Skip to main content

Advertisement

Log in

Measures of the recovery orientation of mental health services: systematic review

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

The review aimed to (1) identify measures that assess the recovery orientation of services; (2) discuss how these measures have conceptualised recovery, and (3) characterise their psychometric properties.

Methods

A systematic review was undertaken using seven sources. The conceptualisation of recovery within each measure was investigated by rating items against a conceptual framework of recovery comprising five recovery processes: connectedness; hope and optimism; identity; meaning and purpose; and empowerment. Psychometric properties of measures were evaluated using quality criteria.

Results

Thirteen recovery orientation measures were identified, of which six met eligibility criteria. No measure was a good fit with the conceptual framework. No measure had undergone extensive psychometric testing and none had data on test–retest reliability or sensitivity to change.

Conclusions

Many measures have been developed to assess the recovery orientation of services. Comparisons between the measures were hampered by the different conceptualisations of recovery used and by the lack of uniformity on the level of organisation at which services were assessed. This situation makes it a challenge for services and researchers to make an informed choice on which measure to use. Further work is needed to produce measures with a transparent conceptual underpinning and demonstrated psychometric properties.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Reference List

  1. Harding CM (2003) Changes in schizophrenia across time: paradoxes, patterns, and predictors. In: Cohen C (ed) Schizophrenia into later life: Treatment, Research and Policy. APPI Press, pp 19–42

  2. Harding CM, Brooks G, Ashikage T, Strauss JS, Brier A (1987) The Vermont longitudinal study of persons with severe mental illness II: long-term outcomes of subjects who retrospectively met DSM-III criteria for schizophrenia. Am J Psychiatry 144:727–735

    PubMed  CAS  Google Scholar 

  3. Deegan P (2001) Recovery: the lived experience of rehabilitation. Psychosoc Rehabil J 11:11–19

    Google Scholar 

  4. Ridgway PA (2001) Restorying psychiatric disability: learning from first person narratives. Psychiatr Rehabil J 24(4):335–343

    PubMed  CAS  Google Scholar 

  5. Anthony WA (1993) Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J 16(4):11–23

    Google Scholar 

  6. Mancini A, Hardiman ER, Lawson HA (2005) Making sense of it all: Consumer providers’ theories about factors facilitating and impeding recovery from psychiatric disabilities. Psychiatr Rehabil J 29(1):48–55

    Article  PubMed  Google Scholar 

  7. Leamy M, Slade M, Le Boutillier C, Williams J, Bird V (2011) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry 199:445–452

    Article  PubMed  Google Scholar 

  8. Davidson L, O’ Connell M, Tondora J, Lawless M (2005) Recovery in serious mental illness: a new wine or just a new bottle? Prof Psychol Res Pract 36(5):480–487

    Article  Google Scholar 

  9. Andresen R, Oades L, Caputi P (2003) The experience of recovery from schizophrenia: towards an empirically validated stage model. Aust N Z J Psychiatry 37(5):586–594

    Article  PubMed  Google Scholar 

  10. Slade M, Hayward M (2007) Recovery, psychosis and psychiatry: research is better than rhetoric. Acta Psychiatr Scand 116:81–83

    Article  PubMed  Google Scholar 

  11. Turton P, Demetriou A, Boland W, Gillard S, Kavuma M, Mezey G, Mountford V, Turner K, White S, Zadeh E, Wright C (2011) One size fits all: or horses for courses? Recovery-based care in specialist mental health services. Soc Psychiatry Psychiatr Epidemiol 46:127–136

    Article  PubMed  Google Scholar 

  12. Happell B (2008) Determining the effectiveness of mental health services from a consumer perspective: part 1: enhancing recovery. Int J Ment Health Nurs 17:116–123

    Article  PubMed  Google Scholar 

  13. Happell B (2008) Determining the effectiveness of mental health services from a consumer perspective: part 2: barriers to recovery and principles for evaluation. Int J Ment Health Nurs 17:123–130

    Article  PubMed  Google Scholar 

  14. Meehan TJ, King RJ, Beavis PH, Robinson JD (2008) Recovery-based practice: do we know what we mean or mean what we know? Aust N Z J Psychiatry 42:177–182

    Article  PubMed  Google Scholar 

  15. Noordsy D, Torrey W, Mueser K, Mead S, O’Keefe C, Fox L (2002) Recovery from severe mental illness: an intrapersonal and functional outcome definition. Int Rev Psychiatry 14:318–326

    Article  Google Scholar 

  16. Davidson L, Tondora J, Staeheli LM, O’Connell MJ, Rowe M (2009) A practical guide to recovery-oriented practice: tools for transforming mental health care. Oxford University Press, Oxford

    Google Scholar 

  17. Anthony WA (2000) A recovery-oriented service system: setting some system level standards. Psychiatr Rehabil J 24(2):159–168

    Google Scholar 

  18. Higgins A (2008) a recovery approach within the irish mental health services. a framework for development. Mental Health Commission, Dublin

    Google Scholar 

  19. Nimhe (2004) Emerging best practices in mental health recovery. NIMHE, London

  20. Australian Health Ministers (2009) Fourth national mental health plan: an agenda for collaborative government action in mental health 2009–2014. Commonwealth of Australia, Canberra

    Google Scholar 

  21. Le Boutillier CLM, Bird V, Davidson L, Williams J, Slade M (2011) What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatr Serv 62:1470–1476

    Article  PubMed  Google Scholar 

  22. Campbell-Orde T, Chamberlin J, Carpenter J, Leff HS (2005) Measuring the promise: a compendium of recovery measures, vol II. Health Services Research Institute, Cambridge

    Google Scholar 

  23. Burgess P, Pirkis J, Coombs T, Rosen A (2011) Assessing the value of existing recovery measures for routine use in Australian mental health services. Aust N Z J Psychiatry 45(4):1–14

    Article  Google Scholar 

  24. Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 26:91–108

    Article  PubMed  Google Scholar 

  25. National Institute of Mental Health in England (2008) Outcomes compendium. National Institute of Mental Health in England, London

    Google Scholar 

  26. National Social Inclusion Programme (2009) Outcomes framework for mental health services. National Social Inclusion Programme, London

    Google Scholar 

  27. Rush AJ Jr (2008) Handbook of psychiatric measures. American Psychiatric Publishing, Washington

    Google Scholar 

  28. Reference Manager Professional Edition [computer program]. Version 11 2005

  29. Scientific Advisory Committee of the Medical Outcomes Trust (2002) Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 11:193–205

    Article  Google Scholar 

  30. Russinova Z, Rogers ES, Langer Ellison M (2006) Recovery-Promoting Relationships Scale: RPRS manual. Center for Psychiatric Rehabilitation, Boston University

  31. Armstrong NP, Steffen JJ (2010) The recovery promotion fidelity scale: assessing the organizational promotion of recovery. Community Ment Health J 45(3):163–170

    Article  Google Scholar 

  32. O’Connell M, Tondora J, Croog G, Evans A, Davidson L (2005) From rhetoric to routine: assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatr Rehabil J 28(4):378–386

    Article  PubMed  Google Scholar 

  33. Marshall SL, Oades LG, Crowe TP (2009) Mental health consumers’ perceptions of receiving recovery-focused services. J Eval Clin Pract 15:654–659

    Article  PubMed  Google Scholar 

  34. Ellis G, King R (2003) Recovery focused interventions: perceptions of mental health consumers and their case managers. Aust e-J Adv Ment Health 2 (2)

  35. Mancini AD (2006) Can recovery orientation inform the implementation of evidence-based practices? In: 114th annual convention for the American Psychological Association

  36. Kidd SA, George L, O’Connell M, Sylvestre J, Kirkpatrick H, Browne G, Odueyungbo A, Davidson L (2011) Recovery-oriented service provision and clinical outcomes in assertive community treatment. Psychiatr Rehabil J 34:194–201

    Article  PubMed  Google Scholar 

  37. Streiner DL, Norman GR (2008) Health measurement scales: a practical guide to their development and use, vol 4. Oxford University Press, Oxford

    Google Scholar 

  38. Slade M, Thornicroft G, Glover G (1999) The feasibility of routine outcome measures in mental health. Soc Psychiatry Psychiatric Epidemiol 34:243–249

    Article  CAS  Google Scholar 

  39. Gralton E, Sher M, Drew-Lopez C (2010) Information and readability issues for psychiatric patient: e-learning for users. The Psychiatrist 34:376–380

    Article  Google Scholar 

  40. McLoughlin KA, Fitzpatrick JJ (2008) Self-reports of recovery-oriented practices of mental health nurses in state mental health institutes: development of a measure. Issues Ment Health Nurs 29:1051–1065

    Article  PubMed  Google Scholar 

  41. Salyers MP, Tsai J (2007) Measuring recovery orientation in a hospital setting. Psychiatr Rehabil J 31(2):131–137

    Article  PubMed  Google Scholar 

  42. Tsai J, Salyers MP (2008) Recovery orientation in hospital and community settings. J Behav Health Serv Res 37(3):385–399

    Article  PubMed  Google Scholar 

  43. Ruggeri M, Leese M, Slade M, Bonizzato P, Fontecedro M, Tansella M (2004) Demographic, clinical, social and service variables associated with higher needs for care in community psychiatric service patients. Soc Psychiatry Psychiatr Epidemiol 39:60–68

    Article  PubMed  Google Scholar 

  44. Slade M (2010) Measuring recovery in mental health services. Israel J Psychiatry 47:206–212

    Google Scholar 

  45. DeVellis RF (2003) Scale development: theory and applications. Sage Publications, London

    Google Scholar 

  46. Liberman RP (2002) Future directions for research studies and clinical work on recovery from schizophrenia: questions with some answers. Int Rev Psychiatry 14:337–342

    Article  Google Scholar 

  47. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432

    Article  PubMed  CAS  Google Scholar 

  48. Donabedian A (1988) The quality of care: how can it be assessed? JAMA 260:1743–1748

    Article  PubMed  CAS  Google Scholar 

  49. Gilburt H, Rose D, Slade M (2008) The importance of relationships in mental health care: a qualitative study of service users’ experiences of psychiatric hospital admission in the UK. BMC Health Serv Res (8):92

  50. Lasalvia ABI, Bonetto C, Saggioro V, Piccione G, Zanoni C, Cristofalo D, Lamonaca D (2011) Multiple perspectives on mental health outcome: needs for care and service satisfaction assessed by staff, patients and family members. Soc Psychiatry Psychiatr Epidemiol 46:11

    Article  Google Scholar 

  51. O’Brien AF, R. Singh, SP (2009) Disengagement from mental health services. Soc Psychiatry Psychiatric Epidemiol 44:11

  52. Arbuckle RBK, Taylor J-L, Kennedy S (2011) Service user attachments to psychiatric key workers and teams. Soc Psychiatry Psychiatr Epidemiol 46:9

    Google Scholar 

  53. Brown M, Essien P, Etim-Ubah P, Ezenwa B, Gabriel M, Hobbs T, Kinouani G, Lindsay L, Mollineau-Angoy E, Pinder D, Weig A, Wint I, Yussuf A (2008) Report of the community led research project focussing on male African and African Caribbean perspectives on recovery. Southside Partnership Fanon

  54. Slade M (2002) Routine outcome assessment in mental health services. Psychol Med 32:1339–1344

    PubMed  Google Scholar 

  55. Department of Health (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages. Department of Health, London

    Google Scholar 

  56. Lloyd-Evans BJS, Slade M (2007) Assessing the content of mental health services: a reivew of measures. Soc Psychiatry Psychiatr Epidemiol 42:10

    Article  Google Scholar 

  57. Slade M, McCrone P, Kuipers E, Leese M, Cahill S, Parabiaghi A, Priebe S, Thornicroft G (2006) Use of standardised outcome measures in adult mental health services: rendomised controlled trial. Br J Psychiatry 189:330–336

    Article  PubMed  Google Scholar 

  58. Knaup C, Koesters M, Schoefer D, Becker T, Puschner B (2009) Effect of feedback of treatment outcome in specialist mental healthcare: meta-analysis. Br J Psychiatry 195:15–22

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study is independent research commissioned through an NIHR Programme Grant for Applied Research (grant RP-PG-0707-10040), and in relation to the NIHR Specialist Mental Health Biomedical Research Centre at the Institute of Psychiatry, King’s College London and the South London and Maudsley NHS Foundation Trust. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Williams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Williams, J., Leamy, M., Bird, V. et al. Measures of the recovery orientation of mental health services: systematic review. Soc Psychiatry Psychiatr Epidemiol 47, 1827–1835 (2012). https://doi.org/10.1007/s00127-012-0484-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-012-0484-y

Keywords

Navigation