Videographies of Adults with Serious Mental Illness: Documenting Conceptualization and Context of Recovery

Background and Purpose: A growing body of literature conceptualizes recovery for adults with serious mental illness, but most research has been unable to capture dynamic contexts of the lived experience of consumers pursuing recovery. This paper fills that gap by using videographies of adults with serious mental illness, offering support for a dominant recovery framework while presenting contextual themes salient to the pursuit of recovery.

Methods: Video cameras were given to 12 adults with an invitation to record personal meanings of recovery and document day-to-day representations of their recovery journeys. Six participants returned videos used for analysis: equally male and female and predominantly White (5 White, 1 Black) with a total of n=72 video clips. Participants were recruited in-person by research staff at a presentation in a community-based organization serving adults with serious mental illness in and around Philadelphia and Norristown, PA. Interviews were transcribed verbatim and analyzed thematically using NVivo qualitative data management software. Analysis began via inductive approaches until the team unanimously agreed that emerging themes aligned with the CHIME framework; inductive analysis enhanced the sub-domains of CHIME, and final coding employed a deductive approach using the adapted CHIME framework. Audiovisual elements of videos were analyzed to triangulate sources of data and affirm coding of transcripts as well as to add contextual themes.

Findings: Data supported the major domains of CHIME to organize themes of recovery for adults who experience serious mental illness. Audiovisual components of videographies added contextual themes and nuance to CHIME domains, challenging notions that recovery takes place only after basic needs are met and highlighting the convergence of narratives associated with recovery and poverty. Socioeconomic barriers in participants’ lives restrict full actualization of CHIME domains as unmet basic needs and associated limitations to freedoms and meaningful choice constrain possibilities of and progress toward recovery goals.

Conclusions and Implications: Conceptualizing recovery without attending to the deep overlap of socioeconomic needs obfuscates the traditional scopious, expansile recovery narratives rooted in hope and optimism for one’s future. Situating recovery in internal processes such as hope, goal-orientations, and quality of life without attending to external limiting and systemic forces such as lack of adequate housing and limited environmental resources risks blaming individuals for constricted healing rather than limiting, structural forces associated with poverty. Policy implications include expanded housing supports, increased choice and freedoms in the service delivery system, attending to environmental surroundings such as access to nature, and increased financial supports for people with psychiatric disabilities.