Carers’ Understanding of Recovery-Oriented Practice in Mental Health Settings: A Systematic Review and Narrative Synthesis

Recovery-oriented practice is a contemporary and internationally accepted approach to mental health care. Moving away from privileging ‘clinical recovery’, it recognises and supports ‘personal recovery’, defined as living a meaningful life. Family and carers' (carers) understanding, and support of recovery-oriented practice is crucial to the provision of comprehensive and continuous mental health care. Few studies exist on carers' knowledge and experiences of recovery-oriented practice. We conducted a systematic review to explore carers' understanding of recovery-oriented practice in mental health settings. A narrative synthesis was undertaken using both deductive and inductive approaches, guided by the established framework for recovery-oriented practice by Le Boutillier and colleagues. Findings indicated that carers have a grasp of the principles and aims of recovery-oriented care, which aligned with the selected framework. However, carers' comprehension also identified shortcomings in how recovery-oriented practices were currently implemented in mental health services. Extending the work of Le Boutillier and colleagues, this review found that carers experienced a ‘disillusionment with mental health services’. While carers were keen to be involved and support recovery, they often felt excluded by mental health workers and the broader mental health system. This sense of exclusion led to carers feeling unsupported and disinclined to engage with the service, and this adversely affected their well-being. Findings suggest that operationalising recovery-oriented practice requires more genuine involvement of carers in decision-making forums such as care planning meetings, and formal feedback mechanisms be made available to integrate their perspectives into service development.