Recovery environment of a sub-acute mental health service

Publication Date13 June 2016
AuthorKerry A Thomas,Debra J Rickwood
SubjectHealth & social care,Mental health
Recovery environment of a sub-acute
mental health service
Kerry A. Thomas and Debra J. Rickwood
Kerry A. Thomas and Debra J.
Rickwood are both based
at the Faculty of Health,
University of Canberra,
Canberra, Australia.
Purpose The purpose of this paper is to examine the recovery environment of a sub-acute residential
mental health service. Such services are increasingly filling a gap in the continuum of care for people with
recurrent mental illness and have a major role supporting the processes of recovery.
Design/methodology/approach A cross-sectional design was used with clients and staff completing the
recovery enhancing environment measure. Nine clients who had entered the service from the community
(step-up), 18 who had transferred from an inpatient unit (step-down) and ten staff completed the measure.
Findings Clients and staff rated the organisational climate of the service positively, with the role of caring
staff being identified as particularly valuable. Clients and staff had similar positive views on the importance of
recovery-based elements and rated the service as performing well in these areas. Step-up clients identified
performance gaps in the areas of self-management, general health, personal strengths, and personal
relationships. Step-down clients identified a range of gaps, including meeting basic needs, empowerment,
and fundamental recovery processes.
Practical implications An assessment of the perceptions of clients and staff can allow services to identify
differences in the attitudes of each group and ascertain areas in which the service can be improved to better
meet the needs of individual clients. This may include being responsive to the setting from which clients have
entered the service.
Originality/value This is the first study that has examined the recovery environment of a residential mental
health service and how it meets the recovery needs of both step-up and step-down admissions.
Keywords Mental health, Recovery, Organisational climate, Residential service
Paper type Research paper
As understanding grows of the processes of recovery from mental illness, many mental health
services are placing a greater focus on providing recovery-based programmes. The concept of
recovery from mental illness has moved away from a medical definition based on absence of
symptoms towards person-centred definitions that are based on individual recovery processes.
The individual nature of recovery is expressed in Andresen and colleagues (2003) definition as
the establishment of a fulfilling, meaningful life and a positive sense of identity founded on
hopefulness and self-determination(p. 588).
In response to the nee ds of people with a mental illness , a range of mental health service s have
been developed that provide varying levels of supervision, treatment and care to assist
people in their recovery journey. Services that are typically provided within this continuum
of care are inpatient services for people with acute needs (Horsfall et al., 2010),
community-based residential services for people with acute or sub-acute needs (Thomas
and Rickwood, 2013), and community-based treatment, such as Assertive Community
Treatment (Phill ips et al., 2001).
Received 17 August 2015
Revised 18 November 2015
Accepted 3 February 2016
DOI 10.1108/MHRJ-08-2015-0023 VOL. 21 NO. 2 2016, pp. 95-106, © Emerald Group Publishing Limited, ISSN 1361-9322
PAG E 95

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