Factors that promote recovery: The views of service-users experiencing psychosis on an acute psychiatric ward

Background: Psychosis was once considered a progressive and untreatable “illness” due to a “diseased brain”. Current thinking suggests childhood adversity along with a combination of psychological, biological and environmental factors influence the development of psychosis experiences, with recovery now considered an achievable aim. Recovery is a multifaceted concept. Research indicates that service-users hold different views about recovery, however research exploring recovery from the viewpoint of those who are currently inpatients is scarce. Aims: The aim of the current study is to explore the views that a group of service-users who are currently inpatients in a psychiatric hospital, hold about what is important to them in recovery. Method: Q-methodology allows the exploration of the distinct viewpoints that are present among a group of people in relation to a subject matter. Thirty-eight participants were recruited across four acute psychiatric wards from a London based psychiatric hospital. Using Q-methodology, participants engaged in a card sort task where they ordered 54 statements relating to recovery from most to least important to them. Results: The analysis revealed four distinct viewpoints held among the group regarding factors that are important to recovery from psychosis. These were: “Stability, independence, and having a roof over your head”, “Hope, optimism, and enhancing wellbeing”, “Emotional change through self-management and social support”, and “Symptom reduction through mental health support”. Conclusions: Service-users who experience psychosis and are currently inpatients, hold different views about what is helpful to them in recovery. Services must be sensitive to the subjective conceptualisations service-users hold of their experiences and be flexible in tailoring support to meet their needs. The findings from this study suggest that changes are required both within services and at a socio-political level, in order to support people with psychosis toward recovery. Clinical implications and areas for future research are discussed.