Recovery-oriented mental health principles in psychiatric hospitals: How service users, family members and staff perceive the realization of practices

Abstract

Aims: The aim of the study was to describe and compare how recovery-oriented mental health principles have been realized in Finnish psychiatric hospitals from the viewpoint of different stakeholders (service users, family members and staff).

Design: A multimethod research design was adopted to combine both quantitative and qualitative descriptive methods.

Methods: A total of 24 focus group interviews were conducted with service users (n = 33), family members (n = 3) and staff (n = 53) on 12 psychiatric Finnish hospital wards (October 2017). The interview topics were based on six recovery-oriented principles (WHO QualityRights Tool Kit, 2012). A quantitative deductive analysis was conducted to describe and compare the realization of the recovery-oriented principles between three stakeholder groups. A qualitative deductive content analysis was used to describe participants' perceptions of the realization of recovery-oriented principles in practice. The GRAMMS guideline was used in reporting.

Results: Out of six recovery-oriented principles, 'Dignity and respect' was found to have been realized to the greatest extent on the psychiatric wards. The most discrepancy between the participant groups was seen in the 'Evaluation of recovery'. Service users and family members found the realization of the practices of all principles to be poorer than the staff members did. Wide variation was also found at the ward level between perceptions among participants, and descriptions of the realization of the principles in psychiatric hospital practice.

Conclusion: Perceptions about the realization of recovery-oriented principles in practice in Finnish psychiatric hospitals vary between different stakeholder groups. This variation is linked to differing ward environments.

Impact: More research is needed to understand the factors associated with variation in perceptions of recovery principles.

Patient or public contribution: Service users and family members participated in this study.

Keywords: WHO QualityRights Tool Kit; family; interview; mental health care; nursing; psychiatric hospitals; recovery-oriented practice; service user.