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      Recovery-oriented care in public mental health policies in Spain: opportunities and barriers Translated title: La atención orientada a la recuperación en las políticas públicas de salud mental en España: oportunidades y barreras

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          Abstract

          ABSTRACT Recovery-oriented care is the proposal incorporated in the new mental health strategic plans of both the World Health Organization and the Spanish National Health System. This article takes a journey from the initial proposals of the recovery model to the way recovery-oriented care is currently defined, understood as a community intervention, person-centred, and based on rights. The existing consensus around the CHIME model is also explained in order to understand what kind of interventions are needed to transform mental health services. Likewise, some of the main existing programs and projects to promote recovery-oriented care are presented, and a number of existing barriers to their implementation are analysed.

          Translated abstract

          RESUMEN La atención orientada a la recuperación es la propuesta incorporada en los nuevos planes estratégicos de salud mental tanto de la Organización Mundial de la Salud como del Sistema Nacional de Salud español. Este artículo hace un recorrido desde las propuestas iniciales del modelo de recuperación hasta la forma en que se define actualmente la atención orientada a la recuperación, entendida como una intervención comunitaria, centrada en la persona y basada en derechos. También se explica el consenso existente en torno al modelo CHIME para comprender qué tipo de intervenciones se necesitan para transformar los servicios de salud mental. Asimismo, se presentan algunos de los principales programas y proyectos existentes para promover la atención orientada a la recuperación y se analizan ciertas barreras existentes para su implementación.

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          Most cited references68

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          Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis.

          No systematic review and narrative synthesis on personal recovery in mental illness has been undertaken. To synthesise published descriptions and models of personal recovery into an empirically based conceptual framework. Systematic review and modified narrative synthesis. Out of 5208 papers that were identified and 366 that were reviewed, a total of 97 papers were included in this review. The emergent conceptual framework consists of: (a) 13 characteristics of the recovery journey; (b) five recovery processes comprising: connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (giving the acronym CHIME); and (c) recovery stage descriptions which mapped onto the transtheoretical model of change. Studies that focused on recovery for individuals of Black and minority ethnic (BME) origin showed a greater emphasis on spirituality and stigma and also identified two additional themes: culturally specific facilitating factors and collectivist notions of recovery. The conceptual framework is a theoretically defensible and robust synthesis of people's experiences of recovery in mental illness. This provides an empirical basis for future recovery-oriented research and practice.
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            Recovery from mental illness: The guiding vision of the mental health service system in the 1990s.

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              Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems.

              An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. Copyright © 2014 World Psychiatric Association.
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                Author and article information

                Journal
                clinsa
                Clínica y Salud
                Clínica y Salud
                Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1130-5274
                2174-0550
                2023
                : 34
                : 1
                : 35-40
                Affiliations
                [01] Barcelona orgnameActivaMent Catalunya Associació Spain
                [02] Barcelona orgnameUniversidad de Barcelona Spain
                [04] Barcelona orgnameUniversidad Internacional de Catalunya Spain
                [03] Sant Boi de Llobregat Barcelona orgnameHospital Benito Menni orgdiv1Complejo Asistencial en Salud Mental Spain
                Article
                S1130-52742023000100005 S1130-5274(23)03400100005
                10.5093/clysa2023a4
                29f4f6ea-3a3a-4e45-98f7-d25dc102dbe3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 December 2022
                : 05 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 69, Pages: 6
                Product

                SciELO Spain

                Categories
                Research Article

                Public policies,Salud Mental,Modelo de recuperación,Políticas públicas,Mental health,Recovery

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