Byrne, L., Happell, B., & Reid-Searl, K. (2015). Recovery as a Lived Experience discipline: A grounded theory study. Mental Health Nursing, 36(12), 935-943. https://doi.org/10.3109/01612840.2015.1076548.
Lived Experience workers and Recovery oriented practice- what is the link?
Take Home Messages
- Recovery is government mandated and a core facet of mental health reform.
- Recovery implementation has been inhibited by a lack of education and understanding from clinicians.
- There are significant barriers to the implementation of Recovery-focused practice -these are recovery is co-opted, lack of Recovery uptake, and Recovery denial by mental health professionals.
- For a genuine Recovery focused mental health system to be developed, Lived Experience workers must be enabled to take their role as Recovery experts and leaders.
To explore the potential of lived experience workers in contributing to the implementations of Recovery based service delivery within the Australian mental health sector
The concept of Recovery was created by people with mental health challenges to describe their own experiences and journeys and an identity beyond the limits of diagnoses. Individuals with a lived experience of mental health challenges championed the concept of Recovery in opposition to the dominant belief that these challenges were unremitting
The term “lived experience” refers to the unique perspective provided by people who have experienced significant mental health challenges, service use, and Recovery. Lived Experience workers work from the perspective of their unique lived understanding.
The lived experience definition of Recovery is described as a life that is chosen, beyond the constraints of illness or illness identity; a life of hope that is unique and deeply meaningful to the individual.
Recovery is frequently co-opted, with clinicians continuing to hold ideas of symptom reduction and clinical recovery, hindering reform and Recovery-informed policies and processes.
Interviews were conducted with 13 people employed to work from a lived experience perspective.
Three factors that were found to inhibit lived experience roles- Recovery being co-opted; Lack of Recovery uptake; and Recovery denial by mental health professionals.
Recovery is Co-Opted
The concept of personal recovery was created by people with lived experience. Lived experience concepts of Recovery are distinct from clinical interpretations. Yet the concept of Recovery changed from its original meaning so that it was no longer a useful term and the concept of Recovery was so co-opted that Lived Experience workers felt compromised in their role. The difference between clinical and lived perceptions of Recovery centred on power and control.
"I think the word “Recovery” has been co-opted so greatly, that’s why I don’t use it. I believe the way it was used originally was really powerful."
Recovery and lived experience work are directly linked to and informing each other.
"The whole basis of employing consumer workers is they provide a special significant different perspective on Recovery, on supporting people who have mental health issues... We [lived experience workers] see Recovery as a human growth process. You could call having a mental illness just like a midlife crisis ... it’s a hurdle or a hiccup, which can and has to be overcome."
The uptake of Recovery within mental health services was impacted by:
Clinical misunderstanding of recovery concepts
A lack of training of mental health professionals
Insufficient time for mental health professionals
"Recovery is what they [non-government/community sector] talk about. They struggle, I think, because their job has been paternalistic. That is really hard to shift from and it’s really easy to pretend you’re doing Recovery when actually you’re just doing rehabilitation."
Nongovernment services have made some progress implementing Recovery. However, a lack of lived experience workers impacted poor Recovery uptake in government services.
A key barrier for Lived Experience workers in government services due is environments being incompatible with lived experience work and Recovery.
Denial of Recovery was most commonly believed to be due to working within an acute care environment and clinicians who predominantly saw people when they were acutely unwell and did not witness other stages of their recovery and wellness.
Some clinicians may view Recovery as a process limited to those with less significant mental health challenges.
When a denial of the concepts of Recovery was believed to exist, limitations for the lived experience role occurred—due to clinicians reportedly not seeing lived experience practitioners as having ever been “real” mental health consumers.
- Mental health professionals were seen as often misunderstanding and misusing the term Recovery confusing personal recovery with “clinical recovery”.
- Mental health professionals were also seen as often not believing Recovery was possible.
- Lived Experience workers were often marginalised or employed in tokenistic roles.
- For reform to be successful, there is a need for mental health professionals to view Recovery as a central tenet of their work
- Until and unless all mental health workers accept Recovery, reform will be severely inhibited.
- Lived experience work and Recovery are linked and Lived Experience leadership is essential to successful Recovery implementation and guiding Recovery education, as well as employing larger numbers of lived experience roles within the sector.
Lived Experience practitioners must be recognised as leaders in Recovery if these barriers are to be overcome and genuine Recovery-focused practice is to become a reality