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Recovery and care continuity experiences of people in mental health care: A conciliatory approach to the challenge of implementing recovery‐based services

Sociology of Health & Illness

Published online on

Abstract

["Sociology of Health & Illness, EarlyView. ", "\nAbstract\nThis study investigates recovery and care continuity experiences of people with serious mental illness negotiating transforming services in the wake of recovery‐based policy implementation. Data were collected in two phases involving (n = 16) service users who had transited from secondary to primary care and (n = 16) supporting workers. A qualitative methodology employed semi‐structured interviews and thematic discourse analysis generating three themes. First, participants’ expectations were misaligned with transforming services. Second, participants constructed competing versions of recovery in their talk. Third, analysis revealed care discontinuities concentrated at the primary care level. A singular notion of top‐down recovery, a proliferation of bottom‐up, competing recovery versions, and misaligned expectations of transforming services are closely allied with escalating service system complexity and fragmentation. This has detrimental implications for care continuity. Top‐down, policy‐based recovery implementation is viewed as a neoliberalist colonization of the recovery concept, understood in the Habermasian sense of colonization of the lifeworld. The detrimental effects of recovery colonization should not lead to repudiation of the concept altogether. Rather, the original radical idea of recovery should be reclaimed as a central concept within mental health care. This can be achieved by a conciliatory policy approach seeking to balance top‐down and bottom‐up forces of recovery appropriation.\n"]