TY - JOUR
T1 - Promoting recovery in long-term institutional mental health care
T2 - An international Delphi study
AU - Turton, Penelope
AU - Wright, Christine
AU - White, Sarah
AU - Killaspy, Helen
AU - Taylor, Tatiana L.
AU - Schützwohl, Matthias
AU - Schuster, Mirjam
AU - Cervilla, Jorge A.
AU - Brangier, Paulette
AU - Raboch, Jiri
AU - Kališova, Lucie
AU - Onchev, Georgi
AU - Fercheva, Anita
AU - Mezzina, Roberto
AU - Ridente, Pina
AU - Wiersma, Durk
AU - Caro-Nienhuis, Annemarie
AU - Kiejna, Andrzej
AU - Piotrowski, Patryk
AU - Tzavelas, Elias
AU - Asimakopoulou, Xeni
AU - Caldas-De-Almeida, José
AU - Cardoso, Graça
AU - King, Michael
PY - 2010/3
Y1 - 2010/3
N2 - Objective: Service provision in psychiatric and social care is increasingly guided by recovery principles. However, little is known about the degree of consensus among stakeholders in diverse contexts on the components of care that most promote recovery. This study aimed to identify specific items of care that key stakeholders regard as most important in promoting recovery for people with longer-term mental health problems in institutional care, to measure consensus between and across stakeholder groups and countries, and to develop a conceptual framework of the most important domains of care. Methods: Ten European countries in various stages of deinstitutionalization participated in a series of conventional three-round iterative Delphi exercises. In each country individuals in four separate expert groups (service users, mental health professionals, caregivers, and advocates) identified components of care that they considered important to recovery and then rated their group's suggestions in terms of importance. Median and consensus ratings were measured. High-ranking items were grouped into domains. Results: A total of 4,098 separate items of care were proposed by the 40 participating groups. Eleven broad domains of care important for recovery were identified: social policy and human rights, social inclusion, self-management and autonomy, therapeutic interventions, governance, staffing, staff attitudes, institutional environment, postdischarge care, caregivers, and physical health care. Consensus between groups and countries was generally high, but some modest differences in priorities were noted. Conclusions: The most consistently highly rated consensus domain was therapeutic interventions. Domains and components of care related to recovery principles were also viewed as important across stakeholder groups.
AB - Objective: Service provision in psychiatric and social care is increasingly guided by recovery principles. However, little is known about the degree of consensus among stakeholders in diverse contexts on the components of care that most promote recovery. This study aimed to identify specific items of care that key stakeholders regard as most important in promoting recovery for people with longer-term mental health problems in institutional care, to measure consensus between and across stakeholder groups and countries, and to develop a conceptual framework of the most important domains of care. Methods: Ten European countries in various stages of deinstitutionalization participated in a series of conventional three-round iterative Delphi exercises. In each country individuals in four separate expert groups (service users, mental health professionals, caregivers, and advocates) identified components of care that they considered important to recovery and then rated their group's suggestions in terms of importance. Median and consensus ratings were measured. High-ranking items were grouped into domains. Results: A total of 4,098 separate items of care were proposed by the 40 participating groups. Eleven broad domains of care important for recovery were identified: social policy and human rights, social inclusion, self-management and autonomy, therapeutic interventions, governance, staffing, staff attitudes, institutional environment, postdischarge care, caregivers, and physical health care. Consensus between groups and countries was generally high, but some modest differences in priorities were noted. Conclusions: The most consistently highly rated consensus domain was therapeutic interventions. Domains and components of care related to recovery principles were also viewed as important across stakeholder groups.
UR - http://www.scopus.com/inward/record.url?scp=77949408067&partnerID=8YFLogxK
U2 - 10.1176/appi.ps.61.3.293
DO - 10.1176/appi.ps.61.3.293
M3 - Article
C2 - 20194407
AN - SCOPUS:77949408067
SN - 1075-2730
VL - 61
SP - 293
EP - 299
JO - Psychiatric Services
JF - Psychiatric Services
IS - 3
ER -