, and saying goodbye. When clients had negative experiences with nurses, they felt a lack of trust towards nurses and felt that their feelings were left unexplored. As a result, the relationships deteriorated. Deterioration began immediately in the first phase called withholding, and continued through the phases of avoiding and ignoring, and struggling with and making sense of. These findings raise healthcare providers\u27 awareness about developing and deteriorating nurse-client relationships, and support the value of the therapeutic relationship as an instrument to restore and promote clients\u27 health