Assessing Recovery-Orientation in Community Mental Health Teams in Québec
Methods: This qualitative exploratory study consisted of 11 semi-structured interviews with social workers and their managers in two community mental health teams, recruited via snowball sampling. Two key informants were also interviewed. All interviews were transcribed verbatim and analyzed using techniques of thematic analysis. As such, broad themes were progressively determined from the data.
Results: Practicing from a recovery orientation was a shared ideal among participants. However the meaning and expression of this ideal was shaped by macro and meso level factors such as the external emphasis on ‘outcomes’. The results suggest that both the recovery approach and conventional social work practice share common values; however, they indicate that although most participants claim to have always adhered to the values found in the recovery orientation, organizational and structural pressures, such as a focus on outcome measures, are of greater concern for participants than the implementation of a recovery orientation. The results indicate that certain aspects of work organization, such as flexibility, autonomy, reflexivity, training, and interdisciplinarity are appreciated and interpreted as facilitators of recovery-oriented practice. However these may be limited by systemic constraints.
Conclusions and Implications: This exploratory study confirms the need to pay more attention to the development of a recovery orientation in community mental health teams in Québec. The results suggest that recovery-oriented systems will be difficult to develop in a result-oriented technocratic paradigm. Participants reported that opposing messages were given to them in terms of how they should practice. If a recovery orientation in policy is going to successfully be translated into practice, greater structural and organizational support of recovery is needed.