"Recovery Is about Getting Better to See Another Day": A Qualitative Investigation of Personal Recovery Among Young Adults Diagnosed with Serious Mental Illnesses

Background and Purpose: Young adulthood is a period when serious mental illnesses (SMI) often emerge, yet treatment engagement remains low. The adult mental health system has expanded its focus from clinical recovery (symptom reduction) to personal recovery, emphasizing hope, meaning, and empowerment. However, the meaning and relevance of recovery and the factors influencing it among young adults with SMI are not well known. This study seeks to deepen understanding of recovery along with the factors that influence it among young adults with SMI.

Methods: Semi-structured interviews were conducted with young adults with SMI receiving community-based services (N=25). Interviews explored participants’ experiences and perspectives on recovery. Transcripts were analyzed using grounded theory coding techniques and constant comparison. Analysts met to discuss initial codes, refine categories, develop memos, and identify themes, and reflexivity discussions occurred to reduce bias.

Results: The sample was predominately male (65.9%) and Black (46.3%), Latino/a (19.5%), or Multiracial (22.1%) with a mean age of 25.4 (SD=4.8). Four qualitative themes were identified. The first theme, personal growth and acceptance (e.g., “It wasn't until [age] 24 when I found self-love, I told myself that I am me, I can't be no more, no less than who I am...I have to accept everything about myself...”), captured the process of self-reflection and self-acceptance. The second theme, coping and managing stigma (e.g., “The most challenging aspects were dealing with the fear of it, all the judgment behind it, the being outcasted, the fear of not being accepted...People would look at me like, I'm crazy or weird”), captured learning to live with their condition and navigating stigmatized identities. The third theme, social support and important others (e.g., “If it wasn't my mom, it was my social worker here, they were...behind me and pushing me and telling me to keep going...the fact that I had people who cared about me and were trying their best to see that I made it was such a big thing for me...”), captures the importance of relationships with family and social workers. The fourth theme, engaging in meaningful activities (e.g., “ making sure you're okay, you're eating healthy, you're showering, you're going outside to take walks... I take a lot of walks, so walking is like one of the best ways I know for personal recovery, because you're outside, you're getting here, you're relaxing, you're breathing, talking to your therapist, talking to a friend, listening to music, doing the things that make you feel good about yourself...”), relates to activities such as music, art, pets, and writing.

Conclusions and Implications: Findings reveal that personal recovery for young adults relates to themes found in the adult literature–such as self-acceptance, managing stigma, and engaging in meaningful activities–while also capturing developmental nuances. These relate to navigating stigmatized identities and the role of family members during developmental transitions. Consistent with recovery principles as an individualized process extending beyond symptom management, exploring developmental distinctions may help align social work science with practices that align with youth culture and preferences.