Friday, 14 January 2005 - 4:00 PM

This presentation is part of: Qualitative Research on Client Experiences of Treatment

The Lived Experience of Recovery from Severe Mental Illness

Purpose: The purpose of this hermeneutic phenomenological study was to examine the lived experience of persons recovering from serious and persistent mental illness (SPMI). This study reports results from the third year of treatment and is part of a three-year longitudinal study. Method: Forty-four adults with SPMI referred to county case management services were recruited for the study. A semi-structured interview was conducted for 1hour to elicit client narratives of their experience in recovery. The interviews were transcribed, read and coded to cluster thematic aspects in each case and across cases. Atlas-ti was used to recode transcripts and retrieve quotes to dimensionalize each essential theme. Transcripts were reread for confirming and disconfirming evidence for each theme. Results: Three themes were identified in this study: the efforts of consumers to reintegrate into the community; to make meaning of the illness experience; and to gradually disengage from the relationship with the case manager. The overarching theme of recovery in this period is the effort of consumers to achieve some level of social reintegration into normal, non-mental health situations and their efforts to cope with barriers to reintegration in the community. Consumers attempt to reconnect with their families and most experience support and assistance from their families; but this support is accompanied by conflicts and ambivalence with family members. Others are rejected by their families and must deal with grief and loss. Community reintegration efforts focus on consumers returning to work. Many work part-time in low level positions, experience discrimination and limited opportunities. Similarly, consumers have lost connections with former friends and find connections in normal communities difficult due to the social stigma of mental illness. The second theme in this later stage of recovery is reflection on the experience of illness. Consumers make meaning of their illness experience; deal with the internalized stigma of mental illness, and develop a sense of self that integrates health and illness factors. The third theme focuses on the factors in the case manager relationship that facilitate recovery. These include reconciliation of conflicts with the case manager, the redevelopment of a positive collaborative relationship, and the gradual disengagement from the case manager relationship. A major task for the case manager is to assess the level of assistance needed at any point in time to support the consumer and maximize empowerment. Implications for Practice: Findings delineate critical factors in the third year of recovery as identified by persons with SPMI. They highlight the need for case managers to facilitate reconnection between consumers and their families; provide advocacy services in area of job discrimination and social stigma; support consumers in developing a functional sense of themselves as a person with mental illness, not a chronic mental patient.

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