Recovery Research Network (RRN)

Recovery Research Network eBULLETIN

January 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 33^rd European Congress of Psychiatry will take place:
Date: 5^th – 8^th April 2025
Venue:  Madrid, Spain
Conference theme: Towards Real-World Solution in Mental Health

For more information, please see here.

ii)  The 7^th European Conference on Integrated Care and Assertive Outreach will take place:
Date:  23^rd – 25^th June 2025
Venue:  Mærsk Tower, Panum, Copenhagen
Conference theme:  Closing the gap in psychiatric care for people with serious mental illness.

For more information, including abstract submissions and registration, please see here.

iii) The 7th Refocus on Recovery conference will take place:
Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery, with a focus on:
1) the role of lived experience in embedding and supporting recovery
2) new perspectives around mental health and recovery
3) extending recovery beyond mental health

Registration is now open, with an abstract deadline of 28th February 2025.
For more information, please see here: https://www.researchintorecovery.com/ronr2025/

Papers and Publications 

) Hawke, L. D., Dada-Philips, W. & Seiyad, H. et al. (2024) Best practice guidelines for the engagement of people with lived experience and family members in mental health and substance use health research: A modified Delphi consensus study. Health Expectations, 28(1) e70152
https://doi.org/10.1111/hex.70152

Abstract
Introduction: People with lived experience of mental health and/or substance use conditions and their families (PWLE) are increasingly engaged in research, yet rigorous guidelines for engagement are lacking. This study aims to co‐design best practice guidelines to support the authentic, meaningful engagement of PWLE in mental health and/or substance use health research.
Methods: A multi‐panel modified Delphi study was conducted with 61 expert panellists (35 PWLE and family members, 26 researchers/research support staff from across Canada). Participants rated 56 recommendations for importance and clarity. Consensus was defined as ≥ 70% of participants rating items at 6 or 7 on a 7‐point Likert scale (‘very important’ or ‘essential’). Qualitative feedback was analysed using content analysis to identify new items and reviewed for improvements in item clarity. After each round, items not meeting the established threshold of importance were removed. Items with low clarity scores were reworded. A PWLE advisory panel was actively involved throughout the study’s design, implementation, interpretation, and reporting, ensuring that the perspectives of people with lived experience were integrated throughout the research process.
Results: Three Delphi Rounds were conducted. In Round 1, importance ratings ranged from 51.7% to 96.7% of participants ranking the items above the established threshold (average 80.1%), with clarity ratings ranging from 39.3% to 86.9% (average 70.7%) and an average importance coefficient of variation (CV) of 0.16. Four items were deleted, two new items were added and fifty‐five items were revised. In Round 2, 60 (98.4%) participants responded. Importance ratings ranged from 57.6% to 96.7% (average 80.2%; average CV = 0.20). Clarity ratings ranged from 50.9% to 93.2% (average 77.9%). Five items were deleted and eleven revised. In Round 3, 60 (98.4%) participants provided importance ratings ranging from 66.7% to 98.3% (average 80.8%; average CV = 0.20), and clarity ratings ranging from 63.3% to 94.9% (average 81.1%). Three items were deleted and nine were revised. Forty‐four final best practices are proposed.
Conclusion: These co‐developed best practice guidelines offer recommendations for meaningful PWLE engagement in mental health and/or substance use health research. By following these guidelines, research teams can ensure that PWLE contributions are genuinely valued and effectively integrated, ultimately enhancing the quality and impact of the research and fostering authentic collaboration.
Patient and public involvement: People with lived experience were engaged throughout the project as key team members, from a patient‐oriented research perspective. They are also co‐authors on this manuscript.

Writing out of the Centre for Addiction and Mental Health, Toronto, the lead author (Dr. Lisa Hawke) advises that the above paper accompanies newly published material entitled:  Best Practice Guidelines for the Engagement of People with Lived Experience in Mental Health and Substance Use Research.  The guidelines are available here.

ii)  Street-Mattox, C., Broome, M.R., Ng, F., Griffiths, L. & Jordan, G. (2025) How does stigma impact acts of compassion among people with borderline personality disorder. Irish Journal of Psychological Medicine. Published online 2025:1-7. 
https://doi.org/10.1017/ipm.2024.72 

Abstract
Borderline personality disorder (BPD) is a highly stigmatised mental disorder. A variety of research exists highlighting the stigma experienced by individuals with BPD and the impacts of such prejudices on their lives. Similarly, much research exists on the benefits of engaging in compassionate acts, including improved mental health recovery. However, there is a notable gap in understanding how stigma experienced by people with BPD acts as a barrier to compassion and by extension recovery. This paper synthesises these perspectives, examining common barriers to compassionate acts, the impact of stigma on people with BPD, and how these barriers are exacerbated for individuals with BPD due to the stigma they face. The synthesis of perspectives in the article highlights the critical role of compassion in supporting the recovery of individuals with BPD, while also revealing the significant barriers posed by stigma. Addressing these challenges requires a comprehensive understanding of the intersection between compassion and stigma, informing the development of targeted interventions to promote well- being and recovery for individuals with BPD.

iii)  Howe, J., MacPhee, M., Duddy, C., et al. (20245) A realist review of medication optimisation of community dwelling service users with serious mental illness.   BMJ Quality and Safety, 34(1), 40-52.  
https://doi.org/10.1136/bmjqs-2023-016615

Abstract
Background:  Severe mental illness (SMI) incorporates schizophrenia, bipolar disorder, non-organic psychosis, personality disorder or any other severe and enduring mental health illness. Medication, particularly antipsychotics and mood stabilisers are the main treatment options. Medication optimisation is a hallmark of medication safety, characterised by the use of collaborative, person-centred approaches. There is very little published research describing medication optimisation with people living with SMI. 
Objective:  Published literature and two stakeholder groups were employed to answer: What works for whom and in what circumstances to optimise medication use with people living with SMI in the community?
Methods:  A five-stage realist review was co-conducted with a lived experience group of individuals living with SMI and a practitioner group caring for individuals with SMI. An initial programme theory was developed. A formal literature search was conducted across eight bibliographic databases, and literature were screened for relevance to programme theory refinement. In total 60 papers contributed to the review. 42 papers were from the original database search with 18 papers identified from additional database searches and citation searches conducted based on stakeholder recommendations.
Results:  Our programme theory represents a continuum from a service user’s initial diagnosis of SMI to therapeutic alliance development with practitioners, followed by mutual exchange of information, shared decision-making and medication optimisation. Accompanying the programme theory are 11 context-mechanism-outcome configurations that propose evidence-informed contextual factors and mechanisms that either facilitate or impede medication optimisation. Two mid-range theories highlighted in this review are supported decision-making and trust formation.
Conclusions:  Supported decision-making and trust are foundational to overcoming stigma and establishing ‘safety’ and comfort between service users and practitioners. Avenues for future research include the influence of stigma and equity across cultural and ethnic groups with individuals with SMI; and use of trained supports, such as peer support workers.

iv)  Patmisari, E., Huang, Y., Orr, M. et al. (2025) Interventions supporting meaningful connections for people with serious mental illness: a concept-framed systematic narrative review. Social Psychiatry and Psychiatric Epidemiology, online:
https://doi.org/10.1007/s00127-025-02812-8

Abstract
Purpose:  Meaningful connections, encompassing relationships providing emotional support, understanding, acceptance, and a sense of belonging, are vital for social inclusion and well-being of Individuals with serious mental illness (SMI). The mixed methods review critically explored multifaceted approaches supporting people with SMI to foster meaningful (nonintimate) social relationships or connections.
Methods:  Searches of eight electronic databases returned 4882 records. Duplicate removal, title abstract, then full-text, screening and hand searching resulted in 23 records for inclusion. Studies were integrated using the CIVIC Framework emphasising the importance of Closeness, Identity, Valued relationships, Involvement, feeling Cared for and accepted. 
Results:  The review identified emotional and physical challenges, societal stigma, and other environmental factors to hinder making meaningful connections. Studies highlighted the necessity for interventions being adaptable, personalised, and encompassing of structured activities, peer and professional supports, and technology-assisted platforms.
Conclusion:  The complexity of social interactions for those with SMI call for comprehensive, holistic strategies to nurture social relationships within their communities.

v)  Eklund, M., & Argentzell, E. (2025). Recovery experiences among mental health service users going through the Balancing Everyday Life^TM intervention – A deductive qualitative study. Scandinavian Journal of Occupational Therapy, 32(1). 2451267 https://doi.org/10.1080/11038128.2025.2451267

Abstract
Background: The occupational therapy intervention Balancing Everyday Life (BEL)^TM aims to support mental health service users towards improved occupational balance and personal recovery. Yet, no research has specifically addressed recovery experiences among BEL^TM participants.
Aim: To investigate how the recovery process was experienced by mental health services users who had participated in BEL^TM.
Methods:  The study was based on qualitative interviews with 11 participants. A deductive content analysis was performed based on the CHIME framework, a research-based tool for characterising the recovery process.
Results:  All categories and most subcategories described in the CHIME framework could be found in the participants’ experiences. The most prominent categories were Sense of connectedness and Empowerment. Most subcategories were identified as well. Additionally, two subcategories not covered in CHIME were distinguished – occupational balance, and self-esteem and self-confidence – which may be specific to an occupational therapy intervention like BEL^TM.
Conclusion: The study showed that CHIME was relevant for characterising the recovery process among BEL^TM participants and identifying the features shaping that process. The findings support CHIME, while also indicating that BEL^TM offers some additional avenues for personal recovery.
Significance: An occupational therapy intervention can support mental health service users
towards personal recovery.

vi)  Swildens, W.E., Visser, E., van Ens, W. et al. (2025) Assessing personal recovery in individuals with severe mental illness: validation of the Dutch Brief INSPIRE-O. Social Psychiatry and Psychiatric Epidemiology, online:
https://doi.org/10.1007/s00127-025-02815-5

Abstract
Purpose:  Recovery is a key objective in mental health services for people with severe mental illness (SMI). In addition to clinical and functional recovery, personal recovery has gained increasing attention. The CHIME Framework identifies five personal recovery processes—Connectedness, Hope, Identity, Meaning, Empowerment—and is the theoretical foundation for the Brief INSPIRE, a validated Patient-Rated Experience Measure (PREM) to evaluate recovery support. Brief INSPIRE was modified to a five-item Patient-Rated Outcome Measure (PROM) assessing recovery, called Brief INSPIRE-Outcome (Brief INSPIRE-O). Subject of this study are the psychometric properties of the Brief INSPIRE-O.
Methods:  Data on validity and reliability gathered through annual routine outcome monitoring were collected for 861 individuals with SMI of Flexible Assertive Community Treatment teams and a follow-up measurement was available for 232 of these individuals. Test–retest reliability was evaluated in a separate subset of 30 individuals with SMI.
Results:  The Brief INSPIRE-O shows good internal consistency (Cronbach’s alpha 0.77), test–retest reliability, construct validity, sensitivity to change and no floor or ceiling effects. Furthermore, change in Brief INSPIRE-O was positively related to changes in quality of life and negatively to problems in clinical functioning and unmet care need.
Conclusion:  Brief INSPIRE-O can be used for research and monitoring to better understand and improve processes of personal recovery in individuals with SMI

vii)  Poon, A. W. C., Hofstaetter, L. & Judd-Lam, S. (2025) Experiences of mental health carers examined using a recovery framework.  Australian Social Work, 78(1), 43-57. 
https://doi.org/10.1080/0312407X.2023.2298925

Absract:

Carers are a crucial support in the recovery of people with mental illness in the community. As they are often severely affected by the impact of mental illness of the person they care for, carers need to recover from the impact alongside the care recipient.  While mental health services focus on the recovery of people with mental illness, carers’ recovery is largely neglected. Using the CHIME (Connectedness, Hope and optimism about the future, Identity, Meaning in life and Empowerment) recovery framework, the authors of this study aimed to examine carers’ experiences and what they needed in their own recovery. A mixed methods approach was used to analyse the responses of 1,918 carers who completed the Australian 2020 National Carer Survey. Thematic analysis was used to identify themes regarding carers’ experiences against the elements of CHIME. Quantitative findings regarding subjective wellbeing and perception of support were used to complement the themes. Themes aligned with CHIME but indicated poor recovery. Recognition (R) was found to be an important recovery factor for carers. Without adequately addressing the needs and wellbeing of carers and giving due recognition for their contribution, carers have difficulty progressing in their own recovery. CHIME-R may be appropriate as a recovery framework for carers.  

Other News /Resources

i)  In the previous section (Papers and Publications) the article from Catrin Street-Mattox is derived from a research workstream investigating the relationship between challenging social experiences and engagement in compassionate acts among Individuals with Borderline Personality Disorder.  The research is ongoing and is currently inviting people to participate.  The invitation flyer is available here.

For further information please contact:
Catrin Street-Mattox:  ces389@bham.ac.uk or, 
Dr. Jordan:  g.jordan@bham.ac.uk (primary academic supervisor) or,
Prof. Broome:  m.r.broome@bham.ac.uk (principle investigator) 

ii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

February 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 33^rd European Congress of Psychiatry will take place:
Date: 5^th – 8^th April 2025
Venue:  Madrid, Spain
Conference theme: Towards Real-World Solution in Mental Health

For more information, please see here.

ii)  The 7^th European Conference on Integrated Care and Assertive Outreach will take place:
Date:  23^rd – 25^th June 2025
Venue:  Mærsk Tower, Panum, Copenhagen
Conference theme:  Closing the gap in psychiatric care for people with serious mental illness.

For more information, including abstract submissions and registration, please see here.

iii) The 7th Refocus on Recovery conference will take place:
Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery, with a focus on:
1) the role of lived experience in embedding and supporting recovery
2) new perspectives around mental health and recovery
3) extending recovery beyond mental health

Registration is now open, with an abstract deadline of 28th February 2025.
For more information, please see here: https://www.researchintorecovery.com/ronr2025/

iv) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:
Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

Papers and Publications 

i)  Aguey-Zinsou, M., Scanlan, J. N., & Cusick, A. (2025). Supporting young adults experiencing psychosis with their employment: A qualitative exploration of occupational therapists’ experiences. Australian Occupational Therapy Journal, 72(1), e13015. 
https://doi.org/10.1111/1440-1630.13015

Abstract
Introduction: Young adults experiencing psychosis have the same plans for work and future careers as their peers; however, many find themselves unable to participate. While there is research available about interventions used to support employment of young adults with psychosis, there is little evidence regarding the experience of occupational therapists working in this field and the vocational rehabilitation interventions and practices they use.
Methods:  A descriptive qualitative study using semi-structured interviews was used to explore the perspectives of occupational therapy practitioners who support young adults experiencing psychosis with employment. Qualitative data analysis was guided by cross case inductive thematic analysis.
Consumer and Carer Involvement:  This study did not include consumer and community involvement.
Findings:  There were nine participants, two male and seven females (average 14.7 years mental health experience and age 39 years). All occupational therapists in this study were providing employment support interventions to young adults experiencing psychosis. These ranged from support with career exploration and job seeking to support with keeping and changing jobs. Thematic analysis generated five themes that characterised their experience including psychosis can make securing employment harder for young adults, young adults’ pathways to work, and employment destinations of young adults. Finally, employment support interventions and strategies for young adults experiencing psychosis and the service system context—providers, problems, and possibilities for change were described.
Conclusion:  Young adults experiencing psychosis can miss out on the employment support they need when services are not accessible and evidence-based interventions, such as individual placement and support and early intervention, are not available. Occupational therapists prioritise employment when working with young adults experiencing psychosis. Occupational therapists with their person-centred, consumer-directed, and occupation-focussed approach can provide a range of employment support interventions to enable young adults experiencing psychosis to reach their work and career goals.

ii)  Thomsen, D. K., Cowan, H. R., & McAdams, D. P. (2025) Mental illness and personal recovery: A narrative identity framework. Clinical Psychology Review, 116.
https://doi.org/10.1016/j.cpr.2025.102546

Abstract
This article presents a metamorphic model to describe the manifold role of narrative identity, a person’s internal life story, across the course of mental illness and personal recovery. First, early adversity and negative co-authoring may contribute to the development of a fragile life story, which itself may combine with life stressors to increase the likelihood of mental illness. Second, mental illness may negatively impact the development of narrative identity, which in turn may exacerbate the devastating effects of mental illness on daily functioning. Finally, positive changes in narrative identity, as they are influenced by recovery stories of peers and the supportive co-authorship provided by mental health professionals, may contribute in powerful ways to the process of personal recovery. In sum, the metamorphic model demonstrates how narrative identity, as it is implicated in a variety of social spheres, shapes and is shaped by the course of mental illness and recovery. We also show how the model differs from other personality-oriented theories of psychopathology and how it may guide future research and interventions.

iii)  Brooks, C., Sunkel, C. & Stewart, H. L. N. (2025) Dignity in mental healthcare: service user perspectives. Academia Mental Health and Well-Being, 2025;2.
https://doi.org/10.20935/MHealthWellB7523

Abstract
Dignity is widely recognized as a foundational concept in the provision of healthcare. Despite this, concepts of dignity are only vaguely described in the literature relating to mental health services, contributing to frequent violations of service users’ dignity. Notably, discussions of dignity in mental health services often do not include the service user perspective. We offer a narrative review of the literature to examine how service users and peer workers articulate the co-production of dignity within mental health services. Seven overarching dimensions of dignity emerge from the available evidence, spanning the social dignity that service users experience in relation with healthcare professionals, the mental health system itself, the physical settings in which mental health services are delivered, and the use of peers as valued members of the mental health workforce and co-creators of knowledge. To ensure that mental health service users are empowered by the mental healthcare they receive, it is imperative that concepts of dignity move beyond ‘vague’ moral and ethical concepts to operational guidelines for best practice in mental health service design and delivery which are grounded in service user perspectives. To this end, we make meaningful recommendations to improve how healthcare professionals are trained, to implement alternatives to coercion in mental healthcare and to explore how lived experience can be centered in mental health services, and we call for the recognition of service users as experts by experience in peer work and the co-creation of new knowledge and evidence.

iv)  Kotera, Y., Daryanani, R. & Skipper, O. et al. (2025) Applying Critical Discourse Analysis to Cross-Cultural Mental Health Recovery Research. JMIR Formative Research, 2025;9:e64087
https://doi.org/10.2196/64087

Abstract
The purpose of this paper is to demonstrate how critical discourse analysis (CDA) frameworks can be used in cross-cultural mental health recovery research. CDA is a qualitative approach that critically appraises how language contributes to producing and reinforcing social inequalities. CDA regards linguistic productions as reflecting, consciously or unconsciously, the narrators’ understandings of, or attitudes about, phenomena. Mental health recovery research aims to identify and address power differentials, making CDA a potentially relevant approach. However, CDA frameworks have not been widely applied to mental health recovery research. We adapted established CDA frameworks to our cross-cultural mental health recovery study. The adapted methodology comprises (1) selecting discourses that indicate positive changes and (2) considering sociocultural practices informed by relevant cultural characteristics identified in our previous research, without placing value judgments. Our adapted framework can support cross-cultural mental health recovery research that uses CDA.

v)  Jensen, R. A. A., Brand, S. L., Holm, T., Slade, M., & Thomsen, D. K. (2025). The impact of life story work during peer worker training: Identity reconstruction, social connection, and recovery. Psychiatric Rehabilitation Journal. Advance online publication.
https://dx.doi.org/10.1037/prj0000639

Abstract
Objective:  Personal recovery has become a guiding vision in mental health care, and peer workers play a key role in assisting individuals on their recovery journey. As a component of training to prepare for this role, peer workers need to engage with their own life story, in order to support recovery in both them and in the service users they will assist. The purpose of the present study was to explore the impact of life story work on peer workers.
Method:  Fifteen individuals training to be peer workers were interviewed to explore the impact of telling and listening to life stories. Reflexive thematic analysis involving two analysts was conducted.
Results:  Three main themes were identified: (a) life story work as identity reconstruction, (b) social connection through life story sharing, and (c) negative impacts of engaging with life stories in peer worker training. Each theme was connected to a number of subthemes. 
Conclusions and Implications for Practice:  Life story work can both facilitate personal recovery in peer workers during their training and aid them in utilizing their stories in their future peer worker roles. Training needs to prepare peer workers to deal with the future role-related challenges of life story work.

vi)  van Dee, V., Swildens, W., Schnack, H.G. & Cahn, W. (2024)  In Pursuit of recovery: A comparative study of stakeholder perspectives on outcomes of people with psychosis. Community Mental Health Journal, 61, 300–313
https://doi.org/10.1007/s10597-024-01399-9

Abstract
There is no consensus on the definition of recovery of people with psychosis. This may be attributed to the broad concept including clinical, functional and personal recovery domains and the diverse interests of stakeholders involved. We hypothesized that service users, informal caregivers and healthcare professionals would exhibit differences in prioritization, reflecting varying roles and viewpoints. Through an open online anonymous questionnaire, stakeholders shared their perspectives on most important aspects of clinical, functional and personal recovery and on facilitators and barriers of recovery. Stakeholder collaboration in study design and interpretation enhanced the study’s robustness. The answers on open questions of respondents were categorized for statistical analyses to compare the answers between respondent groups on the different aspects of recovery. 226 stakeholders participated. While commonalities prevailed, distinctions emerged in recovery domain priorities. Service users and informal caregivers accorded equal importance to clinical, functional and personal recovery, whereas healthcare professionals emphasized clinical recovery. Regarding functional recovery, service users seemed to focus on practical issues while informal caregivers addressed the underlying causes. Disparities were notable in the role of healthcare that was considered as both a facilitator or a barrier to recovery, with informal caregivers prioritizing aspects of healthcare more frequently as most important than healthcare professionals. While commonalities prevailed, we identified several differences in prioritizing recovery domains among stakeholder groups. Awareness and understanding of these differences is crucial for effective communication and collaboration between stakeholders in recovery-oriented healthcare. The study underscores the need for ongoing dialogue between stakeholders.

viii)  Patmisari, E., Huang, Y., Orr, M. et al. (2025) Interventions supporting meaningful connections for people with serious mental illness: a concept-framed systematic narrative review. Social Psychiatry and Psychiatric Epidemiology.  Online.
https://doi.org/10.1007/s00127-025-02812-8

Abstract
Purpose:  Meaningful connections, encompassing relationships providing emotional support, understanding, acceptance, and a sense of belonging, are vital for social inclusion and well-being of Individuals with serious mental illness (SMI). The mixed methods review critically explored multifaceted approaches supporting people with SMI to foster meaningful (nonintimate) social relationships or connections.
Methods:  Searches of eight electronic databases returned 4882 records. Duplicate removal, title abstract, then full-text, screening and hand searching resulted in 23 records for inclusion. Studies were integrated using the CIVIC Framework emphasising the importance of Closeness, Identity, Valued relationships, Involvement, feeling Cared for and accepted.
Results:  The review identified emotional and physical challenges, societal stigma, and other environmental factors to hinder making meaningful connections. Studies highlighted the necessity for interventions being adaptable, personalised, and encompassing of structured activities, peer and professional supports, and technology-assisted platforms.
Conclusion:  The complexity of social interactions for those with SMI call for comprehensive, holistic strategies to nurture social relationships within their communities.

ix)  Sanyal, S. & Karah, H. (2025) Prozac as medicine, metaphor and identity: reimagining recovery as a rhetorical process in Lauren Slater’s Prozac Diary.  Medical Humanities, 0(1), 1-10.
https://doi.org/10.1136/medhum-2024-012973

Abstract
This paper examines Lauren Slater’s memoir, Prozac Diary, to understand the role of language in reimagining the notion of recovery. Written from the standpoint of a consumer of antidepressant drugs, Prozac Diary underlines the pervasiveness of professional psychiatry’s pathologising practices and its psychopharmacological interventions in the 90s in the USA. Moreover, it unpacks the nuances of the relationship between the person and the pill at the intersections of myriad medical and socio-cultural discourses. Reading the memoir from the perspectives of disability studies scholars such as Kimberly E. Emmons and Lennard J. Davis, we argue that Slater’s use of figurative language to critically engage with the Prozac discourse is a rhetorical act of self-care. Furthermore, we contend that by normalising illness and challenging the ableist assumptions of normalcy, Slater also invests in rhetorical care of the collective self/bodymind.
This paper demonstrates how through a metaphorical representation of Prozac, Slater questions the predominant mental health discourses that construct the meanings of ’illness’ and ’health’ and shape illness and health-based identities. Simultaneously, through her dialogical negotiations with the Prozac discourse to reconstitute a complex health identity, she raises fundamental questions about the existence of a ’core’, ’authentic’, ’healthy’, pre-Prozac selfhood that the drug claims to restore. Therefore, by unravelling the intrapersonal, socio-cultural and discursive ramifications of recovery, as opposed to psychiatry’s perfunctory understanding of biological cure as a restoration of a socially desirable state of ’normalcy’, she is able to reclaim the lived experience of recovery. We argue that in Prozac Diary, recovery does not merely imply a passive internalisation of psychiatry’s biological determinism and its psychopharmaceutical approaches. Instead, it is a rhetorical process that enables the medicalised individuals to actively engage with the mental health system and interrogate the possibility of critically responding to its normative frameworks as agentic subjects

Other News /Resources

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

March 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 33^rd European Congress of Psychiatry will take place:
Date: 5^th – 8^th April 2025
Venue:  Madrid, Spain
Conference theme: Towards Real-World Solution in Mental Health

For more information, please see here.

ii)  The 7^th European Conference on Integrated Care and Assertive Outreach will take place:
Date:  23^rd – 25^th June 2025
Venue:  Mærsk Tower, Panum, Copenhagen
Conference theme:  Closing the gap in psychiatric care for people with serious mental illness.

For more information, including abstract submissions and registration, please see here.

iii) The 7th Refocus on Recovery conference will take place:
Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery, with a focus on:
1) the role of lived experience in embedding and supporting recovery
2) new perspectives around mental health and recovery
3) extending recovery beyond mental health

Registration is now open, with a maximum of 220 in-person delegates.
For more information, please see here: https://www.researchintorecovery.com/ronr2025/

iv) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:
Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Worawichayawongsa, P., Ollis, S. & Kyriakopoulos, A. (2025) Mental health staff’s experiences of implementing trauma-informed care in the NHS.  Mental Health Review Journal, 30(1), 35-51
https://doi.org/10.1108/MHRJ-01-2024-0007

Abstract
Purpose:  The NHS long-term plan outlined that mental health services in the UK will be based on the trauma-informed approach in the next 10 years. Staff in leadership roles in those services will face a responsibility to lead the implementation of TIC; however, little is known about the experiences of these staff attempting to create change. Therefore, this study aims to gain an understanding of mental health staff (MHS)’s experiences in implementing trauma-informed care (TIC) in the NHS.
Design/methodology/approach:  In total, 14 mental health staff (MHS), comprising ten psychologists and four multidisciplinary clinicians, were recruited through purposive and snowball sampling. Semi-structured individual interviews were conducted via Microsoft Teams to provide qualitative data. Interviews were transcribed verbatim and analysed using Braun and Clarke’s (2006) reflexive thematic analysis.
Findings:  Five themes were found: 1) having a visionary outlook and high expectations for change, 2) professional growth and personal development, 3) affirmation of the role’s importance and impact, 4) psychological discomfort and 5) ways of coping. Participants strongly believed that TIC should be standard practice for all health-care staff, noting that implementing TIC led to their professional and personal growth. While they found satisfaction in influencing others to value TIC, they experienced negative emotions when their efforts were unsuccessful and used various strategies to overcome barriers and manage psychological discomfort.
Originality/value:  To the best of the authors’ knowledge, this study is the first to explore the experiences of MHS implementing TIC in the NHS. Support recommendations for staff in the role are made and future research is identified.

ii)  Douglas, O., Harper, P., Griffiths, C. (2025). Action for Happiness Pop-Up Cafes in Northamptonshire Healthcare NHS Foundation Trust (NHFT) inpatient mental health services. NHFT
https://acrobat.adobe.com/id/urn:aaid:sc:EU:2088d404-5d58-4be6-8f1d-c74d3983ac36

Abstract
Action for Happiness:  A rapidly growing movement of people who are taking action for a happier and kinder world, together.  Since its launch in 2011, millions of people spread across 193 countries have engaged with its ideas and have joined the global community. As a charity it provides practical resources and brings people together to learn evidence-based skills to promote thriving, and to take personal actions to promote ‘happier living’. The movement is secular, evidence-based and open to all.
Action for Happiness Pop-Up Cafes:  Action for Happiness Pop-Up Cafes are part of the Action for Happiness movement. They are places where those seeking happier lives for themselves and others can connect with each other over a cup of coffee/tea and learn about and/or experience evidence-based knowledge/skills for enhancing health and wellbeing.
Action for Happiness Pop-Up Cafes in inpatient mental health services:  Action for Happiness Pop-Up Cafes in NHFT were started in one of NHFTs mental health hospitals. Pop-Up Cafes in NHFT have been running monthly for several years and are now an integral part of the provision at three hospital sites across Northamptonshire (Berrywood, St Mary’s and Brackley Hospitals). The Cafes are valued by those attending them.

iii)  de Vries, M. L., Janse, P., Anbeek, C. W. & Braam, A. W. (2025) Existential concerns among young adults with psychotic vulnerability in mental health care: a qualitative study in the Netherlands. BMC Psychiatry, 25(103).
https://doi.org/10.1186/s12888-025-06551-7

Abstract
Background:  Young adults with psychotic vulnerability are dealing with disrupting experiences early in life, often with far-reaching or even lifelong impacts. These experiences can lead to existential questions during young adulthood. Identity realization and finding meaning and purpose in life are central to this development stage.
Aim:  The current study investigated to what extent profound experiences such as psychosis in young adulthood lead to existential concerns as formulated by Yalom and to other existential themes during inpatient and outpatient mental health treatment and care.
Methods:  A qualitative study was carried out among patients (N = 11) with psychotic vulnerability aged between 17 and 31 years, participating in interviews about their existential life questions and experiences in mental health care. In the thematic analysis, the primary deductive codes were based on theory, while the subcodes were inductively derived from the interviews.
Results:  The respondents clearly affirmed existential concerns about freedom (e.g., loss of or changed future), meaninglessness (e.g., questioning purpose and meaning), isolation (e.g., disconnection, importance of personal bonds), identity (e.g., loss of self, changed identity) and death (e.g., questioning life and death). The five existential themes appeared to be related to each other. Furthermore, the importance of addressing existential themes in treatment emerged as a latent care need.
Discussion:  The results of this study provide insight into experiences with meaning-making in mental health care and existential themes. The respondents generally expressed positive feelings about addressing and the possibility to talk about existential life questions, which fits within recovery oriented mental health care.

iv)  Van Eck, R. M., Jelsma, A., Blondeel, J. et al. (2025) Clinical treatment interventions in personal recovery stories of patients with severe mental illness: a qualitative study. Social Psychiatry and Psychiatric Epidemiology.
https://doi.org/10.1007/s00127-025-02872-w

Abstract
Purpose:  In quantitative research, small to medium associations were found between clinical and personal recovery in patients with severe mental illness (SMI). This finding may result from varying relationships between clinical and personal recovery depending on the individual patient. The aim of the current study was to explore the subjective experience of clinical treatment interventions in personal recovery stories of patients with severe mental illness.
Methods:  Semi-structured interviews were conducted with 26 patients with SMI receiving treatment of a Flexible Assertive Community Treatment team in Amsterdam, the Netherlands. Thematic analysis was used.
Results:  We found that most clinical treatment interventions can have both positive and negative impact on personal recovery: (1) receiving a diagnosis can lead to relief, but also to stigma, (2) medication has positive effects, but side-effects impair personal recovery, (3) hospitalization and (4) coercive treatment can be helpful, but can also impact the process of recovery negatively, (5) psychological treatment is experienced as beneficial.
Conclusion:  Mental healthcare practitioners’ awareness of patients’ diverging experiences regarding the impact of clinical treatment interventions on personal recovery is important in order to carry out recovery-supportive practice. Communicating a diagnosis with a hopeful narrative, developing personalized medication strategies and post-hospital reflection on the use of restraints are a good basis.

v)  Hallberg, P., Graneheim, U.H. & Olsson-Tall, M. (2025), Promoting personal recovery within psychiatric inpatient care—nurses’ experiences. International Journal of Mental Health Nursing, 34: e13504.
https://doi.org/10.1111/inm.13504

Abstract
To meet the aim of synthesising research on nurses’ experiences of promoting personal recovery within psychiatric inpatient care, meta ethnography according to Noblit and Hare has been chosen as the method, which is a qualitative review of scientific literature that results in a synthesis. The focus is on interpretation and is expressed to be able to reduce a story, but at the same time keep what is unique in used metaphors. Nine articles formed the basis of the synthesis. The analysis resulted in two levels of synthesis. The first level involved the translation of metaphors into one another, which proceeded in two directions, described as two principal headings. The second level produced five overarching metaphors. The first principal heading is that ‘erected walls in psychiatric inpatient care impedes personal recovery.’ It encompasses the overarching metaphors ‘cultivating in exhausted soil’ and ‘nurses are gatekeeping watchdogs’. The second principal heading is ‘torn-down walls in psychiatric inpatient care enable personal recovery’. It encompasses the overarching metaphors ‘disarming and de-escalating’, ‘facing suffering together reveals treasures’ and ‘elevating the competent partner promotes recovery’. Conclusively, if the nurse is to be able to promote personal recovery in psychiatric inpatient care, bridges of cooperation and consensus need to be built to other professions in care. Otherwise, the obstacles to promoting personal recovery will be far too hard to overcome.

vi)  Brijan, B., Strijbos, D. & Körver, J. (2025) The existential dimension in recovery: crisis, loss, and grief in the context of severe mental illness. Religions,16(2), 179.
https://doi.org/10.3390/rel16020179

Abstract
The recovery movement in mental health care has played an important role in the recent renewed and growing focus on understanding the function of meaning and spirituality in the context of severe mental illness. Current recovery thinking is firmly embedded in a body of thought according to which people have meaningful lives. It is characterized by various emphases, including positive transformation. Though valuable and laudable in itself, this bias toward future-oriented improvement leaves our understanding of the nature and implications of a mental health crisis as a crisis in meaning underdeveloped. In this article, we approach recovery from a phenomenological angle and explore mental health crisis as an existential crisis characterized by disruption and radical alteration of sense-making and meaning. In particular, we show how themes of loss and grief are part of this existential crisis and its aftermath. It is argued that themes of loss and grief are crucial aspects of the recovery process. Several fruitful ways are suggested to incorporate those themes. This, it is maintained, provides a more thorough, realistic, integrated, and, therefore, more nuanced view of the complex process of recovery in the context of severe mental illness.

Other News /Resources

 i)  PhD Competition 2026
Mental Health Research UK (incorporating the Schizophrenia Research Fund) is pleased to announce a competition for 3 PhD Scholarships beginning September 2026.

Further information is available here.

ii)  Action for Happiness Pop-Up Cafes in NHFT
In connection with item (ii) in the above ‘Papers and Publications’ section, Dr Chris Griffiths (Senior Research and Evaluation Fellow, Research & Innovation Team, Northamptonshire Healthcare NHS Foundation Trust) has shared details about Action for Happiness Pop-Up Cafes in NHFT, which are being delivered by the Trust’s spiritual well-being team.

Dr Griffiths writes that the innovation is: making a positive difference to the lives of people with mental health issues as part of their mental health recovery. It is a model that could be delivered in any mental health setting across the world. It could be the subject of evaluation/research. I would be happy for my contact details to be listed, should people wish to contact me and discuss.

Contact details for Dr Griffiths:  chris.griffiths@nhft.nhs.uk

iii)  The McPin Foundation
The McPin Foundation quarterly newsletter is a good way of keeping up to speed with projects and events, news and views from the mental health research sector.  Their first newsletter of 2025 has just been issued.  To sign up to the McPin newsletter, please see here.

iv)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

April 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) Women’s Health.  Call for Papers: Sage Open Access
Sage Open Access have made a final call to a special collection:  Addressing Psychosocial Barriers to Engaging in Mental Health Care Services for Women Across the Lifespan
Date:  9^th June 2025
For more information, please see here.

ii)  The 7^th European Conference on Integrated Care and Assertive Outreach will take place:
Date:  23^rd – 25^th June 2025
Venue:  Mærsk Tower, Panum, Copenhagen
Conference theme:  Closing the gap in psychiatric care for people with serious mental illness.

For more information, including abstract submissions and registration, please see here.

iii) The 7th Refocus on Recovery conference will take place:
Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery, with a focus on:
1) the role of lived experience in embedding and supporting recovery
2) new perspectives around mental health and recovery
3) extending recovery beyond mental health

Registration is now open, with a maximum of 220 in-person delegates.
For more information, please see here: https://www.researchintorecovery.com/ronr2025/

iv) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:
Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Jensen, R. A. A., Brand, S. L., Holm, T., Slade, M., & Thomsen, D. K. (2025). The impact of life story work during peer worker training: Identity reconstruction, social connection, and recovery. Psychiatric Rehabilitation Journal, 48(1), 13–22. https://doi.org/10.1037/prj0000639

Abstract
Objective: Personal recovery has become a guiding vision in mental health care, and peer workers play a key role in assisting individuals on their recovery journey. As a component of training to prepare for this role, peer workers need to engage with their own life story, in order to support recovery in both them and in the service users they will assist. The purpose of the present study was to explore the impact of life story work on peer workers.
Method: Fifteen individuals training to be peer workers were interviewed to explore the impact of telling and listening to life stories. Reflexive thematic analysis involving two analysts was conducted.
Results: Three main themes were identified: (a) life story work as identity reconstruction, (b) social connection through life story sharing, and (c) negative impacts of engaging with life stories in peer worker training. Each theme was connected to a number of subthemes.
Conclusions and Implications for Practice:  Life story work can both facilitate personal recovery in peer workers during their training and aid them in utilizing their stories in their future peer worker roles. Training needs to prepare peer workers to deal with the future role-related challenges of life story work

ii)  Gray, B.T. & Sisto, M. (2025), Recovery houses and peer work in them: a service user’s proposal and agenda for change.  Mental Health and Social Inclusion, ahead-of-print.
https://doi.org/10.1108/MHSI-12-2024-0220

Abstract
Purpose:  The purpose of this viewpoint article is to describe the experience of recovery houses and peer work from the perspective of a service user (Ben). The current profile and visibility of recovery houses on mental health wards is low. Indeed, since Ben’s first diagnosis in 2003 and during the last 17 months as a peer worker the importance of recovery houses has not even been mentioned once by staff or service users. It should be noted that this article expresses the view of the first author (Ben) and not the co-author (Matthew).
Design/methodology/approach:  This is also a service user narrative by Ben. He was diagnosed with paranoid schizophrenia in 2003 and spent two years in and out of the mental health unit where he is now a peer worker. Ben had a relapse in 2013 for about six months and then attended Ron Coleman’s and Karen Taylor’s Recovery Champions course and their recovery house on the Isle of Lewis, Scotland, where he first heard of the recovery approach and which improved Ben’s mental health. Ron and Karen’s organisation is called Working to Recovery. Ben is currently a peer worker on the same unit where he was once a patient and working with the Director of Patient Experience, Matthew Sisto. This article is based on lived experience as a service user and peer worker.
Findings:  This article makes a case for and a case against the proposal to incorporate recovery houses more into the fabric of NHS mental health care as well as a possible alternative to psychiatric units. The main argument in this article is to suggest making recovery houses more mainstream, more of them and more accessible to those currently in traditional mental health units. Currently there are no formal mechanisms of discharge from hospital to recovery houses. Not one person on the wards where I was a patient since 2003 or peer worker in the last 17 months has been discharged to a recovery house. Recovery houses are a therapeutic alternative or complement to traditional psychiatric care. They could also have other potential benefits, such as decreasing bed blocking on psychiatric wards (service users who are well and waiting for accommodation), reducing risk of relapse and remedying the loneliness and isolation that is often faced by service users on discharge to the community (changing from being around a lot of people on the ward to no one and isolation at home). Recovery houses are in short supply and in need of scaling up (more of them). There is the need to increase the referral and accessibility of recovery houses for service users on mental health wards. Currently recovery houses offer short-term support, only a matter of weeks or months. They would be better if they offered longer periods and also ongoing support. Recovery houses would also benefit people with mental illness, their carers and others if they incorporated elements of peer support.
Originality/value:  Recovery houses and peer support are relatively new approaches in the mental health journeys of people with mental illness. This article is important because it makes a case for/ case against and addresses the feasibility of incorporating the recovery approach and recovery houses into the quite antiquated and slow to change fabric of the conventional NHS. It considers traditional and alternative pathways of care and steps for change to make recovery houses more mainstream and accessible to NHS psychiatric patients (and even perhaps to replace conventional psychiatric care in the long run).

iii)  Siantz, E., Fox, S., Rougelot, E. et al. (2025) It’s Like Adding a Drop of Ink to Milk and Shaking It: Newly Certified Peer Specialist Reflections on Lived Recovery Expertise and Professional Identity. Community Mental Health Journal.
https://doi.org/10.1007/s10597-025-01455-y

Abstract
Introduction:  Self-disclosure of lived recovery experiences is a cornerstone of peer support work. However, few studies have explored how early career certified peer specialists (CPSs) integrate or plan to integrate their own lived recovery experiences into their CPS work, or the challenges they expect to experience when doing so. In this qualitative study, we explore how early career CPSs use their lived recovery experience and challenges that accompany self-disclosure.
Methods:  Qualitative data were collected as part of multistate, 3-year observational prospective cohort study of CPS graduate employment trajectories. We conducted in-depth, semi-structured interviews with a subsample of early-career CPSs about their transition to the workforce; this study reports on interview material focused on how participants use and expect to use their recovery experiences. Data were analyzed using thematic and content analysis informed by constant comparative methods.
Results:  N = 25 individuals participated in an interview. While participants generally felt positive about sharing their personal recovery stories in their CPS role, some reported potential challenges they expect to experience, such as misalignment of recovery experiences or being re-traumatized when sharing their recovery stories with clients and coworkers.
Conclusion: That study participants held mixed feelings about sharing lived experience suggests that the peer support workforce needs early career professional support, such as peer-to-peer supervision models that focus on CPS wellbeing, in addition to job performance.

iv)  Zierotin, A., Norton, M. J., O’Donoghue, B. et al. (2025) Physical health in psychosis: a perspective on the recovery paradigm. Irish Journal of Psychological Medicine. Online. https://doi.org/10.1017/ipm.2025.1

Abstract
This paper explores the intersection of physical health and recovery-oriented approaches in psychosis, offering a unique perspective through autoethnography. By combining personal experience with a broader analysis of existing mental health frameworks, the paper highlights the often overlooked importance of physical health in the recovery process for individuals with psychosis. The autoethnographic narrative reveals the complex challenges posed by antipsychotic medications, including weight gain and metabolic complications, and their impact on overall well-being. It emphasizes the dual stigma of mental health challenges and weight gain, highlighting the need for a more integrated, holistic approach to mental health care. Recommendations include enhanced education for healthcare providers, personalized care plans, and a multidisciplinary approach aimed at bridging the gap between physical and mental health in psychosis recovery.

v)  Valery, K. M., Felix, S., Caiada, M. et al. (2025) The power of beliefs in recovery-oriented practice: A brief report from the STIGMAPRO Survey. Community Mental Health Journal. https://doi.org/10.1007/s10597-024-01437-6

Abstract
Despite the international incentives and the worldwide development of recovery-oriented policies, it has proven challenging to establish recovery-oriented mental health services that take into account users’ subjectivity and perspectives (Slade et al., World Psychiatry 13(1):12–20, 2014. https://doi.org/10.1002/wps.20084). The objective of this study was to identify individual beliefs that are correlated with six recovery-oriented practices in schizophrenia among mental health professionals.  Seven individual beliefs were examined for their association with each of the aforementioned practices: belief in recovery possibilities, biological beliefs, desire for social distance, perceived similarities, professional utility beliefs, continuum beliefs, and categorical beliefs. The results indicated that belief in the possibility of recovery from schizophrenia and professional efficacy beliefs were the most strongly associated with the six recovery-oriented practices examined. Conversely, there was a negative association between stigma score (desire for social distance) and the six recovery-oriented practices.  The remaining four beliefs—biological, perceived similarity, categorical, and continuum—were found to be more weakly associated with recovery-oriented practices.  In light of these findings, it is evident that mental health professionals’ individual beliefs warrant further consideration in research endeavours aimed at fostering and facilitating the implementation of recovery-oriented practices.

vi)  Derblom, K., Dahlberg, K., Gabrielsson, S. et al (2025) Key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments: A modified delphi study.  Journal of Clinical Nursing, 34(2), 565-579.
https://doi.org/10.1111/jocn.17631

Abstract
Aim:  To identify key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments.
Design:  A modified Delphi study with three rounds.
Methods:  A 24-member expert panel was recruited consisting of people with lived experience of mental ill-health, registered nurses working in emergency care, registered nurses specialised in psychiatric and mental health nursing and mental health recovery researchers. In the initial round, important aspects of recovery-oriented practice were identified through focus group interviews. Thematic analysis generated statements that were then reformulated as a questionnaire for subsequent rounds. The experts rated each statement’s perceived importance on a 5-point Likert scale. The consensus level was set at ≥ 80%. Descriptive statistics were used to analyse the data.
Results:  Consensus was reached on the importance of 39 of 73 statements, with ≥ 80% deemed ‘very important’ in recovery-oriented practice in general emergency departments.
Conclusion:  The study emphasises the delicate balance between the essential elements of recovery-oriented practice, their practical feasibility and the predominant biomedical perspective in general emergency department care. It proposes strategies to empower nursing staff and managers to adopt recovery-oriented practices that enhance the quality of care for people with mental ill-health. Enabling staff by providing the necessary prerequisites and a care environment that supports reflective practices is crucial. The responsibility for facilitating these changes needs to be a shared commitment between nursing staff and managers.

vii)  Melillo, A., Sansone, N., Allan, J. et al. (2025)  Recovery-oriented and trauma-informed care for people with mental disorders to promote human rights and quality of mental health care: a scoping review. BMC Psychiatry. 25(1)
https://doi.org/10.1186/s12888-025-06473-4

Abstract
Background:  In several countries, the growing emphasis on human rights and the ratification of the Convention on the Rights of Persons with Disabilities (CRPD) have highlighted the need for changes in culture, attitudes and practices of mental health services. New approaches, such as recovery-oriented care (ROC) and trauma-informed care (TIC) emphasize the users’ needs and experiences and promote autonomy and human rights.
Aims:  To provide an overview of the literature on recovery-oriented care (ROC) and trauma-informed care (TIC) and their relevance to the promotion of human rights and quality of mental health care.
Method:  We conducted a scoping review by searching the following databases: PubMed, Scopus, PsycINFO. We performed a qualitative synthesis of the literature aimed at reviewing: (1) current conceptualisations of recovery in mental health care; (2) recovery-oriented practices in mental health care; (3) current conceptualizations of trauma and TIC in mental health care; (4) trauma-informed practices in mental health care; (5) the relationship between ROC and TIC, with a particular focus on their shared goal of promoting alternatives to coercion, and on trauma-informed and/or recovery oriented alternatives to coercion.
Results:  According to prevailing conceptual frameworks, ROC and TIC share many underlying principles and should be regarded as complementary. Both approaches affirm the conceptualization of service users as persons, foster their autonomy and rely on their involvement in designing and monitoring mental health services. Both approaches promote human rights.  A wider consensus on conceptual frameworks, tools and methodologies is needed to support ROC and TIC implementation and allow comparison among practices. Recovery-oriented and trauma-informed models of care can contribute to the implementation of non-coercive practices, which show promising results but warrant further empirical study.
Conclusions:  Recovery-oriented and trauma-informed practices and principles may contribute to the shift towards rights-based mental health care and to the implementation and successful uptake of alternatives to coercion. Local and international work aimed to promote and test these approaches may provide a contribution to improving mental health care world-wide. Future research should focus on the outcomes of all involved stakeholders’ and include the perspectives of both staff members and service users in different contexts.

Other News /Resources

i)  PhD Competition 2026
Mental Health Research UK (incorporating the Schizophrenia Research Fund) is pleased to announce a competition for 3 PhD Scholarships beginning September 2026.

Further information is available here.

ii)  Writing out of the University of Nottingham, Research Fellow Dr Joy Llewellyn-Beardsley offers an invitation to participate in an expert consultation on mental health-related citizen science.  We repeat the full invite below:

INVITATION
Seeking mental health citizen scientists – deadline extended due to UK media interest!

The Recovery Research team at the Institute of Mental Health, University of Nottingham, UK are currently seeking people who have been involved with mental health-related citizen science projects (either running or contributing to them) to participate in an online expert consultation as part of our CSTACS study (Citizen Science to Achieve Coproduction at Scale).

You are invited to take part here: https://forms.office.com/e/VJ6yAbtqxK
The deadline for submission is Sunday 11 May 2025.
We’re keen to consult as widely as possible so would also be enormously grateful if you could also forward this invitation to your networks.
You can find more information about the consultation here, about mental health citizen science here and about the CSTACS study here.

With our thanks from the CSTACS Team

iii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

May 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) Women’s Health.  Call for Papers: Sage Open Access
Sage Open Access have made a final call to a special collection:  Addressing Psychosocial Barriers to Engaging in Mental Health Care Services for Women Across the Lifespan
Date:  9^th June 2025
For more information, please see here.

ii)  The 7^th European Conference on Integrated Care and Assertive Outreach will take place:
Date:  23^rd – 25^th June 2025
Venue:  Mærsk Tower, Panum, Copenhagen
Conference theme:  Closing the gap in psychiatric care for people with serious mental illness.

For more information, including abstract submissions and registration, please see here.

iii) The International Society for Psychological and Social Approaches to Psychosis (ISPS) are hosting a webinar entitled: The others in us and the discovery of the self: Multifamily Psychoanalysis
Date:  25^th June 2025.  
Time: 20:00 – 21:30 Central European Summer Time (CEST)
For further details including a detailed description and speakers please see here.

iv) The 7th Refocus on Recovery conference will take place:

Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery
Registration is open, with a maximum of 220 in-person delegates.
Some speaker biographies are now available:
https://www.researchintorecovery.com/speakers-refocus-on-recovery-2025/
For more information please see here.

v) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:
Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Badu, N., Schutte, N., Rice, K. et al. (2025) Measurement of mental health recovery knowledge and attitudes of professionals and students: development of the R-KAS tool. BMC Psychiatry, 25(551).
https://doi.org/10.1186/s12888-025-06995-x

Abstract
Background:  The Recovery Knowledge Inventory (RKI) has been used widely across various settings to measure mental health professionals’ and students’ knowledge and attitudes about recovery. However, evidence suggests that this measure lacks sound psychometric properties and may not fully capture the multidimensional nature of recovery. This study aimed to adapt and establish the psychometric properties of a modified version of the RKI, resulting in both a long and a short version.
Methods:  An exploratory sequential mixed-method design was employed in this study. In the first phase, qualitative interviews were conducted using a semi-structured guide to explore participants’ understanding of mental health recovery. Their responses informed the development of a new survey tool used in the second phase. In total, 173 respondents were recruited via Qualtrics to complete an online survey. Descriptive and inferential statistics were conducted, including exploratory factor analysis, reliability analysis, Spearman correlation, and the Mann–Whitney U test. 
Results:  The 52 self-reported items were administered to 115 professionals and 58 students to assess the psychometric properties of this adapted measure. Exploratory Factor Analysis resulted in the removal of 14 items with low factor loadings, retaining 38 items in the long version of the newly adapted measure, the Recovery Knowledge and Attitude Scale (R-KAS). Also, a short 21-item version was developed. Both versions consist of three subscales namely Competence, Roles, and Responsibilities, and Process. Both the long and the short versions had good to excellent factor loadings (range .60 to.81) and high reliability (Cronbach’s alpha 38 items; α=0.95, 21 items, α=0.93). Known-groups validity was supported, as professionals who had received mental health recovery training scored significantly higher than those who had not.
Conclusions:  Adapted from the original RKI and refined with input from consumers, the newly developed R-KAS tool appears to be psychometrically sound for assessing recovery knowledge and attitudes among professionals and students. Initial findings indicate that the R-KAS is a reliable and valid measure that may better reflect recovery-oriented practices in contemporary mental health settings

ii)  Knopes, J. (2024) Mental health conditions between neurodiversity and the medical model. AJOB Neuroscience, 16(1), 20–31.
https://doi.org/10.1080/21507740.2024.2412549

Abstract
Scholarship in neuro-ethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centring the voices of people with mental health conditions in neuro-ethics research can help us better understand how such models apply in everyday people’s lives. Drawing on qualitative data from a study on mental health peer providers’ lived experiences of recovery, this paper will demonstrate that peers borrow from both a neurodiversity framework and the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuro-ethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honouring their values and recognizing both the promise and pitfalls of living with a mental health condition.

iii)  Moxham, L., Roberts, M., Yousiph, T. et al. (2025) ‘I Can’t See Myself Seeking Help’: The influence of clinical placements on nursing students’ stigmatising beliefs and intentions to seek help for their own mental health issues: A prospective cohort study. International Journal of Mental Health Nursing, 34: e13429.
https://doi.org/10.1111/inm.13429

Abstract
Mental health conditions such as anxiety, depression and psychosis represent a global health challenge. Stigma surrounding mental health continues to hinder help-seeking behaviours for people with mental illness and as this study demonstrates, nursing students as well. However, if student nurses are reluctant to seek help for mental health issues, how can others be expected to do so? This reluctance poses challenges in mental health nursing, impacting both care provision and nursing education. The present study seeks to explore the influence of traditional versus non-traditional mental health clinical placements on second year nursing students’ stigmatising beliefs and intentions to seek help for mental health issues. Employing a prospective cohort design using the TREND checklist, the study sampled second-year nursing students assigned to either traditional hospital-based or non-traditional recovery-focused mental health clinical placements. Using validated scales, stigmatising beliefs and help seeking intentions were measured before and after the placements. Statistical analyses were conducted to assess changes in these variables over time and across placement settings. A significant impact of placement setting on help-seeking intentions was observed, with students in non-traditional placements showing an increased willingness to seek help. Additionally, non-traditional placements were found to significantly reduce stigmatising beliefs in all measured domains, suggesting that these settings may provide a more conducive environment for fostering positive attitudes towards mental health. Recovery-focused placements appear to offer experiences that can diminish stigma and encourage more positive perceptions and intentions related to mental health support.

iv)  Speyer, H., Roe, D. & Slade, M. (2025) Recovery-oriented psychiatry: oxymoron or catalyst for change? The Lancet Psychiatry, (0)0. Online:
https://doi.org/10.1016/S2215-0366(25)00092-6

Summary
This Personal View provides a normative and conceptual analysis of the intersection between the recovery movement and psychiatry. Although recovery emerged as a grassroots social justice movement emphasising empowerment and systemic change, psychiatry remains rooted in the medical paradigm. We aim to develop a nuanced conceptual framework that fosters academic debate and meaningful implementation, while avoiding superficial or tokenistic adoption of recovery principles. Our analysis explores the contrasting values, ontologies, and epistemologies of these perspectives, identifying points of tension and areas of compatibility. We examine and discuss integrative and non-integrative pluralistic approaches, and we conclude with actionable recommendations for transformation at different organisational levels.

v)  Lysaker, P. H., Roe, D. & Lysaker, J. T. (2025) Promoting reflection on the process of recovery: Unique contributions from literature and the humanities for practitioner. Community Mental Health Journal, 61, 221–227.
https://doi.org/10.1007/s10597-024-01254-x

Abstract
Recovery from serious mental illness requires persons to make their own meaning and deal with evolving challenges and possibilities. Psychiatric rehabilitation thus must offer more than manualized curricula that address symptoms and skills.  We suggest that exposure to the humanities and in particular literature may offer practitioners unique avenues for developing interventions that are sensitive to the processes that enable meaning to be made. We suggest that through what the poet Keats called negative capability, reading novels may enhance practitioners? abilities to see and accept uncertainty, tolerate ambiguity without need for complete resolution, and accept the complex and ambiguous nature of persons. As an illustration we described how reading two novels, The Trial and Slaughterhouse-Five enhanced the process of meaning making while supporting the recovery of one prototypical person with serious mental illness during his efforts to make sense of his experience of returning to work.

vi)  Tham, S. S. & Solomon, P. (2024) Development of a culturally safe recovery-oriented mental health practice. Journal of Social Work Practice, 39(2), 257-271. 
https://doi.org/10.1080/02650533.2024.2411050

Abstract
This paper provides a comprehensive perspective on recovery, highlighting the significance of cultural awareness and the use of intersectionality theory to further the understanding of the influence of diverse identities on the recovery journey. A conceptual model is being introduced for culturally safe recovery-oriented practices, encompassing key domains: ways of knowing, presence, doing, and operating. Social workers are urged to lead the adoption of these practices, addressing service delivery gaps and promoting cultural safety for mental health service users. The model encourages mental health practitioners to engage in self-reflexivity, challenge power structures, and dismantle social inequities that hinder mental health recovery. The holistic embrace of all four practice domains can enhance service delivery and foster cultural safety for service users in recovery.

vii)  Haslam, N. & Tse, J. S. (2025) Public awareness of mental illness: Mental health literacy or concept creep? Australasian Psychiatry, 33(1), 18-20.
https://doi.org/10.1177/10398562241292202

Abstract
Rising awareness of mental illness has increased the public’s mental health literacy, with positive implications for help-seeking and destigmatization. We argue that it has also enlarged the public’s concept of mental illness. People have become better at recognizing the presence of mental illness but may have become worse at recognizing its absence. This conceptual expansion fosters unwarranted self-diagnosis, the pathologization of ordinary distress, and unnecessary treatment. It is incumbent on mental health professionals to promote accurate knowledge of mental illness and push back against overly expansive concepts of it

viii) Ingall, B-R., McPhilbin, M., Lewandowski, F. et al. (2025) Personal explanations for psychosis: A systematic review and thematic synthesis. Schizophrenia Bulletin Open, 6(1), sgaf006.
https://doi.org/10.1093/schizbullopen/sgaf006

Abstract
Background and Hypothesis: Psychosis refers to the state whereby one’s experience of reality differs from those around them. The ineffability of psychosis does not render the experience void of meaning, and the ways individuals integrate their experiences of psychosis into their life narratives cannot be dismissed. Meaning is an essential part of recovery. This review aimed to identify categories of personal explanations that people with psychosis use to explain their experiences.
Study Design: This systematic review is based on a preregistered protocol (CRD42023421125). Four databases, MEDLINE, Embase, Scopus, and PsycINFO, and 5 journals were searched April to November 2023. Qualitative and mixed-methods studies that explored the personal explanations employed by adults who experience psychosis, regardless of diagnostic status, were included.
Study Results: Twenty-five studies met the inclusion criteria, representing the views of 682 participants from 15 countries. Included studies were appraised using the CASP Qualitative Studies Checklist. Results: were synthesized using thematic analysis. Personal explanations for psychosis experiences were grouped into 5 themes: Physical and psychiatric; Traumatic and adversarial; Emotional; Religious, spiritual, and magical; No explanation. Participants reported multiple explanations for their experiences.
Conclusions: Individuals with experience of psychosis seek to explain these experiences, and these personal explanations may be multiple and complex in nature. The identified personal explanations can be used to further explore the ways that people situate their experiences into their personal context. This understanding should be utilized by professionals to support the provision of recovery-oriented care, with implications for assessment, treatment, intervention, and recovery outcomes.

ix)  Åsbø, G., Haavind, H., Kruse, S. H. et al. (2025) “Why shouldn’t I expect a lot from life?” A qualitative study of what facilitates long-term recovery in first-episode psychosis. BMC Psychiatry, 25(423).
https://doi.org/10.1186/s12888-025-06681-y

Abstract
Background:  Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-term recovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery.
Methods:  Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by a research team that included a peer researcher.
Results:  The analysis generated that personal resources and agency were experienced as the overarching facilitators of recovery, with five themes: (1) Doing recovery in everyday life, involving agency in daily life; (2) Re-evaluating risk, involving re-evaluating limitations and stress reduction; (3) Becoming a caregiver, involving development from being cared for to taking care of others; (4) Negotiating normality, involving identity and social inclusion; (5) Owning and sharing your story, involving accepting lived experience and overcoming stigma. Discussion:  All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users’ agency with strength- based interventions and shared-decision making, as well as refining psychoeducation on stress reduction in a long-term perspective.

x)  Kotera, Y., Ronaldson, A., Takhi, S. et al. (2025) Cultural influences on fidelity components in recovery colleges: A study across 28 countries and territories: General Psychiatry, 38(3) (e102010).
https://gpsych.bmj.com/content/38/3/e102010

Abstract
Background:  Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.
Aims:  To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.
Methods:  A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).
Results:  The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.
Conclusions:  This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.

xi)  S. Ramon, & D. Zaviršek (eds.)  (2025) Social Work in war-torn contexts: “From that moment there was no peace”.  Springer. (Release date: July 2025)

This timely book finds relevance in our monthly ebulletin not least because of the intersection between distress, trauma and professional Social Work intervention.  The publisher’s blurb reads:
This book provides a wide-ranging exposure of current developments related to war-torn contexts, post-war societies and social work approaches as well as analysis of the key issues facing social work in war contexts. The topic is timely due to the increased number of armed political conflicts; the number of internally displaced people, refugees and asylum seekers; increased length of wars; and, consequently, increased number of civil victims, which contribute to an exponential growth in the demand for social work. As there are few updated texts on this issue, this book meets the considerable gap existing in the social work literature and includes updates as well as continuing trends.

Currently a huge number of countries are in a state of war in different continents, some of which have gone on for more than a decade. Inevitably this fact has considerable implications for their social workers as well as for the people they serve, with social workers in these countries sharing the reality of the war as citizens. The war experience is known to have long-lasting, intergenerational impacts. It also has a strong impact on the many other countries that receive refugees and asylum seekers and/or support militarily another country at war and/or refuse to support it.

The book’s country-focused chapters on Afghanistan, Bosnia and Herzegovina, Greece, Israel, Italy, Jordan, Northern Ireland, Serbia, South Sudan, Syria, UK and Ukraine cover major topics including:

• The contexts of armed political conflicts from a social work perspective;
• The impact of war on disadvantaged individuals and groups;
• Forced migration;
• Post-war societies and post-war reconstructions from a social work perspective;
• The ethical issues related to war and peace from a social work perspective;
• The implication for social work education and research.

Social Work in War-Torn Contexts is an important and timely resource for social work and social science researchers, lecturers in different areas of social sciences, social work practitioners, as well as students. Politicians, war correspondents, international humanitarian organizations and volunteers also will find the book of interest.

xii)  Sheldon, A., Griffiths, C., Baukaite, E. & Walker, K. (2025) “Well-Track” healthy lifestyle coaching in severe mental illness: A qualitative study exploring participant experience and impact. Open Journal of Preventive Medicine, 15, 99-122.
https://doi.org/10.4236/ojpm.2025.155006

Abstract
Background:  Unhealthy lifestyle behaviours contribute to the poor physical health experienced by people with severe mental illness (SMI). Severe mental illness symptoms and the medications used in treatment make adopting a healthy lifestyle challenging. Intervention: Well-Track uses a wearable activity tracker and three sessions with a health coach to promote healthy lifestyle behaviour change. The tracker allows physical activity, sleep and calorie expenditure to be monitored. The coach provides personalised support and accountability through motivational interviewing, goal-setting, healthy lifestyle advice and feedback.
Participants:  Fifteen participants under the care of a community mental health team (CMHT) were interviewed following their completion of the intervention. They comprised 7 females, 7 males and 1 non-binary, with an age range of 21 to 62 years. Methods:  Individual in-depth one-to-one interviews were conducted. The qualitative data collected were analysed using thematic analysis.
Results:  Participants benefitted from the combination of the activity tracker and health coaching. By setting personalised goals, monitored by the tracker and supported by the health coach, individuals increased physical activity and improved their sleep hygiene and eating habits. Participants described enhanced physical fitness and healthy weight management alongside improvements in mood, self-confidence, positive self-identity and reduced social isolation.
Conclusion:  Well-Track can enable healthy lifestyle changes to improve the physical and mental health and well-being of people with SMI.

Other News /Resources

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

June 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 7th Refocus on Recovery conference will take place:

Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery.
Registration is open, with a maximum of 220 in-person delegates.  Speaker biographies are now available:
https://www.researchintorecovery.com/speakers-refocus-on-recovery-2025/
For more information, including our provisional programme: https://www.researchintorecovery.com/ronr2025/

ii) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:

Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

iii) The 25^th WPA World Congress of Psychiatry is scheduled for:

Date:  5^th – 8^th October 2025
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The Role of Psychiatry in the Changing World
A comprehensive and detailed range of information is available here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Guerrero, E., Barrios, M. & Sampietro, H. M. et al. (2025) Recovery in mental health: An international Delphi study from a recovery-oriented professional perspective. Social Science and Medicine. 381, 118302,
https://doi.org/10.1016/j.socscimed.2025.118302

Abstract
Current public policies emphasize the need for recovery-oriented services. However, a lack of consensus on the meaning of recovery poses challenges for implementing recovery-oriented interventions. This study aims to establish an international consensus on the key elements of recovery from the clinician perspective, specifically from recovery-oriented mental health professionals. A three-round Delphi study was conducted to gather expert opinions on the definition of recovery, progress indicators, and factors that facilitate and hinder recovery.  Seventy-eight recovery-oriented professionals agreed to participate and completed a sociodemographic questionnaire after providing informed consent. In the first Delphi round, open-ended questions were used to gather initial opinions, which were analyzed and compiled into a list of statements. In the second and third rounds, participants rated the relevance of each statement using a Likert-type scale. Statements rated as “relevant” or “very relevant” by at least 80 % of participants were considered consensus statements. Recovery was defined as the development of a sense of agency, empowerment, autonomy, and self-determination. Key indicators emphasized agency, empowerment, user safety, and informed decision-making. Facilitators included the promotion of self-determination, a holistic approach within services, and the integration of peer support. Social exclusion emerged as the most significant obstacle to recovery. This study provides an international consensus on the key elements of recovery in mental health from the perspective of recovery-oriented professionals, offering insights for implementing interventions, developing recovery-oriented services, and refining measurement instruments.

ii)  Takhi, S. K., Brown, H. H. & Ronaldson, A. et al. (2025) The content of Recovery College courses in England: A 71 college document analysis.  Frontiers in Psychiatry, 16.
https://www.doi.org/10.3389/fpsyt.2025.1605498

Abstract
Introduction: Recovery Colleges (RCs) exist in 28 countries and across five continents. The concept of recovery and recovery-oriented care has become widespread internationally and embedded in policy documentation and mental health services. As a result, Recovery Colleges, which focus on adult learning and co-production, have now developed a global presence, but many psychiatrists are unfamiliar with this intervention. RCs can be categorized as ‘Strengths Oriented’, focusing on skills and knowledge development, or ‘Community-oriented’, emphasizing strengthening community and social connections. Research has not sufficiently investigated RC curriculum and how course provision differs depending on RC orientation. The study aimed to develop a typology of RC courses and assess differences in course types across RC orientations.
Method: A document analysis was conducted. The websites of 88 RCs in England were searched to collect online prospectuses. Overall, 2,330 courses described in 551 documents from 71 RCs were collated. Inductive content analysis was applied to the course titles to develop a typology of courses offered. Mann-Whitney U tests were used to assess differences in the median number of course types offered by Strengths-Oriented versus Community-Oriented colleges.
Results: A typology of 14 superordinate course categories was created. The three most common course categories were Self-management of Well-being (96% RCs ≥1 course, median 10 courses per RC), Mental Health Conditions and Symptoms (85% RCs ≥1 course, 4 courses per RC), and Creativity (86% RCs ≥1 course, 3 courses per RC). The least common course categories included issues relating to the Extended Support Network and Issues relating to Staff (38% RCs ≥1 course, 0 courses per RC) (6% RCs ≥1 course, 0 courses per RC). The median number of courses did not differ between Strengths-oriented versus Community-oriented RCs, with the exception of more Practical Life Skills (p=0.021) and Involvement, Co-production and Research (p=0.036) courses in Strengths-oriented RCs.
Conclusions: RCs support mental health recovery through a diverse curriculum. Community-facing and strengths-based, health service-affiliated RCs offer similar courses. RCs prioritize equipping students with knowledge about living with mental health issues. Courses targeted to informal carers are lacking. Further cross-cultural extension of the typology is needed. 

iii)  Yeo, C., Charles, A. & Lewandowski, F. et al. (2025) Healing Houses systematic review: Design, sustainability, opportunities and barriers facing Soteria and peer respite development. Journal of Mental Health, 34(3), 318-329.
https://doi.org/10.1080/09638237.2024.2361233

Abstract
Background: Soteria houses and peer respites, collectively called Healing Houses, are alternatives to psychiatric hospitalisation.
Aims: The aim of this research is to review Healing Houses in relation to design characteristics (architectural and service), sustainability and development opportunities and barriers.
Methods: This systematic review followed a PROSPERO protocol (CRD42022378089). Articles were identified from journal database searches, hand searching websites, Google Scholar searches, expert consultation and backwards and forward citation searches.
Results: Eight hundred and forty-nine documents were screened in three languages (English, German and Hebrew) and 45 documents were included from seven countries. The review highlights 11 architectural design characteristics (atmosphere, size, soft room, history, location, outdoor space, cleanliness, interior design, facilities, staff only areas and accessibility), six service design characteristics (guiding principles, living and working together, consensual treatment, staff, supporting personal meaning making and power), five opportunities (outcomes, human rights, economics, hospitalization and underserved) and four types of barriers (clinical, economic and regulatory, societal and ideological).
The primary sustainability issue was long-term funding.
Conclusion: Future research should focus on operationalizing a “home-like” atmosphere and the impact of design features such as green spaces on wellbeing of staff and service users. Future research could also produce design guidelines for Healing Houses.

iv)  Lases, M. N., Bruins, J. & Scheepers, F. E. et al. (2025) Is personal recovery a transdiagnostic concept? Testing the fit of the CHIME framework using narrative experiences, Journal of Mental Health, 34(3), 254-262.
https://doi.org/10.1080/09638237.2024.2361225

Abstract
Background: Personal recovery is operationalized in the CHIME framework (connectedness, hope, identity, meaning in life, and empowerment) of recovery processes. CHIME was initially developed through analysis of experiences of people mainly with psychosis, but it might also be valid for investigating recovery in mood-related, autism and other diagnoses. Aims: To examine whether personal recovery is transdiagnostic by studying narrative experiences in several diagnostic groups.
Methods: Thirty recovery narratives, retrieved from “Psychiatry Story Bank” (PSB) in the Netherlands, were analyzed by three coders using CHIME as a deductive framework. New codes were assigned using an inductive approach and member checks were performed after consensus was reached. 
Results: All five CHIME dimensions were richly reported in the narratives, independent of diagnosis. Seven new domains were identified, such as “acknowledgement by diagnosis” and “gaining self-insight”.  These new domains were evaluated to fit well as subdomains within the original CHIME framework. On average, 54.2% of all narrative content was classified as experienced difficulties.
Conclusions: Recovery stories from different diagnostic perspectives fit well into the CHIME framework, implying that personal recovery is a transdiagnostic concept. Difficulties should not be ignored in the context of personal recovery based on its substantial presence in the recovery narratives.

v)  Lowe, P. E., McManus, S. & , Asadi Zeidabadi, P. et al (2025) Black and minoritized women’s experiences of specialist domestic violence services in the United Kingdom (UK): A scoping review. Trauma, Violence, & Abuse, 0(0), 1-16. https://doi.org/10.1177/15248380251335038

Abstract
This scoping review maps the existing available literature on Black and minoritized women’s experiences with specialist Domestic Violence and Abuse (DVA) services in the UK to summarize current understanding and identify knowledge gaps. A comprehensive search was conducted across multiple databases and gray literature sources. All articles had to include Black and minoritized women’s experiences of DVA services. In total, 29 UK-based studies published between 2000 and 2024 were identified. Data were synthesized to identify key themes and gaps. Thematic analysis of the findings revealed three main themes: additional service needs, barriers to accessing support, and the pivotal role of “by and for” services. Our review concludes that “by and for” services—provided by and for minoritized women—which adopt an intersectional approach are crucial in addressing the unique needs of Black and minoritized “survivor–victims”, particularly in terms of language support, practical assistance, and community-related support. There is a need for more peer-reviewed literature to recognize the role of “by and for” services, using diverse methodologies to support Black and minoritized communities better.

vi)  Duffy, J., O’Shea Brown, G. & Tosone, C. (2024) Teaching the art of compassionate inquiry: Involving survivors from 9/11 in social work education.  Social Work Education, 1-18.
https://doi.org/10.1080/02615479.2024.2361730

Abstract
This paper reports findings from pedagogic research evaluating the impact of the involvement of survivors from the World Trade Centre attacks in New York City in 2001 in trauma-specific social work education. A pedagogic approach to mental health education is discussed which aims to prepare students to develop trauma- informed assessment and intervention skills concurrent with their encounters with trauma survivors in field practice placements. The small-scale research involved surveying students’ evaluations at a university in New York, following exposure to first-hand accounts of survivors’ experiences. Across the three areas—confidence in knowledge of trauma, impact on learning, and preparation for field practice—the evaluation findings indicate that the students’ knowledge, gained from the involvement of 9/11 survivors, improved over time. This paper presents the background to this project, preparations involved, and findings from research evaluations with the students. The findings suggest that the involvement of those with direct and lived trauma experience in classroom teaching, whilst challenging, can yield positive impacts for students. The 9/11 survivors poignantly shared with students that their lives were changed forever in the aftermath of these events. The findings have potential global educational impact and resonance.

vii)  Moran, P., Bick, D. & Biddle, L. et al. (2025) Perinatal emotional skills groups for women and birthing people with borderline personality disorder: Outcomes from a feasibility randomised controlled trial. BJPsych Open, 11(1):e12.
https://doi.org/10.1192/bjo.2024.833

Abstract
Background:  There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.
Aims:  To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.
Method:  Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.
Results:  A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6–11). At 4 months, levels of BPD symptoms (adjusted coefficient −2.0, 95% CI −6.2 to 2.1) and emotional distress (−2.4, 95% CI −6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person.
Conclusions:  Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking.

viii)  Panadevo, J., Kotera, Y. & Køcks, N. R. et al. (2025)  Personal recovery after mental illness from a cultural perspective: A scoping review. International Journal of Social Psychiatry. 71(3), 444-468.
https://doi.org/10.1177/00207640241303026

Abstract
Background:  Although personal recovery has become a well-known concept in most Western countries, it remains under-recognised in non-Western countries.
Aims:  This scoping review aimed to investigate how culture impacts the conceptualisation of personal recovery by evaluating how well the personal recovery framework CHIME (Connectedness, Hope, Identity, Meaning and Empowerment) fits amongst individuals from non-Western ethnic origin.
Method:  A scoping review with systematic searches was conducted. Studies were included in the scoping review if they examined personal recovery among individuals from non-Western cultures. Articles were excluded if the target population had no experience with mental illness or had an ethnic Western origin. The review used the CHIME framework in a ‘best-fit’ framework synthesis, to understand how culture impacted the understanding and experience of recovery. A comprehensive search of five databases (PsycInfo, ProQuest, EMBASE, MEDLINE and CINAHL) resulted in the inclusion of 76 studies out of the 1,641 studies identified. The search was conducted in February 2023 and updated the same month in 2024.
Results:  The 76 studies demonstrated that the CHIME framework is applicable in non-Western cultures, with few adjustments to the subcategories. Generally, there was a greater emphasis on connectedness with others across all categories of CHIME, and religion was more frequently used as source to achieve the components of CHIME more often in non-Western cultures. Socio-structural factors influenced how personal recovery can be experienced, and important factors such as welfare benefits impacts recovery.
Conclusion:  Special attention should be given to the importance of relationships, especially family, in achieving recovery and religion should be recognised as a crucial element to experiencing connectedness, hope, identity, meaning and empowerment. To enhance the CHIME framework, integrating the sub-components shared responsibility and shared control would be beneficial. Socio-structural factors should be considered when using the CHIME framework.

Other News /Resources

i)  The Centre for Mental Health draw attention to a number of publications in their May 2025 communication.  We include the introduction below, with embedded links, and the full URL.

Dear friend,
This month we’ve launched two new publications, exploring how to improve support for people with both mental health and substance use problems, and setting out six key areas where investment could make the biggest difference to mental health.
I’m also excited to bring you an update about our IPS training. Individual Placement and Support (IPS) helps people with mental health problems into paid employment as part of their recovery. For over 12 years, we’ve been training IPS services in how to provide this life-changing support. 

In 2021, we started to assist the rollout of IPS in drug and alcohol services. Since then, we’ve trained over 1,000 IPS workers in these services. With the Government’s new Connect to Work initiative expanding IPS even further, our training is in high demand, and we’re excited to be part of this national effort. We also recently attended the IPS annual conference in Tennessee, where we connected with global experts to share best practices. Explore our training courses here.

https://us3.campaign-archive.com/?e=63554dce36&u=60c1b1ba2c1557649e61daa9a&id=a9984ddb5c

ii)  The McPin Foundation
As we mentioned in the March edition of the RRN ebulletin, the McPin Foundation quarterly newsletter is a great resource and an excellent way of keeping up to speed with a broad range of projects and events, news and views from the mental health research sector.  Their Summer newsletter for 2025 has just been issued.  To sign up to the McPin newsletter, please see here.

iii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

July 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 7th Refocus on Recovery conference will take place:

Date: Thursday September 4^th – Friday September 5^th 2025
Venue:  Crowne Plaza Hotel, Nottingham, UK
Conference theme 2025: Reimagining Recovery.
Registration is open, with a maximum of 220 in-person delegates.  Speaker biographies are now available:
https://www.researchintorecovery.com/speakers-refocus-on-recovery-2025/
For more information, including our provisional programme: https://www.researchintorecovery.com/ronr2025/

ii) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:

Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025

For more detailed information, including important dates, please see here.

iii) The 25^th WPA World Congress of Psychiatry is scheduled for:

Date:  5^th – 8^th October 2025
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The Role of Psychiatry in the Changing World
A comprehensive and detailed range of information is available here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Kotera, Y., Ronaldson, A. & Takhi, S. et al. (2025) Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories. General Psychiatry, 38:e102010.
https://doi.org/10.1136/gpsych-2024-102010

Abstract
Background:   Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories.  However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.
Aims:  To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.
Methods:  A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).
Results:  The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence.
Conclusions:  This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.

ii)  Ingall, B-R., McPhilbin, M. & Lewandowski, F. et al. (2025) Personal explanations for psychosis: A systematic review and thematic synthesis. Schizophrenia Bulletin Open, 6(1), sgaf006.
https://doi.org/10.1093/schizbullopen/sgaf00

Abstract
Background and Hypothesis:  Psychosis refers to the state whereby one’s experience of reality differs from those around them. The ineffability of psychosis does not render the experience void of meaning, and the ways individuals integrate their experiences of psychosis into their life narratives cannot be dismissed. Meaning is an essential part of recovery. This review aimed to identify categories of personal explanations that people with psychosis use to explain their experiences.
Study Design:  This systematic review is based on a preregistered protocol (CRD42023421125). Four databases, MEDLINE, Embase, Scopus, and PsycINFO, and 5 journals were searched April to November 2023. Qualitative and mixed-methods studies that explored the personal explanations employed by adults who experience psychosis, regardless of diagnostic status, were included.
Study Results:  Twenty-five studies met the inclusion criteria, representing the views of 682 participants from 15 countries. Included studies were appraised using the CASP Qualitative Studies Checklist. Results: were synthesized using thematic analysis. Personal explanations for psychosis experiences were grouped into 5 themes: Physical and psychiatric; Traumatic and adversarial; Emotional; Religious, spiritual, and magical; No explanation. Participants reported multiple explanations for their experiences.
Conclusions:  Individuals with experience of psychosis seek to explain these experiences, and these personal explanations may be multiple and complex in nature. The identified personal explanations can be used to further explore the ways that people situate their experiences into their personal context. This understanding should be utilized by professionals to support the provision of recovery-oriented care, with implications for assessment, treatment, intervention, and recovery outcomes.

iii)  Grundy, A. C. (2025) The traumas of hostile voice-hearing experiences in the context of acute psychiatric admissions: A lived experience testimony. Psychosis, 1–6. https://doi.org/10.1080/17522439.2025.2492641

Abstract
In this paper, Dr. Andrew C. Grundy (a lived experience researcher who has been given a diagnosis of “schizophrenia”) gives testimony to his trauma of hostile voice-hearing experiences and of related experiences of iatrogenic trauma in the context of acute psychiatric admissions. This paper then seeks to contextualise these experiences in the research literature, and it offers recommendations for trauma-informed care of people experiencing hostile and distressing voices.

iv)  Piot, M.A., Stabler, S. & Köenig, M. et al. (2025) Experience of personal recovery from mental disorders among West African refugees: A clinical case study. Culture, Medicine and Psychiatry. Online:
https://doi.org/10.1007/s11013-025-09923-6

Abstract
Exposure to multiple vulnerability factors increase the likelihood of refugees experiencing mental health issues. Certain post-migratory factors exacerbate these disorders, while the processes of personal recovery remain unclear. This study explored the experience of personal recovery among West African refugees with mental issue, with the aim of helping health professionals in host countries to provide more appropriate care. We used the qualitative interpretative phenomenological analysis method. Ten participants were purposively sampled for face-to-face semi-structured interviews. Two themes emerged from the analysis. Despite their extreme socioeconomic precariousness, mental disorders were perceived as forbidden conditions compared to the processes of acceptance of their somatic pathologies; hindering access to mental healthcare more markedly. Rebuilding a sense of security basis in the host country was seen as an essential step but was also associated with factors that hindered the care process. Certain encounters could enable a return to care with patience, understanding and warmth. Our results highlighted the need to overcome some short-term self-protection strategies by adopting a benevolent attitude and active listening, ensuring secure socio-economical conditions first to enable mental care, increase the multicultural skills of healers, and support therapies that are not limited to face-to-face approach through activity, art, and group support. This may help to limit the risk of transmission of suffering to future generations.

v)  Mekuriaw, B., Cutler, N. A. & River, J. (2025), Carers’ understanding of recovery-oriented practice in mental health settings: A systematic review and narrative synthesis. International Journal of Mental Health Nursing, 34:e70035.
https://doi.org/10.1111/inm.70035

Abstract
Recovery-oriented practice is a contemporary and internationally accepted approach to mental health care. Moving away from privileging ‘clinical recovery’, it recognises and supports ‘personal recovery’, defined as living a meaningful life. Family and carers’ (carers) understanding, and support of recovery-oriented practice is crucial to the provision of comprehensive and continuous mental health care. Few studies exist on carers’ knowledge and experiences of recovery-oriented practice. We conducted a systematic review to explore carers’ understanding of recovery-oriented practice in mental health settings. A narrative synthesis was undertaken using both deductive and inductive approaches, guided by the established framework for recovery-oriented practice by Le Boutillier and colleagues. Findings indicated that carers have a grasp of the principles and aims of recovery-oriented care, which aligned with the selected framework. However, carers’ comprehension also identified shortcomings in how recovery-oriented practices were currently implemented in mental health services. Extending the work of Le Boutillier and colleagues, this review found that carers experienced a ‘disillusionment with mental health services’. While carers were keen to be involved and support recovery, they often felt excluded by mental health workers and the broader mental health system. This sense of exclusion led to carers feeling unsupported and disinclined to engage with the service, and this adversely affected their well-being.  Findings suggest that operationalising recovery-oriented practice requires more genuine involvement of carers in decision-making forums such as care planning meetings, and formal feedback mechanisms be made available to integrate their perspectives into service development.

vi)  Whittle, H. J. (2025) Ronaldo on the Clapham Omnibus: Complex recoveries in complex psychosis. Culture, Medicine and Psychiatry.  Online:
https://doi.org/10.1007/s11013-025-09931-6

Abstract
Dominant cultural framings of recovery in psychosis describe a process of increasing social connection, community integration, identity reclamation, and hope. Drawing on 6 months of ethnographic fieldwork on a psychiatric rehabilitation ward for ‘complex psychosis’ in London, I consider what we might learn from recoveries that appear not to follow this trajectory. My primary case study, of a man diagnosed with treatment-resistant schizoaffective disorder who identifies with/as the famous ex-footballer Ronaldo, interrogates the social implications of his attempts to ‘mask’ his identity while on leave from the hospital to avoid “caus[ing] trouble”—strategically embodying, in effect, the fictitious ‘ordinary’ person denoted by the English idiom the man on the Clapham omnibus. I argue that his complex recovery, built on a trial-and-error process of retreat from social connection and caution towards hope, reflects a degree of clinical complexity seldom acknowledged outside psychiatric rehabilitation. Engaging with more nuanced anthropological theories of recovery in psychosis, my analysis illuminates how the time, space, and relative safety of a lengthy involuntary hospital admission proved necessary for his complex recovery to unfold. This insight contrasts with the dominant operationalisation of recovery in contemporary mental health systems, which seems to be fuelling disinvestment in such rehabilitative admissions.

vii)  Anderson, J. & Spandler, H. (2025). Mad Zine pedagogy: using zines in critical mental health learning and education. Social Work Education, 1–19.
https://doi.org/10.1080/02615479.2025.2469586

Abstract
This article explores how zines might be used as a medium for generating and communicating alternative forms of Mad-centered knowledge in diverse learning contexts. It draws on our research project about ‘madzines’ which involved identifying madzines; ‘being with’ them; sharing examples with others, and facilitating madzine workshops across both formal and informal settings. Here, we use these activities to reflect on the possibilities, as well as the limitations, of using these informal DIY publications as a form of critical mental health learning, focusing on social work education. Drawing on Alison Piepmeier’s idea of zines as pedagogies of hope, we explore how using madzines in teaching might help: enable learners to: process alternative knowledge and understanding; actively critique existing services and the policy that informs them; and imagine alternatives. We also identify several limitations to be aware of when introducing zines in formal educational settings: decontextualisation, unethical sharing, the othering of madness; and instrumentalising zines. We suggest that our reflections have wider applications across professional, and indeed nonprofessional, settings.

viii)  Veseth, M., Salbu, M. Ø. & Ness, O. et al. (2025) “Billie is ready for a new chapter in life”: Exploring constructions of schizophrenia recovery from the perspectives of Norwegian youth using story completion. Journal of Psychosocial Rehabilitation and Mental Health.
https://doi.org/10.1007/s40737-025-00477-9

Abstract
This study employs the story completion method to explore how Norwegian youth describe and understand recovery processes and life following treatment for schizophrenia. Data was collected from 131 participants aged 17–27 years who were students in upper secondary schools and a university. Using reflexive thematic analysis, we identified five key themes: (1) The ongoing battle with a severe mental illness; (2) the double-edged sword of treatment; (3) rebuilding a life in the community; (4) claiming identity and purpose; and (5) resilience and hope in recovery. Our findings highlight the complex and multifaceted nature of recovery, emphasizing both ongoing challenges and the potential for growth and positive change. The study reveals a tendency towards problem-saturated narratives, even when prompted with recovery-oriented cues, suggesting a need for more diverse and nuanced representations of recovery experiences. These insights have significant implications for mental health education, stigma reduction efforts, and the development of recovery-oriented services. The study contributes to the growing body of literature advocating for a more holistic, socially embedded conceptualization of recovery, aligning with citizenship models and emphasizing the importance of community integration.

Other News /Resources

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

August 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

i) Writing out of Amstersam UMC, Dr Robin Van Eck has informed the RRN eulletin that his PhD thesis on personal recovery (entitled Transcending Illness) has been published online.  Many congratulations to Dr Van Eck for succussfully completing the thesis. A link to the document is included here.

Dr Van Eck has kindly provided the following abstract and may be contacted on the email address supplied should the readership have any questions:
r.m.vaneck@amsterdamumc.nl

Abstract
The aim of this thesis was to investigate the relationship between clinical and personal recovery in patients with psychosis. Clinical recovery means remission of symptoms and functional improvement. Personal recovery is about the development of new meaning and purpose in life as one grows beyond the effects of mental illness.  
We conducted a systematic review and meta-analysis and a longitudinal study at flexible assertive community treatment teams. We found a negative association between symptom severity and personal recovery, however with a small effect-size. Affective symptoms showed a more substantial association with personal recovery than psychotic symptoms. From qualitative interviews we learned that clinical treatment interventions can have both positive and negative impact on personal recovery.
We also investigated whether factors associated with personal recovery in patients, unaffected siblings and healthy controls were similar. Resilience was linked to personal recovery in all three groups.

We conclude that recovery transcends illness, because:
1. Personal recovery seems to occur largely independent of remission of (psychotic) symptoms.
2. Personal recovery is associated with factors that are universally human.
For clinical practice this means that symptom reduction is not the only road to personal recovery. It is important to pay attention to affective symptoms. The finding that patients and nonpatients share supportive factors of personal recovery, may suggest that carers and professionals can use their own experiences with coping to help patients recover.
Future studies should be co-created with people with lived experience to bring recovery-oriented research and care forward.

Conferences, Events and Calls for Papers
i) The XV World Congress of World Association for Psychosocial Rehabilitation (WAPR) & the Canadian PSR Conference is scheduled for:
Date:  27^th – 23^rd September 2025
Venue:  Sheraton Wall Centre, Vancouver, Canada
Deadline for abstracts:  31^st March 2025
For more detailed information, including important dates, please see here.

ii) The 25^th WPA World Congress of Psychiatry is scheduled for:
Date:  5^th – 8^th October 2025
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The Role of Psychiatry in the Changing World
A comprehensive and detailed range of information is available here.

Papers and Publications 
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Guerrero, E., M. Barrios, H. M. & Sampietro, A. et al. (2025) Support for recovery in mental health: A Delphi study from the family’s perspective.  International Journal of Mental Health Nursing, 34(4): e70119
https://doi.org/10.1111/inm.70119.

Abstract
Mental health services are increasingly adopting a recovery-oriented approach that prioritises human rights and user empowerment. In this evolving landscape, family members, who are often the primary support network for mental health service users, face unique challenges in assisting a person’s recovery. This study aims to establish an international consensus on supportive actions for the recovery process and to identify key facilitators and obstacles to providing support from the perspective of families of mental health service users. Methodological rigour was ensured by following the CREDES checklist. A total of 53 family caregivers from around the world agreed to participate in a three-round e-Delphi study. Consensus was reached on 47 statements detailing supportive actions, among which an awareness of the user’s needs was considered the most important. The study also identified 42 facilitators of providing support, with openness to learning and trusting the user being the most significant. A total of 23 obstacles were also acknowledged, with the major barrier being the emotional or physical absence of the caregiver. These results highlight the multifaceted nature of support and the critical role families play in a person’s recovery journey. The findings also underscore the need for training programmes based on these consensus statements so as to empower families to provide more effective and person-centred support.

ii) Slade, M. (2025) The ten harmful myths of psychiatry.  Journal of Recovery in Mental Health. 8(2), 76-91.
https://doi.org/10.33137/jrmh.v8i2.45275

Abstract
Psychiatry has powerfully influenced how mental health issues are conceptualized and addressed internationally. Many people report benefits from mental health assessment and treatment, but other individuals report being harmed by the mental health system. In this regard, mental health services are distinct from other areas of health care. For example, no other area of medicine has an equivalent of a psychiatric survivor movement. This article identifies ten embedded assumptions within psychiatry, which may account for some of these negative experiences. They are myths, in the sense of being beliefs which are widely held, often un-noticed and un-challenged, and routinely applied as if universally true despite being either wholly untrue or only sometimes true. They are also harmful, both in creating direct damage and in consuming patient, clinician, and societal resources which could be better spent in other ways. The myths are: Mental health problems are individual; Mental ill-health is fundamentally biological; A clinician knows what is in the patient’s best interests; A clinician can predict the patient’s future; Diagnosis is fact; Treatment is always justified; Patients need to be trained for social roles; Side effects are peripheral; Improvement is always due to treatment; and Supporting recovery is ‘business as usual.’ Approaches to developing new knowledge about mental health are then proposed: learning from people living with mental health issues and not using services; developing a salutogenic knowledge base about wellness to balance our current pathogenic knowledge base about illness; and using standpoint epistemologies to develop more inclusive approaches to knowledge creation.

iii)  Llewellyn-Beardsley, J., Ali, Y. & Bailey, S. (2025). Lived experience narratives for mental health recovery: The Narrative Experiences Online (NEON) Programme. Nottingham:
Institute of Mental Health.

A detailed report has been collaboratively produced by the Narrative Experiences Online (NEON) Programme.  The following extract is taken from the introduction to the report.  The report is available here:

Introduction
This report is a summary of learning from the Narrative Experiences Online (NEON) programme of research that was led from England, UK from 2017-2023. We describe what our study involved, what we learned, and how people might benefit from this work in the future.

The personal stories of people who have experienced mental health problems (described here as people with ‘lived experience’) were at the heart of the NEON study. So in this document we present our learning in two ways:
1. through descriptions of what we did and found, and
2. through the stories of people involved in the study, as lived experience advisors, research participants, and researchers.

iv) Burger, T. .J., Van Eck, R. M. & Lachmeijer, M. et al. (2024) Perspective matters in recovery: the views of persons with severe mental illness, family and mental health professionals on collaboration during recovery, a qualitative study. BMC Psychiatry. 24(802) https://doi.org/10.1186/s12888-024-06198-w

Abstract
Background:  Recovery from severe mental illness, including psychosis has been described as a personal and unique process, but it rarely is a journey undertaken without profound influences of significant others (family, mental health professionals). Diverging perspectives between persons with severe mental illness, family and professionals are frequent during the recovery process, notably in psychotic disorders. We aimed to explore processes of collaboration during recovery, to inform recovery supporting practices.
Methods:  Current qualitative study had a participatory design and was set within long-term mental healthcare for severe mental illness. We conducted semi-structured interviews and focus groups with persons with severe mental illness (most had a history of psychosis), family and professionals on their mutual contact during recovery. Using reflexive thematic analysis, we developed themes representing processes of collaboration during recovery.
Results:  We described roles persons with severe mental illness, family and professionals attribute to each other in mutually influential terms of unconditional and meaningful contact (which takes time to establish) and problem oriented aspects. Secondly, experienced differences over problem definition, “needing help” and consequently over the role parties attribute to one another, may result in negative interactions, in the area of having expectations; (not) informing; (not) having agency to change; experiencing (dis)agreement or struggle.
Conclusions:  Unconditional, meaningful contact and knowing each other’s perspective are important to fruitful interaction in a triad when perspectives on mental health problems diverge. Relationally centred and process oriented care with continuity of family and professionals involved are needed to advance recovery in severe mental illness, especially psychosis.

v) Omundo, J., Stiehl, S. A. & Schulz, M. et al. (2025) CHIME in practice: a qualitative exploration of CHIME framework training experiences and outcomes for service users and mental health professionals. The Journal of Mental Health Training, Education and Practice,  20 (3), 170–183.
https://doi.org/10.1108/JMHTEP-05-2024-0052

Abstract
Purpose:  This study aims to explore the experiences and outcomes associated with participating in a brief training course based on the CHIME (Connectedness, Hope and Optimism, Identity, Meaning of Life and Empowerment) Framework among service users and mental health care professionals (MHPs).
Design/methodology/approach:  The authors used a focus group discussion approach to evaluate the outcomes of a brief four-hour CHIME Framework training. The study sample consisted of eight individuals (four service users and four mental health professionals) who completed the training and provided consent to participate in the interview. The study applied thematic analysis to identify key themes related to participants’ experiences and outcomes.
Findings:  The authors identified five main themes based on participants’ experiences and outcomes of the CHIME Framework training: the meaning of recovery, relationships that support recovery, co-production, recovery and empowerment and barriers to recovery.
Research limitations/implications:  This study is limited by its small sample size and the qualitative design of the research, which restricts the generalizability of the findings and emphasizes their exploratory nature. Future studies should aim to expand the sample size and enhance participant diversity, particularly with regard to gender representation, to strengthen the robustness of the results.  Moreover, quantitative or longitudinal research designs are recommended to establish the causal relationship between the CHIME Framework training and the participant’s meaningful engagement in mental health practice and recovery processes.
Practical implications:  Addressing the knowledge deficit among mental health staff and service users regarding the integration of a recovery-oriented approach into mental health practice has the potential to enhance overall well-being, improve mental health literacy and reduce stigma for both groups.
Originality/value:  This qualitative work explored the role of the outcomes of CHIME Framework training within a mental health centre and the effect this training might have on the MHPs and service users. The findings contribute to the growing body of knowledge on recovery-oriented approaches in mental health practice, making it relevant and significant for clinical practice.

vi)  Markham, S. (2025) Stigmatisation and marginalisation of forensic psychiatric patients.  Illness, Crisis and Loss.  33(3) 613-635.
https://doi.org/10.1177/10541373241268095

Abstract
In this article, we will explore evidence for structural and public stigmatization and marginalization of forensic psychiatric patients within mental health services and the human rights justice system. It can be argued that patients in secure and forensic services (often referred to as mentally disordered offenders) are potentially the most marginalized and extensively stigmatized of all patient cohorts, and that the extent to which they are discriminated against should not be under-estimated. We will also consider the potential for breaches of the Human Rights Act (1998) and associated injustices which may present in the treatment of these individuals, and how praxis can be improved so that harms are remedied and well-being and mutual respect improved.

vii)  Gaudreau, H., Radziszewski, S. & Houle, J. et al. (2025)  Self-management strategies in youth with difficulties related to anxiety or depression: What helps them feel better. Journal of Adolescent Research.40(1), 66-98.
https://doi.org/10.1177/07435584231154840

Abstract
Anxiety and depressive disorders are the most prevalent mental health problems in adolescents, however, little is known about the strategies they use to deal with their difficulties and regain power over their symptoms. This exploratory study documented the self-management strategies used by adolescents to recover from difficulties related to anxiety and/or depression. Individual interviews were conducted in Montreal, Canada with 49 participants aged 11 to 18 years (28 girls, 20 boys, and 1 non-binary person from various cultural origins) after approval by the Institutional Review Board. Young people were questioned about the self-management strategies they put in place when they felt stressed, sad, or anxious. The data were coded according to the thematic analysis method using an inductive approach. Participants reported 73 self-management strategies, regrouped in four broad themes: (a) I think through; (b) I surround myself with people/animals; (c) I feel and manage my emotions; (d) I continue my daily activities. Their strategies emphasize the role played by their social network and the place of social media as a support in their recovery. Self-management is an empowering process that allows adolescents to take responsibility and to make decisions that foster their recovery.

viii)  Ustrup, M., Roe, D., & Speyer, H. (2025). Antipsychotic deprescribing analyzed as a wicked problem. Journal of Humanistic Psychology, 0(0). https://doi.org/10.1177/00221678251328088

Abstract
The values and ideologies underpinning mental health care are evolving, shifting from a narrow focus on symptom reduction to a broader emphasis on recovery, human rights, and enhancing quality of life. To overcome the risk that health care systems will pay lip service to these emerging values and remain stuck in familiar one-size-fits-all solutions in clinical guidelines, there is a need for reshaping the clinical and scientific inquiries, by broadening our research questions and the epistemic methods employed. In this paper, we use the models of “tame” and “wicked” problems to understand this mismatch between current clinical guidelines and emerging recovery-oriented health care. We use the example of decisions on deprescribing antipsychotic medication, with its multiple inherent dilemmas and paradoxes, as a wicked problem in need of transdisciplinary solutions. Finally, we emphasize the value of preserving people’s dignity of risk-taking and conclude that the focus must shift from ensuring adherence to how we can best support people’s efforts to pursue meaningful lives, in line with the values of contemporary, recovery-oriented mental health care.

ix) Moeller, S.B., Larsen, P.V., Austin, S.F. et al. (2025) Assessing change and establishing empirical cutoffs: The Brief INSPIRE-O measure for personal recovery in mental health services. Social Psychiatry and Psychiatric Epidemiology.
https://doi.org/10.1007/s00127-025-02948-7

Abstract
Introduction:  Personal recovery in mental health services, encouraged by the World Health Organization, has gained significance in research and clinical settings. However, measuring personal recovery remains challenging due to the lack of universally accepted instruments. This study assessed Brief INSPIRE-O’s ability to map personal recovery by determining cut-off scores and its ability to detect change in the process of personal recovery.
Method:  Data was from the internet-based monitoring system (IMS) at the Mental Health Service, Capital Region of Denmark.  Between 2018 and 2020, 8,192 patients with baseline data on Brief INSPIRE-O were included to assess its role in measuring personal recovery. Additionally, for analyses focusing on Brief-INSPIRE-O as a measure of change in personal recovery, we included 2,714 patients with pre- and post-treatment data.
Materials:  Brief INSPIRE-O was examined along with well-being (WHO-5) and measures of symptom distress (SCL-10), and functioning (SDS-M).
Results:  Scores on all measures improved from pre- to post-treatment, except for functional impairment (SDS-M). Convergent validity was established with symptom distress (SCL-10; r = −0.63) and functioning (SDS-M; r = −0.55). A 10-point change in WHO-5 corresponded to an 18.9-point increase in Brief INSPIRE-O. ROC analysis identified an empirical cutoff of 50 for personal recovery and 8 points for clinically relevant change.
Discussion:  The Brief INSPIRE-O demonstrated strong validity and sensitivity to change, supporting its use as a reliable tool for assessing personal recovery and treatment quality in clinical practice. It can be considered a relevant brief patient reported outcome measure to be used in international standards of quality and outcome monitoring.

Other News /Resources

i) The August 2025 edition of the Newsletter from the Institute of Mental Health, Nottingham, carries an invitation from researchers to participate in the ‘Evaluating Positive Changes in Psychosis’ (EPOCH) study.  The invitation reads as follows:

Researchers at the Institute invite you to take part in the EPOCH study. The Evaluating Positive Changes in Psychosis (EPOCH) study aims to develop a new digital intervention to support post-traumatic growth in people with lived experience of psychosis. There are three participant groups, including:

Mental health clinicians – are you a mental health clinician with experience of working with people with psychosis? Could you attend a brief focus group and offer valuable feedback to researchers? View the EPOCH Clinician Focus Group participant information sheet.

People with lived experience of psychosis – are you 18+ and living in England? Would you like to join a two-hour focus group and share your thoughts on a new digital intervention? You’ll be reimbursed for your time.  View the EPOCH Lived Experience Focus Group participant information sheet.

NHS peer support workers – do you have experience of working alongside people living with psychosis? Could you attend a one-day workshop to help develop training resources? You’ll be reimbursed for your time.

View the EPOCH Peer Support Worker Workshop participant information sheet.

If you know someone who may be interested, please share these links with your network, colleagues, and friends. If you have any questions, email Dr Fiona Ng. 

Readers who are interested in signing up to the Institute’s Newsletters may do so here

ii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

September 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus, and what needs to be provided for people suffering from Long Covid.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The 25^th WPA World Congress of Psychiatry is scheduled for:
Date:  5^th – 8^th October 2025
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The Role of Psychiatry in the Changing World
A comprehensive and detailed range of information is available here.

Papers and Publications 
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Nielsen, K.M., Nordgaard, J. & Henriksen, M.G. (2025) Fundamental issues in epistemic injustice in healthcare. Medicine, Health Care and Philosophy, 28, 291–301
https://doi.org/10.1007/s11019-025-10259-6

Abstract
The research field of epistemic justice in healthcare has gained traction in the last decade. However, the importation of Miranda Fricker’s original philosophical framework to medicine raises several interrelated issues that have largely escaped attention. Instead of pushing forward, crafting new concepts or exploring other medical conditions, we suggest that it is time to take stock, reconsider, and articulate some fundamental issues that confront the field of epistemic injustice in healthcare.  This paper articulates such fundamental issues, which we divide into scientific, conceptual, and theoretical issues. Scientifically, the research field is confronted by a lack of empirical evidence. It relies on cases, making generalizations impossible and the field vulnerable to bias. Conceptually, many of the claims advanced in the literature are presented as facts but are merely hypotheses to be tested. Moreover, a criterion for applying the concept of testimonial injustice in medicine is lacking, impeding the development of a construct to empirically measure said injustices. Theoretically, many of the cases discussed in the literature do not prima facie qualify as cases of testimonial injustice, since they lack necessary components of testimonial injustice in Fricker’s framework, i.e., being unintentional and caused by identity prejudices in the hearers. If epistemic injustice is as pervasive as it is claimed in this literature, it should be of concern to us all. Addressing the issues raised here may strengthen the conceptualization of epistemic injustice in healthcare and lead to development of constructs that finally can explore its empirical basis.

ii) Fox, J., Ramon, S. & Hamaizia, R (2025) The process of deinstitutionalization from within an institution: Evaluating innovations in a closed ward for women with (borderline) personality disorder.  Socialno Delo, 64(1-2), 45-70.

Abstract
Although UK Mental Health services have been de-institutionalised since the end of the 20th century, women with (borderline) personality disorder are often admitted compulsorily to closed psychiatric wards due to high level of self-harm. The paper focuses on the evaluation of introducing innovative intervention methods, alongside dialectical behaviour therapy, in the Daffodil ward which promoted the agency and self-responsibility of service users in managing their mental health. The evaluation reported in the article includes individualised photovoice followed by interviews of the inpatients, and in parallel receiving providers’ reports about every three months. The photovoice method enabled service users to take photos representing their experiences on the ward; this provided a basis for interview content. The new interventions promoted the recovery and empowerment of service users and utilised the transformative role of peer support and experts by experience in improving ward culture. The interim findings highlight how the impact of an effective culture of experts by experience involvement and the introduction of a new service model can provide a context for deinstitutionalisation from within an institution, providing a template for future hospital service delivery.

iii)  Todowede, O., Rennick-Egglestone, S. & Boyde, D. et al. (2025) How can citizen science enhance mental health research quality: theory of change development. BMJ Open, 15:e091007. 
https://doi.org/10.1136/bmjopen-2024-091007

Abstract
Objective:  Public involvement in mental health research enhances research quality. The use of citizen science methods in mental health research has been described as a conclusion of a movement towards increased public involvement; however, this field is in its early stages of development. Our objective was to create a theory of change (ToC) for how citizen science can be used to enhance mental health research quality.
Design:  Iterative consultation with the stakeholders of an existing citizen mental health science study, that is, change for citizen science to achieve co-production at scale (C-STACS: https://www.researchintorecovery.com/research/c-stacs/)
Methods:  We co-developed a ToC through an iterative consultation with C-STACS stakeholders who were (a) representatives of mental health community organisations (n=10), individuals with public involvement experience (n=2) and researchers (n=5). In keeping with established ToC practice, entities were identified, including long-term impacts, outcomes needed to create an impact, stakeholder assumptions and indicators for tracking progress.
Results:  A desired primary long-term impact of greater co-production of research was identified between researchers and members of the public, which would create a secondary impact of enhancing public capacity to engage in citizen mental health science. We proposed long-term outcomes needed to enable this impact: (1) greater co-production of research objectives and pathways between researcher and the public, (2) greater embedment of citizen mental health science into funder processes (eg, the creation of specific funding calls for citizen mental health science proposals, (3) greater clarity on the boundaries between citizen science and other participatory approaches (eg, so that there is not loss of impact due to conceptual confusion between these, (4) increased knowledge around effective frameworks to enable mass public participation and (5) greater availability of technology platforms, enabling safe and accessible engagement with citizen mental health science projects.
Conclusion:  The proposed ToC is grounded in the C-STACS project, but intended to be broadly applicable. It allows the continued formation of a community of practice around citizen mental health science and should be reviewed, as greater knowledge is developed on how citizen mental health science creates change.

iv)  Kotera, Y., Newby, C. & Kuzman, M. R. et al (2025) Cultural impacts on shared decision-making: A cross-European study of psychiatrist preferences in 38 countries.  European Psychiatry, 68(1), e108, 1–7.
https://doi.org/10.1192/j.eurpsy.2025.10082

Abstract
Background:  Shared decision-making (SDM) is a collaborative process between clinicians and service users to select treatment, guided by evidence and service user preferences. SDM has clinical, economic, and ethical benefits compared to clinician-led decision-making; yet, implementation remains challenging. An important knowledge gap is the influence of culture on implementation. Cultural impacts on service user decision-making preferences have been documented, but little is known about how culture impacts clinician preferences. This study examined associations between country-level cultural characteristics and decision-making preferences of psychiatrists in routine care settings across Europe. 
Methods:  We analysed data from 751 psychiatrists and trainees in 38 European countries, who completed the Clinical Decision-Making Style–Staff (CDMS-S) scale. Country-level Hofstede cultural dimensions were linked to CDMS-S scores using univariate and multivariate regression models. Mixed-effects models were used to account for country-level clustering and controlling for professional and economic variables. 
Results:  In univariate analyses, all six dimensions were associated with SDM preferences.  However, only three remained significant in mixed-effects models. Higher levels of Indulgence and Individualism were associated with stronger preferences for SDM, while higher Power Distance was associated with more clinician-led decision-making. These associations did not remain significant in fully adjusted multivariate models, suggesting professional and systematic factors mediate cultural influences.
Conclusions:  Indulgence, Individualism, and Power Distance are associated with psychiatrists’ decision-making preferences across Europe. Culturally sensitive SDM interventions should address not only clinician attitudes but also healthcare structures and patient expectations. Findings offer an empirical foundation for tailoring SDM training and policy to diverse cultural contexts within European psychiatry.

Abstract
Background:  Personal narratives describing recovery from mental health problems are widely available to the public. We developed theory on the characteristics and impact of recovery narratives, developed curation procedures for the NEON Collection of 659 recovery narratives and developed and evaluated the NEON Intervention, a theory-informed web application providing access to the NEON Collection.
Objectives:  To evaluate the effectiveness and cost-effectiveness of the NEON Intervention as compared to usual care and whether this varies by prior health service usage.
Design:  Three pragmatic parallel-group randomised controlled trials of the NEON Intervention. Intervention arm participants received immediate access. Control arm participants received access after a 52-week follow-up. The effectiveness analysis was a linear regression model of outcome at 52 weeks. The cost-effectiveness analysis compared the incremental cost-effectiveness ratio to the £20,000–30,000 threshold defined in the National Institute for Health and Care Excellence reference case. All analyses were intention-to-treat and baseline-adjusted, with multiple imputation for missing data.
Setting:  England.
Participants:  All trials recruited people who were aged 18+ years, resident in England, capable of accessing or being supported to access the internet, able to understand written and spoken English and capable of providing online informed consent. NEON Trial participants also had experience of mental health-related distress in the last 6 months, and psychosis in the previous 5 years. NEON-O (i.e. non-psychosis) Trial participants also had experience of mental health-related distress in the last 6 months, but with no psychosis in the previous 5 years. People identifying as informal carers for people affected by mental health problems but not eligible for the NEON Trial or NEON-O Trial were recruited to the NEON-C feasibility trial. All inclusion criteria were self-rated. Recruitment was from March 2020 to March 2021, through public communications by the central study team, and the work of clinical support officers at 11 secondary care research sites.
Interventions:  The NEON Intervention has four narrative access mechanisms: theory-informed algorithmic recommendation, random selection, self-selection by narrative category and return to impactful narratives. Participants used the NEON Intervention as much as they wished.
Main outcome measures:  Primary outcome: quality of life (Manchester Short Assessment). Secondary outcomes: distress, hope, self-efficacy, meaning in life and health status.
Results:  For the NEON-O (i.e. non-psychosis) Trial, we found a significant baseline-adjusted difference of 0.13 (95% confidence interval 0.01 to 0.26, p = 0.041) in the Manchester Short Assessment score between intervention and control, and a significant baseline-adjusted difference of 0.22 (95% confidence interval 0.05 to 0.40, p = 0.014) in the presence subscale of the Meaning in Life Questionnaire. The incremental cost-effectiveness ratio was £12,526 per quality-adjusted life-year, lower than a threshold of £30,000 per quality-adjusted life-year used for health service commissioning in England. For participants who had used specialist mental health services at baseline, the intervention appeared to reduce cost, although confidence intervals were wide and results were not statistically significant (–£98, 95% credible interval –£606 to £309). It also improved quality-adjusted life-years (0.0165, 95% credible interval 0.0057 to 0.0273) per participant. Hence, for this subgroup of participants, it dominated usual care.
For the NEON Trial, no significant baseline-adjusted differences in outcome were found. An incremental cost-effectiveness ratio of £110,501 was found for the NEON Intervention. A subgroup analysis provided preliminary evidence for greater cost-effectiveness for current mental health service users, with an incremental cost-effectiveness ratio of £35,013. The NEON-C Trial showed acceptability and feasibility for informal carers. It recommended integration of carer narratives and creation of an online carer community.
Limitations:  Participants were recruited during a period in which movement and social interaction were widely affected by the COVID-19 pandemic, with the potential to influence generalisability. For the NEON-O Trial, we had an unrepresentative proportion of female-gendered participants (79.3%). Therefore, our NEON-O Trial findings cannot be generalised.
Conclusions:  This research programme has shown promising findings from the testing of the NEON Intervention. There is further research to do before implementation can be suggested.
Future work:  The NEON Intervention should be evaluated through a randomised controlled trial with people experiencing psychosis and using mental health services. The NEON Intervention should be refined to suit the needs of carers and then evaluated through a randomised controlled trial. The NEON-O Trial should be repeated with narrower mental health populations (e.g. mood disorders, eating disorders) to refine knowledge on effectiveness and cost-effectiveness. This may include refining the narrative collection used with these populations. If the NEON Intervention is implemented on a larger scale for people with non-psychosis mental health problems, then studies should be conducted to monitor benefits, continuously assess safety and documentation implementation processes. Future studies should consider alternative forms for presenting recovery narratives, including through multilanguage or multiculture support, and addressing digital exclusion by providing access through widely available technologies, such as smartphones and text messaging. Longitudinal designs are needed to document the short-term, medium-term and long-term impacts of recovery narratives.

vi)  Kotera, Y., Jebara, T. & Lawrence, V. et al (2025)  Enhancing cross-cultural applicability in recovery colleges: A global Delphi study protocol. PLoS One, 20(9): e0332729.
https://doi.org/10.1371/journal.pone.0332729

Abstract
Background:  Recovery Colleges (RCs) offer an innovative model of mental health support that blends co-production with adult learning to promote personal recovery and social inclusion. While evidence supports their effectiveness, most RC research and practice have been developed in Western contexts, raising concerns about cross-cultural applicability. The RECOLLECT Change Model (RCM) and RECOLLECT Fidelity Measure (RFM) were developed in England to characterise RC mechanisms and assess fidelity. Our previous studies have identified cultural influences on the RC operational model, however how to address these influences remains unknown. Given the increasing global interest in RCs, the aims of this study are to (a) identify the level of cultural influence on the RCM mechanisms and RFM items, and (b) provide recommendations to inform cross-cultural applicability of RCM and RFM.
Methods:  This global Delphi study follows Belton’s six-step methodology and uses a decentring approach to cross-cultural research that seeks to extend the relevance of tools developed in a single culture to multiple cultural contexts. Experts will be recruited via the RECOLLECT International Research Consortium, covering 31 countries across six continents. We aim to recruit approximately 100 panellists with at least three years’ RC experience. Data collection will occur via Microsoft Forms across iterative Delphi rounds. Panellists will rate the importance and cultural difficulty of RCM and RFM items, provide feedback on culturally aligned response types, and suggest revisions for improved cultural fit. Quantitative data will be analysed using non-parametric statistics and a collapsed three-point Likert scale to address cross-cultural response bias. Qualitative responses will be analysed using descriptive content analysis informed by Hofstede’s cultural dimension theory. Member checking will be conducted after the final round to enhance trustworthiness.
Discussion:  This study will identify which RCM and RFM components are cross-culturally applicable and which require adjustment, contributing to the balance between fidelity and fit in mental health approaches. By developing culturally informed recommendations, this study aims to expand the accessibility and relevance of RC frameworks across diverse settings. Findings will benefit RC practitioners, researchers, and policymakers seeking to improve service delivery and recovery outcomes in culturally meaningful ways.

vii)  Ng, F., Jordan, G. & Lewandowski, F. et al (2025)  A bioecological approach to conceptualising posttraumatic growth in psychosis. Psychosis, 17(3), 314-320.
https://doi.org/10.1080/17522439.2024.2360964

Abstract
Background: Posttraumatic growth (PTG) refers to positive psychological changes arising from adversity. PTG in psychosis is an emerging area of focus, however the individualistic conceptualisation of PTG has been questioned. We extend these debates to consider environmental influences on PTG in psychosis.
Methods: In this paper, we outline the application of Bronfenbrenner’s Bioecological Model to PTG in psychosis. 
Results: The Bioecological Model comprises six ecological systems; 1) biophysical (individual characteristics), 2) microsystem (immediate environment), 3) mesosystem (system interactions), 4) exosystem (impact on individual despite minimal participation), 5) macrosystem (cultural/societal influences), and 6) chronosystem (time).
Discussion: PTG in psychosis research has predominately focused on the biophysical ecosystem. We argue that extending PTG research to address the other systems will be advantageous, providing an ecologically valid conceptualisation of PTG and the development of a causal model of PTG in psychosis. Implications for future research are discussed.

viii)  Beckers, T. & Koopmans, M. (2025) Recovery colleges as enablers of personal recovery: qualitative evaluation of the development of a recovery college in the Netherlands. BMC Psychiatry, 25, 465
https://doi.org/10.1186/s12888-025-06917-x

Abstract
Background:  In the Netherlands, maintaining high standards of mental healthcare faces challenges due to an increasing demand for mental healthcare and a focus on symptomatic recovery rather than personal growth and improvement in the quality of life. Recovery colleges, which emphasize personal recovery through hope, autonomy, and empowerment, offer a transformative approach by fostering an environment where individuals with mental distress can learn and thrive. The aim of this study was to explore the experiences of students and relevant stakeholders (like family members or regional social workers) with the recovery college.
Methods:  This study evaluated the experiences of students working on their personal recovery at the Recovery College Venlo, by utilizing qualitative methods including focus group interviews, personal interviews and thematic analyses.
Results:  The participants reported benefits such as enhanced personal growth and a reduction in self-stigma and reliance on traditional mental health services. Peer workers with lived experience were reported to play a pivotal role in facilitating recovery. Although recovery colleges show promise in supporting personal recovery and providing costeffective
alternatives to conventional mental health services, challenges remain in increasing awareness, accessibility, and family involvement. Further research is needed to optimize the implementation of recovery colleges and fully understand their effectiveness.
Conclusions:  The study underscores the importance of co-creation in the development of recovery-oriented services, and highlights areas for improvement, including enhanced family support and more streamlined access for potential students

ix)  Pasere, E., O’Hara, D. & Ballard, E. (2025) A narrative review of medical and surgical nurses’ attitudes and perceptions when caring for patients with a secondary diagnosis of mental illness.  Nurse Education Today, 151, 106684.
https://doi.org/10.1016/j.nedt.2025.106684

Abstract
Background:  Medical and surgical nurses are responsible for prioritising patient-centred and holistic care. It is necessary for nurses to possess the relevant knowledge and interpersonal skills to deliver culturally responsive, compassionate, safe, and effective care to patients who have comorbidities inclusive of mental health conditions. It is important to acknowledge reported experiences of mistreatment, and discrimination from patients with a secondary diagnosis of mental illness (SDMI). To counter poor nursing practice and disrupt discriminatory attitudes and perceptions of medical and surgical nurses it is necessary for nurse educators to embed anti-discriminatory and social justice pedagogy into pre-registration nurse education.
Aim:  This review seeks to explore and identify the attitudes and perceptions of medical and surgical nurses when caring for patients with a secondary diagnosis of mental illness.
Method:  This literature review used a systematised approach to retrieve evidence that assessed the attitudes and perceptions of nurses when caring for patients with a SDMI in medical and surgical ward environments. Five databases were searched (PubMed, Embase, Clinical Knowledge Network, Cochrane and PsycInfo) between 2011 and 2023. Thematic synthesis was conducted on studies that met the following inclusion criteria: a) nurses as research participants who have cared or currently care for patients with a SDMI, b) nurse’s attitudes, perceptions, feelings, and experiences, and c) surgical and medical inpatient units. Studies were excluded if they were: a) systematic reviews; b) reviews; c) literature not in English and d) grey literature.
Results:  8 peer reviewed articles were included. Nurses’ attitudes and perceptions were found to be stigmatising and discriminatory towards patients with a SDMI and negatively impacted their care. The themes from the retrieved evidence suggests that nurses commonly viewed patients with a SDMI as risky, unpredictable, fear inducing, and created feelings of futility and reduced professional satisfaction. Nurses felt unprepared when caring for this patient group. Several factors that negatively impacted nurses’ preparedness included their previous education in mental health, personal experience with mental health issues, and social demographic variables.
Conclusion:  Education reform in nursing is necessary to improve healthcare advocacy and safety for patients with a SDMI, cared for in medical and surgical nursing environments. This can only be achieved through a nursing workforce cognisant with human rights and social justice principles. Fair, just, and compassionate nursing responses to patient with a SDMI recognizes critical concepts of mental health recovery, hope and anti-discriminatory pedagogy in nurse education. Critical social justice approaches in curriculum provides nursing students with lessons to understand complex health issues, and national and global disparities in health that exist according to social, cultural, racial and political determinants of health and wellbeing. Recommendations to address these concepts include in-service mental health training focusing on clinical knowledge, clinical mentorship, anti-stigmatising training and simulation-based exercises based upon social justice principles in pre-registration nurse education curriculum.

x)  Dallinger, V. C., Krishnamoorthy, G. & du Plessis, C. et al. (2025) Conceptualisation of personal recovery and recovery-oriented care for youth: Multisystemic perspectives. International Journal of Mental Health and Addiction, 23, 1308–1332. https://doi.org/10.1007/s11469-023-01170-3

Abstract
There is a substantial body of evidence on the construct of personal recovery and the value of recovery-oriented mental health care worldwide. Personal recovery refers to the lived experience of those with mental illness overcoming challenges and living satisfying lives within the limitations of mental health symptomology. Conceptualisations such as CHIME have primarily relied on adult frameworks. With growing concerns about youth mental health, the present study aimed to understand the experiences of personal recovery and recovery-oriented care for youth. Given the multisystemic influences on youth development, the study analysed narratives from youth, caregivers, and mental health professionals.  The analysis revealed two developmentally unique recovery processes involving the restoration of capabilities and existing relationships (restorative processes) and the bolstering of protective influences and strengths (resilience processes). Deductive analysis identified alignment to the CHIME framework. Implications of the findings for recovery-oriented care for youth are discussed.

xi). Correll, C. U., Cortese, S. & Solmi, M. et al (2025) Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults. World Psychiatry, 24(3):296-318. 
https://doi.org/10.1002/wps.21338

Abstract
Improving meaningful outcomes is the main goal of clinical care for mental  disorders. Traditionally, the focus in clinical research and practice has been on outcome domains that refer to symptom severity or service use (e.g., hospitalization), relate to categorical diagnoses, and favour clinician-rated measures. More recently, self-rated and dimensional as well as transdiagnostic outcome domains have gained traction, and functioning, quality of life and well-being/life satisfaction, along with the construct of personal recovery, have become a stronger focus. These key multidimensional outcome domains need to be properly defined and assessed. Further, the concepts of “functional” and “personal” recovery need to be differentiated. “Functional recovery” is defined by observed functioning across the domains of self-care, social interactions, leisure time activities, and educational or vocational activities. “Personal recovery” involves the subjective sense of living a personally meaningful life, irrespective of whether symptoms continue, or ongoing/intermittent support is needed. Despite the multi-stakeholder relevance of these outcome domains, no comprehensive account of how to measure them is available. To fill this gap, we provide here an overview of the main tools to assess functioning, quality of life/well-being/life satisfaction, and personal recovery outcomes across mental disorders in adults, aiming to also identify additional needs that should be addressed. We identified tools that can be used in clinical and research practice to assess people with the following mental health conditions: anxiety disorders, bipolar disorder, dementias, eating disorders, major depressive disorder, obsessive-compulsive and related disorders, personality disorders, post-traumatic stress disorder, schizophrenia, and substance use disorders. Both transdiagnostic and disorder-specific measures are described. Suggested tools were selected keeping feasibility and scalability needs in mind. The incorporation of these measures in both research and clinical care will enrich patient assessment as well as treatment planning and evaluation, increasing the likelihood of enhanced outcomes in people living with mental disorders.

Other News /Resources 
i) The August 2025 edition of the Newsletter from the Institute of Mental Health, Nottingham, carries an invitation from researchers to participate in the ‘Evaluating Positive Changes in Psychosis’ (EPOCH) study.  The invitation reads as follows:

Researchers at the Institute invite you to take part in the EPOCH study. The Evaluating Positive Changes in Psychosis (EPOCH) study aims to develop a new digital intervention to support post-traumatic growth in people with lived experience of psychosis. There are three participant groups, including:

Mental health clinicians – are you a mental health clinician with experience of working with people with psychosis? Could you attend a brief focus group and offer valuable feedback to researchers? View the EPOCH Clinician Focus Group participant information sheet.

People with lived experience of psychosis – are you 18+ and living in England? Would you like to join a two-hour focus group and share your thoughts on a new digital intervention? You’ll be reimbursed for your time.  View the EPOCH Lived Experience Focus Group participant information sheet.

NHS peer support workers – do you have experience of working alongside people living with psychosis? Could you attend a one-day workshop to help develop training resources? You’ll be reimbursed for your time.

View the EPOCH Peer Support Worker Workshop participant information sheet.

If you know someone who may be interested, please share these links with your network, colleagues, and friends. If you have any questions, email Dr Fiona Ng. 

Readers who are interested in signing up to the Institute’s Newsletters may do so here

ii) An overview of the NEON trails (an example paper from the NEON trails is included in item v in the ‘papers and publications’ section of this issue of the RRN ebulletin) is provided in the Autumn 2025 edition of the McPin Foundation Newsletter.  Signing up to the Newsletter is free and is available here.  A link to an overview of the NEON trails by McPinn is available here.

iii)  Writing out of the Care Policy and Evaluation Centre at the London School of Economics and Political Science, Dr Michael Clark draws attention to the following NIHR-supported Mental Health Social Care (MHSC) Research Incubator initiative: 

Mental health social care is a vital part of good local mental health systems. It encompasses the roles and responsibilities of social workers, local authorities, and the community and voluntary sector. It is though, a sector that is under-developed in terms of its research capacity. Recognising this, the NIHR Academy committed to support an Incubator to help grow MHSC research. The Incubator is co-led by Dr. Michael Clark (LSE) and Prof. Catherine Robinson (University of Manchester). We have also received support from the NIHR 3 Schools’ Mental Health Programme. We have a growing community of people interested in MHSC who want to engage more with research – either just to understand it, to support projects, or even to develop their own research funding applications. We have already had notable successes with colleagues developing funded applications for Fellowship awards. As our network grows, we can support more people. Please sign up and join at the link at the following website to keep up to date with our exciting opportunities.
The NIHR-supported Mental Health Social Care (MHSC) Research Incubator

Thank you.

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

October 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus, and what needs to be provided for people suffering from Long Covid.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The European Psychiatric Association (EPA) will be hosting the 34th European Congress of Psychiatry on:
Date:  28-31 March 2026
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The 2026 Congress motto will be “Mental Health: Improving Care and Expanding Horizons”, emphasising the need to improve mental healthcare across all contexts and for every citizen living in Europe. “Expanding Horizons” underscores the importance of strengthening collaboration with allied professionals and including experts by experience and carers in the improvement of mental healthcare.

A comprehensive and detailed range of information is available here

Papers and Publications 
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Dubreucq, J., Franck, N. & Plasse, J. et al. (2025) Evaluation of a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France: stepped-wedge cluster randomised controlled trial protocol. BMC Psychiatry, 25, 982.
https://doi.org/10.1186/s12888-025-07253-w

Abstract
Background:  While recovery orientation is national policy in many countries, evidence remains limited for the effectiveness at a service level. This paper describes the protocol for implementing a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France. The aim is to evaluate whether REFOCUS-RETAFORM plus usual care leads to improved outcomes for adolescent and adult mental health service users compared with usual care alone.
Methods:  A two-step stepped wedge cluster randomised controlled trial will be conducted, with a nested qualitative sub-study exploring stakeholders’ views on changes in staff-user relationships and implementation influences. The REFOCUS-RETAFORM intervention is a training intervention for mental health staff, to develop recovery-promoting relationships and pro-recovery working practices. Clusters are services, which transition sequentially from control to intervention condition in a randomised order. Eight clusters are randomised to deliver REFOCUS-RETAFORM in year one and eight clusters in year two. Each cluster delivers REFOCUS-RETAFORM to two teams from their organisation (32 teams in total). Participants are a) service users aged 13–65 years attending services implementing REFOCUS-RETAFORM, and b) staff receiving the intervention. The primary outcome is the Questionnaire about the Process of Recovery. Secondary outcomes include perceived stigma and coercion, self-stigma and wellbeing for service users, and recovery-orientation for staff. Data will be collected from 540 service users (180 at baseline, 180 at month 12, 180 at month 24) and 220 staff. We will use multilevel mixed-effects models, adjusting for secular trends and thematic analysis for the qualitative interview data.
Discussion:  Findings will inform the continued transformation of French specialist mental health services toward a recovery orientation.

ii)  Slade, M., Todowede, O., Boyd, D. et al. (2025) Living with mental health issues: citizen science project on self-management strategies. npj Mental Health Research, 4:50, 1-9
https://doi.org/10.1038/s44184-025-00166-2

Abstract
People living with mental health issues use a range of self-management strategies. Most strategy recommendations have been developed by clinicians and researchers, so they may not reflect the full range of approaches used in practice. A citizen mental health science methodology can address this bias in strategy identification. We co-created a list of 77 pre-defined self-management strategies, and 1116 public contributors (n = 468 mental health service users, n = 497 lived experience not using services, n = 151 no lived experience) living in the United Kingdom completed an online survey identifying their use of each strategy, and identifying extra strategies. A wide range of pre-defined strategies were used by contributors, with differences in usage patterns identified between the three groups. 401 distinct extra strategies were identified. The active use of avoidance as a self-management strategy was more common than anticipated, including avoiding alcohol, social media, thinking about problems, other people, and mental health services.

iii)  Kotera, Y., Hara, A., Newby, C. et al. (2025) Development and evaluation of a mental health recovery priority measure for cross-cultural research: global INSPIRE. Social Psychiatry and Psychiatric Epidemiology, 60, 2695–2706
https://doi.org/10.1007/s00127-025-02946-9

Abstract
Purpose:  This study developed and evaluated a new personal recovery scale—Global INSPIRE—in English and Japanese, and compared responses between Japan and the UK. Personal recovery—living a satisfying and meaningful life despite mental health challenges—has gained attention in mental health. The widely-used CHIME framework identifies five recovery processes: Connectedness, Hope, Identity, Meaning, and Empowerment. Full INSPIRE evaluates whether service users feel supported in each CHIME process. However, emerging cross-cultural evidence indicates differences in the priority placed on each CHIME domain. No tool exists to assess recovery priorities, hindering cross-cultural research.
Methods:  The 20-item self-completed Global INSPIRE was adapted from the Full INSPIRE to assess recovery priorities of both service users and non-service users. Participants in the UK (n = 512) and Japan (n = 507) completed the Global INSPIRE at baseline and two-week follow-up. Psychometric properties were evaluated, including reliability, test-retest stability, and discriminant validity with two established recovery scales—CORE-10 and QPR-15. Cross-national differences in recovery priorities were also examined.
Results:  Both versions showed excellent reliability (α = 0.91 UK; 0.97 Japan), test-retest stability (4/5 processes UK, 5/5 Japan), and acceptable model fit (CFI = 0.80 UK; 0.85 Japan). Measurement invariance supported configural (CFI = 0.89) and metric invariance (CFI = 0.89) but not scalar invariance (CFI = 0.83). Discriminant validity was supported by weak correlations with CORE-10 and QPR-15. UK participants prioritised Hope, Meaning, and Empowerment, while Japanese participants prioritised Identity.
Conclusion:  Global INSPIRE is a reliable and culturally adaptable tool for assessing distinct recovery priorities. Future research should explore demographic differences and expand testing across diverse cultural contexts

iv)  Pan, D. (2025). Personal recovery and its key processes: Validating the connectedness, hope, identity, meaning, empowerment, and difficulties (CHIME-D) framework. Psychiatric Rehabilitation Journal. Advance online publication.
https://doi.org/10.1037/prj0000669

Abstract
Objective: This study aimed to comprehensively evaluate the connectedness, hope, identity, meaning, empowerment, and difficulties (CHIME-D) framework and its six core processes as predictors of personal recovery among individuals with psychiatric disabilities.
Methods:  A total of 339 adults with self-reported psychiatric disabilities were recruited from https://ResearchMatch.org and completed an online survey comprising validated measures of personal recovery and variables operationalizing the six CHIME-D processes. A hierarchical regression analysis was conducted to assess the individual contributions of each process and the overall predictive power of the CHIME-D framework for personal recovery. Results: The final regression model accounted for 69% of the variance in personal recovery. Each CHIME-D process contributed a statistically significant portion of the variance. In the final model, all variables except community integration remained significant predictors of personal recovery.
Conclusions and Implications for Practice:  Findings support the CHIME-D framework as a robust, evidence-based guiding framework for recovery-oriented care. Each CHIME-D process represents a potential target for interventions aimed at promoting personal recovery. Psychiatric rehabilitation professionals are encouraged to attend to all six processes when working with individuals with psychiatric disabilities to enhance recovery outcomes.

v)  Best, D., Duffy, S. & Smith, D. (2025) An “outside in” model of recovery capital growth: building personal and social recovery capital from community resources, Addiction Research & Theory. Online:
https://doi.org/10.1080/16066359.2025.2523825

Abstract
Recovery capital has been defined as the breadth and depth of internal and external resources available to individuals to support their recovery journey. It is seen as a strengths-based approach consisting of dynamic growth across three domains – personal, social and community – that has provided a model for the quantification of recovery growth. In this paper we advance, first, a theory of recovery growth as ‘outside-in’ based on a social ecological approach where access to community resources creates a cascade for building personal and social capital. Second, we argue that this cascade is going to be particularly important for individuals with low (or negative) levels of baseline personal/family and social capital and high levels of problem severity, complexity and chronicity. Third, we illustrate this conceptual framework for how this happens, using the example of Inclusive Recovery Cities to demonstrate not only how this approach can create the conditions for individuals to grow their recovery capital but that this in turn contributes to overall community wellbeing through creating a model of ‘reciprocal altruism’ and building collective efficacy across communities and diverse cultural contexts. The paper concludes with suggestions for how this model can be adequately tested and what it might contribute to a socioecological approach.

vi)  Ahuvia, I. L., & Link, B. G. (2025). The mental illness self-labelling model: A conceptual model for studying the effects of mental-illness self-labelling on clinical outcomes. Clinical Psychological Science, 0(0).
https://doi.org/10.1177/21677026251338829

Abstract
Self-labelling with a mental illness, for example, deciding that one “has depression,” has the potential to affect clinical outcomes through multiple cognitive and behavioural pathways. Despite such possibilities, little empirical research has examined these pathways. We propose a conceptual model, which we call the “Mental Illness Self-Labelling Model,” that can be used to study the clinical consequences of mental-illness self-labelling. We begin by reviewing existing literature on self-labelling, including sociological research on modified labelling theory, and how it can be leveraged to support the conceptual approach we propose. We then outline the proposed model, articulating how self-labelling can cause beliefs about mental illnesses to be internalized and how subsequent changes in psychological mediators (e.g., perceived control, self-blame, and others) can have downstream effects on clinical outcomes. Our model provides a conceptual framework and methodological tool kit for researchers interested in investigating the clinical consequences of mental-illness self-labelling.

vii)  Eddington, K. M., & Badillo-Winard, E. (2025). Mental illness identity: A scoping review. Identity, 25(3), 412–427. 
https://doi.org/10.1080/15283488.2024.2379412

Abstract
Mental illness identity (MII) is the extent to which a mental illness is integrated into a person’s self-concept. MII plays an important role in help-seeking and health outcomes, but findings have been mixed. The primary aims of this scoping review were to examine the breadth and depth of research on MII and synthesize this disparate literature. A literature search (PsychInfo, PubMed) using “disability identity,” “illness identity,” “health identity,” and “mental illness identity” identified studies (assessed by two reviewers) reporting data on adults with mental health concerns aiming to understand the nature or function of identity in relation to mental illness conditions. The 22 studies varied in their populations, theoretical underpinnings, and identity assessment methods (13 quantitative, 8 qualitative, and 1 that included both). Quantitative measures varied, some using adapted or standard questionnaires and others using items that had not been psychometrically tested. There was some racial, ethnic, and gender diversity, but less than half of all studies reported these characteristics. MII is dynamic and has been defined primarily in terms of acceptance/rejection or centrality/salience of the condition. Future research should focus on multidimensional measurement development, consideration of positive and negative components, the dynamic nature of identity, moderators, and intersectionality.

viii)  Kidd, I. J., Spencer, L. & Carel, H. (2025) Epistemic injustice in psychiatric research and practice. Philosophical Psychology, 38(2), 503–531.
https://doi.org/10.1080/09515089.2022.2156333

Abstract
This paper offers an overview of the philosophical work on epistemic injustices as it relates to psychiatry. After describing the development of epistemic injustice studies, we survey the existing literature on its application to psychiatry. We describe how the concept of epistemic injustice has been taken up into a range of debates in philosophy of psychiatry, including the nature of psychiatric conditions, psychiatric practices and research, and ameliorative projects. The final section of the paper indicates future directions for philosophical research of epistemic injustices and psychiatry, concerning neurocognitive disorders, identity prejudices in psychiatric illness, concepts of epistemic privilege in psychiatry, and the prospects for combining phenomenological psychopathology and epistemic justice. We argue that much remains to be done in the conceptualization of these epistemic injustices and suggest that this future work should be multidisciplinary in character and sensitive to the phenomenology of psychiatric condition

ix)  Faissner, M., Braun, E. & Hempeler, C. (2025) Epistemic oppression and the concept of coercion in psychiatry. Synthese, 205(24). Online:
https://doi.org/10.1007/s11229-024-04853-z

Abstract
Coercion is still highly prevalent in contemporary psychiatry. Qualitative research indicates, however, that patients and psychiatric staff have different understandings of what they mean by ‘coercion’. Psychiatric staff primarily employ the concept as referring to instances of formal coercion regulated by law, such as involuntary hospital admission or treatment. Patients, on the other hand, use a broader concept, which also understands many instances of informal psychological pressure as coercive. We point out that the predominance of a narrow concept of coercion in psychiatry can have negative consequences for patients, and argue that this difference in how the concept ‘coercion’ is used is both grounded in epistemic oppression and reinforces such oppression. Epistemic oppression, as defined by Dotson, refers to the persistent epistemic exclusion of members of marginalized groups from participation in practices of knowledge production. We first demonstrate how patients may experience inferential inertia when communicating their experiences of coercion. We then show that the resulting predominance of a narrow concept of coercion in psychiatry can be described as a case of hermeneutical injustice in a context shaped by institutional hermeneutical ignorance. We argue for a change in institutional practices in psychiatry that allows for the adequate consideration of patients’ perspectives on coercion

x)  Lynch, L., Moorhead, A., & Long, M. et al. (2025) “I felt like there was something wrong in my brain”: Growing up with trauma – how young people conceptualise, self-manage and seek help for mental health problems. Journal of Child & Adolescent Trauma, 18, 103–125.
https://doi.org/10.1007/s40653-024-00650-5

Abstract
Background:  Youth mental health is an important global healthcare topic and early interventions that are timely and evidence-based to support young people can increase quality of life and lower deaths by suicide. Research exploring young people’s mental health experiences and how they manage can further understanding into help-seeking processes.
Objective:  This study aimed to explore young people’s experiences of living with and managing mental health problems and how this impacts professional help-seeking.
Methods:  Eighteen young people were recruited, aged 16–25 years, with experiences of help-seeking to services for mental health problems (N = 18). Data were analysed using Constructivist Grounded Theory methods (Charmaz, Constructing grounded theory, 2014).
Findings:  The findings were presented across three sub-categories: (1) “Early experiences”; (2) “Conceptualising mental health” and (3) “Managing mental health”. Findings expand understanding on the resource pressures that young people experience whilst managing persistent mental distress emanating from early experiences of trauma, life stressors, and developmental tasks. Findings also report lived experiences of pain, loneliness and stigma, and how individual conceptualisations of mental health are informed. The preference for self-reliance can be rooted in developmental needs or learned behaviours and how this impacts self-management and help seeking is discussed.
Conclusion:  Through an enhanced understanding about how young people experience mental distress, developmental pressure points, marginalisation and stigma, mental health providers can prioritise individualised approaches to healthcare that can both respect a young person’s individual conceptualizations and positively leverage self-management strategies, which can contribute positively to young people’s development, quality of life, and healthcare outcomes.

Other News /Resources

i) Writing out of the University of Nottingham, Prof. Mike Slade draws attention to a new online resource from the Schizophrenia Society of Canada.  Information from the website explains that Your personal Recovery Journey is a six-module program based on the CHIME
framework for personal recovery (Leamy et al 2011) including:

• Connectedness
• Hope and optimism
• Identity
• Meaning
• Empowerment 

Your Personal Recovery Journey is for people living with signs and symptoms of a mental illness or a mental health problem that affects their lives. It is for people who may or may not have a specific diagnosis.  The program offers participants opportunities to explore their own recovery paths.  Participants will: 

• Learn about recovery and about five processes that are important in life and in recovery (connections, hope and optimism, identity, meaning, and empowerment).
• Hear lived experience stories and ideas about the module topics through videos and discussions.
• Reflect on (i.e. think deeply or carefully about) and discuss thoughts that they have about their experiences (if they choose to share).
• Develop their own personal recovery strengths and discover ways that they can take what they learn and use it in their lives.

 For more details on this innovative programme, please see here.

ii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

November 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus, and what needs to be provided for people suffering from Long Covid.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers

i) The European Psychiatric Association (EPA) will be hosting the 34th European Congress of Psychiatry on:
Date:  28-31 March 2026
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The 2026 Congress motto will be “Mental Health: Improving Care and Expanding Horizons”, emphasising the need to improve mental healthcare across all contexts and for every citizen living in Europe. “Expanding Horizons” underscores the importance of strengthening collaboration with allied professionals and including experts by experience and carers in the improvement of mental healthcare.

A comprehensive and detailed range of information is available here

Papers and Publications 
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Griffiths, C. & Jiang, H. (2025) “Hospital at Home” Mental Health Psychiatric Hospital Return to the Community Transition Support: Impact on Self-Reported Wellbeing. Psychology, 16(11), 1283-1297.
https://doi.org/10.4236/psych.2025.1611073

Abstract
Background: People who are discharged from mental health psychiatric hospitals often have low average levels of wellbeing and require support to improve wellbeing, enable mental health recovery, and facilitate successful transition back into the community to prevent mental health crisis and readmission. Low levels of wellbeing are linked to worse mental health symptoms, anxiety, and depression.
Intervention: Hospital at Home is a two-week intervention that provides at-home support for people who are discharged from a mental health hospital or who are at risk of a mental health crisis and hospital admission. It is a trauma-informed, behaviour-change, and strengths-based approach; staff provide individualised practical and emotional support, identifying needs and goals to help individuals stabilise, build confidence, develop and apply coping strategies, recover, self-manage, connect with community-based services and resources, and reconnect with previous social contacts and activities.
Purpose/aim: This study investigated the impact of Hospital at Home on wellbeing. The study addressed the question: “What is the impact of Hospital at Home transition support on self-reported psychological wellbeing?”
Methods: An open-label patient cohort design with no control group was used. Pre- and post-intervention assessments were conducted using the self-report measure, the Short Warwick–Edinburgh Mental WellBeing Scale (WEMWBS). Participants were 102 Hospital at Home clients, 28 (27.5%) males and 74 (72.5%) females. The average age of the participants was 50.1 years (range 25 to 95 years; SD = 14.8).
Results: Prior to the start of participation in Hospital at Home, 89% of participants reported low wellbeing, with only 11% reporting in the normal range of wellbeing. At the end of participation in Hospital at Home, 54% reported in the normal range of wellbeing and 2% in the high range of wellbeing. SWEMWBS scores significantly improved by 5.52 points (SD = 4.05) with a very large effect size (Cohen’s d = −1.36). SWEMWBS scores significantly improved in participants with a primary diagnosis of anxiety by 5.44 points (SD = 4.14) with a very large effect size (Cohen’s d = −1.31). SWEMWBS scores significantly improved in participants with a primary diagnosis of depression by 5.28 points (SD = 3.76) with a very large effect size (Cohen’s d = −1.40). SWEMWBS scores significantly improved in participants with a primary diagnosis of schizophrenia by 6.60 points (SD = 3.79) with a very large effect size (Cohen’s d = −1.74).
Conclusion: Hospital at Home was found to be beneficial in terms of improving wellbeing, which is linked to improvements in mental health. The SWEMWBS results indicate improvements in optimism, self-efficacy, calmness, coping, clarity of thinking, closer connections with others, and personal agency, which can enhance a successful return to the community, mental health recovery, and reduce the risk of relapse and readmission. Hospital at Home is relatively low-cost and can be offered by all mental health providers. Further research is justified to support roll-out.

Even though the following article does not mention the concept of recovery, the RRN ebulletin editors have included the following international paper.  The article prompted reflection upon how and in what ways the CHIME framework (for example) may be represented within prison populations.  This is not to say that the topic has not been addressed previously, but simply to revisit it.

ii)  Emilian, C., Al-Juffali, N. & Fazel, S. (2025) Prevalence of severe mental illness among people in prison across 43 countries: a systematic review and meta-analysis. Lancet Public Health, 10: e97–110.
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00280-9/fulltext

Abstract
Background:  Prison populations have been increasing worldwide. Previous studies suggest that there is a high burden of psychiatric morbidity in people in prison, but, to our knowledge, the last published meta-analysis of prevalence is more than a decade old. We aimed to describe the pooled prevalence of depression, psychosis, bipolar disorder, and schizophrenia spectrum disorders for people who are incarcerated.
Methods:  In this updated systematic review and meta-analysis, we searched six databases and grey literature published from database inception until Aug 8, 2024, with no language or geographical restrictions. We included primary quantitative studies that reported the prevalence of depression and psychotic disorders in the unselected prison population, based their diagnoses on clinical examination or from interviews and by the use of validated diagnostic instruments, met standardised criteria of the ICD or the Diagnostic and Statistical Manual of Mental Disorders for the diagnoses, and provided pooled prevalences for psychosis in the previous 6 months and clinical depression in the previous 2 weeks to 1 month. We excluded studies that used selected samples or were only qualitative. We investigated bipolar and schizophrenia spectrum disorders as separate diagnostic subcategories. We synthesised studies using random-effects meta-analysis and explored heterogeneity with meta-regression and subgroup analyses. The protocol is registered with PROSPERO, CRD42022378568.
Findings:  We identified 131 publications reporting the prevalence of mental illness in 58 838 people in prison in 43 countries. We estimated that the prevalence of depression was 12·8% (95% CI 11·1–14·6) and for any psychosis was 4·1% (3·6–4·7). For diagnostic subcategories, we found that the prevalence of bipolar disorder was 1·7% (1·0–2·6) and schizophrenia spectrum disorders was 3·6% (1·3–7·1). Between-study heterogeneity was substantial for these estimates (I² 69–97%) with few explanations. However, subgroup analyses revealed that people in prison in lowincome and middle-income countries had higher prevalences for depression (16·7% [95% CI 13·6–20·0]) than in high-income countries (10·8% [9·0–13·0]), and that, for people with psychosis who are incarcerated, psychiatrists were less likely to diagnose (3·5% [2·8–4·3]) than were non-psychiatrists (4·7% [3·9–5·5]).
Interpretation:  Our study indicates that the prevalence of severe mental illness in people who are incarcerated worldwide is considerable. Meeting the treatment needs of people in prison who have mental ill health remains an ongoing challenge for public mental health. More evidence on how to improve the assessment, treatment, and linkage to services on release, which will require more research-friendly prison services, is now needed.

iii)  Kotera, Y., Ronaldson, A., Hayes, D. et al. (2025) Cross-cultural insights from two global mental health studies: Self-enhancement and ingroup biases. International Journal of Mental Health Addiction, 23, 3572–3581.
https://doi.org/10.1007/s11469-024-01307-y

Abstract
This commentary highlights two cross-cultural issues identified from our global mental health (GMH) research, RECOLLECT (Recovery Colleges Characterisation and Testing) 2: selfenhancement and ingroup biases. Self-enhancement is a tendency to maintain and express unrealistically positive self-views. Ingroup biases are differences in one’s evaluation of others belonging to the same social group. These biases are discussed in the context of GMH research using self-report measures across cultures. GMH, a field evolving since its Lancet series introduction in 2007, aims to advance mental health equity and human rights. Despite a 16.5-fold increase in annual GMH studies from 2007 to 2016, cross-cultural understanding remains underdeveloped. We discuss the impact of individualism versus collectivism on self-enhancement and ingroup biases. GMH research using concepts, outcomes, and methods aligned with individualism may give advantages to people and services oriented to individualism. GMH research needs to address these biases arising from cross-cultural differences to achieve its aim.

iv)  Dino, M., Koga, G. & Yokoji, A. et al. (2025) How researchers refer to individuals with schizophrenia: Person-first and identity-first language in academic papers. Schizophrenia, 11(146).
https://doi.org/10.1038/s41537-025-00692-0

 Abstract

Stigma associated with schizophrenia has been well-documented in both society and healthcare settings. However, the use of stigmatizing language in research papers remains largely unexplored. This study examined how researchers refer to schizophrenia in peer-reviewed articles, aiming to characterize the descriptive terms used to refer to individuals with schizophrenia and assess the adoption of person-first language. We conducted an electronic search on PubMed using the MeSH term “schizophrenia” and randomly selected 500 articles. Descriptive terminology was categorized as neutral (e.g., “schizophrenia patients”), person-first (e.g., “person with schizophrenia”), or identity-first (e.g., “schizophrenic patient”). Reference terms were assessed based on their alignment with a person-first perspective. Of the 500 studies, 475 (95%) included at least one term referring to people affected by schizophrenia. Among them, 238 (50.1%) used identity-first terms, 228 (48%) used person-first terms, and 91 (18.2%) employed both. Over time, the use of identity-first terms decreased. The decline in identity-first terms over time suggests a positive impact of the person-first movement. Despite these encouraging findings, our data also indicate that there is still room for improvement in reducing the use of identity-first terms. We propose recommendations for researchers to promote less stigmatizing language.

v)  Crestois, N., Kempton, M. J. & Twumasi, R. (2025) A systematic review and meta-analysis of employer discrimination towards people living with psychosis.  Schizophrenia Research, 278, 35–46.

Abstract
Background: Employment discrimination against people living with psychosis is well established, with implications for their quality of life. However, a meta-analysis of studies exploring this link has not yet been conducted. This systematic review and meta-analysis aims to quantify employer attitudes and potential discrimination towards people living with psychosis.
Methods: We systematically searched multiple electronic databases from inception to July 15, 2024 for studies exploring the links between employer hiring attitudes and decisions related to people living with psychosis. Random-effects meta-analysis was performed on pooled studies which measured different but related outcomes concerning employer attitudes and behaviors towards hiring individuals with psychosis.
Results:  A total of 10 studies with 4080 total participants were included in the systematic review which consistently found that employers view individuals with psychosis as less employable compared to those with other health conditions or no disabilities. Meta-analysis of 6 studies which met inclusion criteria pooling a total of 4315 assessments of potential employees living with psychosis revealed a statistically significant medium to large pooled effect size (Hedges g) of 0.57 (95 % CI [0.21 to 0.94], p = 0.010), indicating statistically significant discrimination. Subgroup analysis estimated that 76.00 % (95 % CI [62.90 % to 89.09 %], p < 0.001) of employers expressed negative attitudes towards hiring individuals with psychosis. 
Conclusions: This first meta-analysis on the topic reveals statistically significant (p = 0.010) employer discrimination towards individuals with psychosis. Findings highlight the need for targeted interventions to address misconceptions and promote inclusive hiring practices. Future research should focus on developing and evaluating strategies to reduce workplace stigma and improve employment outcomes for people living with psychosis.

vi)  Suso-Ribera, C. (2025) Unpacking societal stigma toward schizophrenia: Development of a multidimensional scale with sociodemographic insights.  International Journal of Mental Health Promotion,27(7), 929-951.
https://doi.org/10.32604/ijmhp.2025.065646

Abstract
Objectives: Schizophrenia is a profoundly stigmatized mental health condition, characterized by misconceptions that affect societal attitudes, policy development, and the lived experiences of individuals with the condition. This study aimed to develop and validate a multidimensional scale for assessing societal stigma towards schizophrenia, while exploring how demographic factors influence such attitudes.
Methods: Drawing on an extensive literature review and consultations, the study identified five domains of stigma: Workplace Capability, Intimate Relationships, Autonomy, Risk Perception, and Recovery. Using a two-phase methodology, a preliminary 38-item scale was administered to 729 participants from the general Spanish population, refining the measure through descriptive and exploratory factor analysis. Subsequently, a revised 34-item scale was validated through confirmatory factor analysis with an independent sample of 417 participants.
Results: The final model showed good fit (RMSEA = 0.056, CFI = 0.938, TLI = 0.933) and strong internal consistency (α = 0.73–0.86). Findings revealed that stigma was most pronounced in the domain of Autonomy (Mean = 2.83, SD = 0.91), reflecting pervasive doubts about individuals’ ability to live independently and achieve meaningful integration into society. Stigma varied significantly across demographic variables, with higher levels reported among men, older individuals, married participants, and those outside health professions (p < 0.01). Conversely, healthcare professionals, younger individuals, and those familiar with someone with schizophrenia generally reported less stigma (p < 0.01).
Conclusion: This study developed and validated a robust multidimensional scale for assessing societal stigma toward schizophrenia. The five-factor model—Workplace Capability, Intimate Relationships, Autonomy, Risk Perception, and Recovery—was empirically supported. Autonomy and Recovery emerged as the most stigmatized domains across the Spanish general population. The scale demonstrated strong psychometric properties and effectively captured stigma patterns linked to key sociodemographic variables.

vii)  Grundy, A. C. (2025). The traumas of hostile voice-hearing experiences in the context of acute psychiatric admissions: a lived experience testimony. Psychosis, 1–6.
https://doi.org/10.1080/17522439.2025.2492641

Abstract
In this paper, Dr. Andrew C. Grundy (a lived experience researcher who has been given a diagnosis of “schizophrenia”) gives testimony to his trauma of hostile voice-hearing experiences and of related experiences of iatrogenic trauma in the context of acute psychiatric admissions. This paper then seeks to contextualise these experiences in the research literature, and it offers recommendations for trauma-informed care of people experiencing hostile and distressing voices.

viii)  Hegde, S., Quadros, S. & Appaji, R. et al (2025) ‘Life minus illness = recovery’: A phenomenological study about experiences and meanings of recovery among individuals with serious mental illness from Southern India.  Community Mental Health Journal, 61:281–292.
https://doi.org/10.1007/s10597-024-01312-4

Abstract
Traditional medical models have given way to recovery-oriented approaches over the years in the management of individuals with serious mental illnesses. However, very little is known about such recovery-based models in the Indian context. This qualitative study used a phenomenological approach to explore the experiences and meanings of recovery among individuals with serious mental illness in southern India. Purposive sampling with maximum variation was used to recruit participants. In-depth interviews were conducted with ten participants, using a semi-structured interview guide. Thematic analysis resulted in three themes: “The illness journey,” “Life minus illness = Recovery,” and “It takes a village to recover,”. Illness and recovery seemed to be two sides of the same coin with the context playing an influential role in the perceptions of recovery. The term “recovery” seemed to be a misnomer giving the impression that one is expected to return to an illness free state.

ix)  Dring, J. A.E., Powell Davies, R. & Carigan, N. (2025) Personal recovery in mental health difficulties in people with experience of homelessness: qualitative systematic review. BJPsych Open, 11(6):e265.
https://doi.org/10.1192/bjo.2025.10851

Abstract
Background:  Given the complex challenges facing people experiencing homelessness, existing mental health recovery models are probably insufficient for this population.
Aims: To investigate qualitative accounts of mental health personal recovery in people with experience of homelessness, and to adapt the widely adopted connectedness, hope, identity, meaning and empowerment (CHIME) model of personal recovery to better represent the experiences of this population.
Method:  PROSPERO registration no. CRD42023366842. A systematic review identified qualitative studies investigating first-person accounts of mental health personal recovery in people with experience of homelessness. Nine databases were searched: CINAHL, SCOPUS, Embase, Medline, PsychINFO, PubMed, Web of Science, ASSIA and Social Services Abstracts. Risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist. Included studies underwent ‘best fit’ framework synthesis, comprising deductive analysis using the CHIME first- and second-order themes, as well as inductive analysis to capture aspects not covered by the a priori framework.
Results: The review expanded the CHIME model and identified the following recovery processes in this population: security and stability; encouragement and hope; constructing identity; understanding and meaning; relationships and connectedness; and empowerment and dual recovery (SECURED). Importantly, security and stability were identified as a necessary prerequisite for the other recovery processes. Challenges within each recovery process were also identified.
Conclusions:  SECURED offers a transdiagnostic framework to support understanding of mental health personal recovery in the context of homelessness. Findings support the Housing First model of service provision. However, findings also highlight that housing alone is not sufficient and that the other processes must also be supported.

x)  Grim, K. & Ramon, S. (2025) Working towards successfully centering dignity and epistemic justice in mental health practice.  Academia Mental Health and Well-Being, 2(4) https://doi.org/10.20935/MHealthWellB7930

Abstract
Dignity is rooted in values such as autonomy, freedom, and responsibility. Every interaction in a health care setting has the potential to be a positive dignity encounter, enabled by service providers. This review article presents positive examples of the implementation of dignified and successful approaches in different mental health service contexts in the UK, Germany, and Sweden. These examples highlight the translation of values into practice, providing guidance and inspiration to support positive changes internationally.  Epistemic injustice highlights the vulnerabilities that mental health service users may face. Concepts from epistemic injustice theory are applied to exemplify how epistemic justice can be strengthened through approaches and methods that affirm service users as knowers and testifiers. Shared decision-making permeates several of our examples, alongside the involvement of family and peers in the planning and delivery of care and the use of EbEs (experts-by-experience). Likewise, the examples highlight how respecting service users’ experiences and empowering them to actively participate in their care are essential components in promoting dignity. Hence, implementing the methods indicated in this article requires a willingness to focus on the strengths and resources of service users and informal carers, validating them as competent and indispensable sources of knowledge, in addition to the knowledge brought in by professionals.

Other News /Resources

i) Writing out of the University of Nottingham, Prof. Mike Slade draws attention to a new online resource from the Schizophrenia Society of Canada.  Information from the website explains that Your personal Recovery Journey is a six-module program based on the CHIME
framework for personal recovery (Leamy et al 2011) including:

• Connectedness
• Hope and optimism
• Identity
• Meaning
• Empowerment

Your Personal Recovery Journey is for people living with signs and symptoms of a mental illness or a mental health problem that affects their lives. It is for people who may or may not have a specific diagnosis.  The program offers participants opportunities to explore their own recovery paths.  Participants will:

• Learn about recovery and about five processes that are important in life and in recovery (connections, hope and optimism, identity, meaning, and empowerment).
• Hear lived experience stories and ideas about the module topics through videos and discussions.
• Reflect on (i.e. think deeply or carefully about) and discuss thoughts that they have about their experiences (if they choose to share).
• Develop their own personal recovery strengths and discover ways that they can take what they learn and use it in their lives.

For more details on this innovative programme, please see here.

ii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

December 2025

RRN Meetings
The national and international situation regarding Coronavirus (Covid-19) remains a topic of discussion and while Covid-19 restrictions have ended in the UK, guidance continues to emanate from central government as we learn to live with the virus, and what needs to be provided for people suffering from Long Covid.  We continue to encourage our readers to keep safe and follow relevant guidance as appropriate.  UK guidance is available here, and international information via the World Health Organisation is available here.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available here.

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

i)  Laura Hankey, who is a Year 3 Trainee Clinical Psychologist, writing out of the University of Birmingham draws attention to work currently being undertaken on the topic of post-traumatic growth following a first episode of psychosis.  Laura writes:

Dr Gerald Jordan (University of Bristol), Dr Alice Welham and Laura Hankey (University of Birmingham) are seeking to assess NHS staff awareness of post-traumatic growth following a first episode of psychosis. Existing research highlights that post-traumatic growth is a positive psychological change that can occur following an adverse event, such as a first episode of psychosis, and that the relationship people experiencing psychosis have with the staff team supporting them can be key to them developing post-traumatic growth. What is currently unknown is whether staff members themselves are aware of post-traumatic growth and whether there are groups of staff members who may be more or less likely to know about it. The aim of this study is to understand how big this knowledge gap is and to make recommendations to address it, leading to better clinical outcomes for people experiencing a first episode of psychosis. This is a mixed methods study incorporating a short online survey followed by a small number of qualitative interviews. Eligible participants are any NHS staff member working in Early Intervention for Psychosis services in England. Please follow the link below for more information: 
https://bhampsychology.eu.qualtrics.com/jfe/form/SV_ekW14KVdtGLupng

Many thanks, 
Laura Hankey 

Conferences, Events and Calls for Papers
i) The European Psychiatric Association (EPA) will be hosting the 34th European Congress of Psychiatry on:
Date:  28-31 March 2026
Venue:  Prague Congress Centre, Prague, Czech Republic
Congress theme:  The 2026 Congress motto will be “Mental Health: Improving Care and Expanding Horizons”, emphasising the need to improve mental healthcare across all contexts and for every citizen living in Europe. “Expanding Horizons” underscores the importance of strengthening collaboration with allied professionals and including experts by experience and carers in the improvement of mental healthcare.

A comprehensive and detailed range of information is available here

Papers and Publications 
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i)  Hawke, L.D., McKee, S. & Harris, H. et al. (2025)  ‘Every Voice Matters’: A Photovoice study on the personal impacts of co-production in recovery colleges. Health Expectations, 28: e70441.
https://doi.org/10.1111/hex.70441

Abstract
Background: The engagement of people with lived experience (PWLE) of mental health and substance use health challenges in the co‐production of health services, programming and research has many benefits, but how co‐production impacts those involved remains unclear. Recovery Colleges are low‐barrier, generally co‐produced education programmes focused on mental health and wellness. Designed to support individuals on their personal recovery journeys, they provide a meaningful setting to explore the impacts of co‐production.
Objective: This co‐produced study explored the impact of co‐production within recovery‐oriented programming using a photovoice methodology. Photovoice captured the lived experiences and expertise of people involved in Canadian Recovery Colleges as curriculum designers, facilitators and/or students.
Method: A sample of 21 participants with co‐production experience took part in seven photovoice workshops. These culminated in a final photo submission that illustrated how co‐production has impacted them. Eighteen participants completed a focus group discussion on the topic, which was audio recorded, transcribed and analysed using codebook thematic analysis. 
Results: Five themes were generated from the data. Participants found that co‐production (1) reduced stigma, (2) provided a space to collectively share lived experience, (3) helped them develop a sense of belonging, (4) helped them advance their personal recovery journeys and (5) supported their personal growth.
Conclusions: This study demonstrated that co‐production in Recovery College settings has a wide range of positive impacts for the individuals involved, across a range of personal factors. The co‐production of services, programme development and research can create positive meaning for those involved in mental health and substance use health settings, as well as potentially other broader health settings, which may aid in their recovery journeys.
Patient or Public Contribution: A Recovery College research subcommittee, including individuals with lived experience of mental health and/or substance use challenges, co‐produced every phase of this study.

ii)  Tam, D. M. Y., Collins, T., Kwok, S. M., Pope, J., Baylis, P. & Ng, L. (2025), Photovoice groups on youth mental health: lessons learned under the global pandemic, Social Work with Groups
https://doi.org/10.1080/01609513.2025.2551823

Abstract.
This article describes the Photovoice Project, which was developed to engage youth in exploring mental health and enhancing their emotional well-being. As the project was about to begin, the COVID-19 pandemic reached Canada in late winter 2021. During this period, youth experienced heightened isolation due to evolving social distancing restrictions and growing mental health challenges. Despite these difficulties, six Photovoice groups were successfully conducted in a western province of Canada, involving 44 youth participants. Program feedback was collected from youth, parents or guardians, youth advisors, group facilitators, and project coordinators who were involved in designing and implementing the project. This article presents end-of-program findings on: (1) challenges in implementing the Photovoice Project during the pandemic; (2) lessons learned overcoming challenges under the pandemic; (3) meaningful group experiences for youth; and (4) Photovoice’s promising potential for youth engagement. The article concludes with implications for social work practice, education, and research.

iii)  Oswald, M. & Chen, D. (2025) Exploring recovery narratives of physicians and medical trainees with mental illness: A thematic analysis. Journal of Medical Humanities, 
https://doi.org/10.1007/s10912-025-09958-1

Abstract
In order to gain a greater understanding of what life is like for physicians and medical trainees experiencing mental illness, six book-length memoirs written by physicians and trainees were analysed via thematic analysis. All exhibited elements of a recovery narrative. We then queried our data to explore two specific questions we felt would be of special interest to our audience along with a discussion of relevant literature to place our findings in context: (1) What factors are involved in the mental illness recovery journey of physicians and trainees? (2) What stressors do physicians and trainees face as part of their career that may impact how they experience their mental illness? Our analyses revealed that the authors’ recovery journeys were fostered by mental health treatment, social supports, religion and/or spirituality, and personality traits. Physicians and trainees both experienced career stressors that impacted their mental health, and these stressors highlighted important issues such as barriers to treatment, medical licensure policies, and stigma. This study provides greater insight into not only some of the challenges of living with mental illness as a physician or trainee but also into what made recovery possible for them and how we might be able to support those who are struggling in the future. Discussing these important topics will hopefully reduce stigma for those experiencing mental illness and potentially influence public policy, specifically around de-stigmatizing physician licensure applications.

iv)  Kotera, Y., Miyamoto, Y. & Vilar‑Lluch, S. et al. (2025) Cross‑cultural comparison of recovery college implementation between Japan and England: Corpus‑based discourse analysis.  International Journal of Mental Health and Addiction, 23, 4362–4386.
https://doi.org/10.1007/s11469-024-01356-3

Abstract
Recovery Colleges (RCs) are mental health learning communities, operated in 28 countries across cultures. However, the RC operational model is informed by Western countries sharing similar cultural characteristics such as individualism and short-term orientation. How RC operational model needs to be adapted to non-Western culture remains unknown. We investigated how RCs are introduced to the public in two countries with contrasting cultural characteristics: Japan (collectivism, long-term) and England (individualism, short-term). Corpus-based discourse analysis on 22,827 words from promotional texts (13 RCs in Japan, 61 in England) revealed that both countries emphasised mental illness lived experiences. In Japan, the focus was on the relational and long-term aspects of recovery. In England, the focus was on personal learning and skill acquisition. People attending RCs in Japan may anticipate experiencing collectivistic and long-term elements, which are viewed unfavourably in the operational model. Findings suggest refinements to the operational model to include under-represented cultural characteristics.

v)  Deering, K., Kempton, J. & Onifade, O. et al. (2025) Exploring risk and safety within acute mental health inpatient settings.  Mental Health Nursing, Feb/Mar 2025. 10-14.

Abstract
This paper provides a critical overview of assessment and management of service user risks and/or promotion of their safety needs within acute mental health hospitals. It discusses what risk is and what risk might mean in terms of mental health care. The characterisation of risk and risk management practices in mental health care are critiqued informed by key sociological theories. Thereafter the paper outlines what could be more considered in inpatient care settings in order for mental health nurses to strive for the enriching of patient safety in hospital and using a more safety-recovery-based approach.

vi)  Gurdak, K., Pahwa, R. & Thorning, H. (2025) “You got it on you”: How the experience of community is influenced by stigma. Journal of Community Psychology. 54: 1–15.
https://doi.org/10.1002/jcop.70072

Abstract
This study explores how stigma influences community experiences among individuals with serious mental illness (SMI), using the structural‐function‐experiential (SFE) model as a guiding framework. Qualitative semi‐structured and social network interviews were conducted with 30 participants receiving assertive community treatment (ACT) services in New York state.  Modified grounded theory approach guided the analysis. Four themes emerged: (1) “Maybe I’m as crazy as they say I am,” (2) avoiding disclosure and relationships, (3) providers or no one, and (4) longing for connection. These themes illustrate how stigma operates in an ecological framework such as the SFE model consisting of structural, functional, and experiential dimensions of community. Stigma disrupts social relationships, inhibits disclosure, and reinforces social isolation. Applying the SFE model highlights community‐level mechanisms through which stigma can be mitigated. Findings inform transformative change efforts to enhance social inclusion and recovery for people with SMI.

vii)  Bhatarasakoon, P. & Thongyu, R. (2026) Determinants of personal recovery in people with Schizophrenia in Asia: A systematic review and meta-analysis report. PRIJNR, 30(1), 111-134. 
https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/275639

Abstract
Personal recovery in schizophrenia emphasizes hope, identity, meaning, and empowerment beyond symptom reduction. Although numerous predictors have been identified in Western contexts, Asian-specific  evidence remains limited. This study aimed to evaluate factors associated with personal recovery in people with schizophrenia in Asian contexts, focusing on personal experience rather than clinical remission. The systematic review followed the JBI methodology for aetiology and risk, and was registered with PROSPERO (CRD42020179623). Six databases and grey literature were searched for studies published between 1990 and 2021 examining factors related to personal recovery in people with schizophrenia across Asian countries. Only quantitative analytical observational studies were included. Two reviewers independently selected, appraised, and extracted data. Meta-analysis was conducted using MedCalc software.
Results from 2,343 records, 11 studies met the inclusion criteria (5 for meta-analysis, 6 for narrative synthesis). A meta-analysis showed a significant, moderate, and negative correlation between structural self-stigma and personal recovery (r = -0.409; 95% CI: -0.549 to -0.246; n = 681). Narrative synthesis revealed that clinical factors consistently impeded recovery. Psychological resources facilitated recovery, with hope showing the strongest protective effects (r = 0.641), followed by self-efficacy and self-esteem. Social support enhanced recovery, while loneliness created barriers. Male gender and later onset age were associated with poorer outcomes. In conclusion, personal recovery requires multi-domain interventions targeting hope cultivation, stigma reduction, social network strengthening, and symptom management. These findings provide evidence-based priorities for recovery-oriented practice in Asian contexts, though limitations include study heterogeneity and cross-sectional designs. Future research should explore culturally tailored longitudinal interventions.

viii)  Faccio, E., Rocelli, M. & Bitetti, L. et al. (2025)  One or many recoveries? Recoveries in the plural for a better understanding of one’s healing journey. Health Expectations, 28: e70209. 
https://doi.org/10.1111/hex.70209

Abstract
Background: Since the 60s, the recovery‐oriented approach has greatly influenced mental health policy and practice, and much research has been devoted to exploring it. In the face of a generic definition of the ‘recovery’ construct, to which many articles refer, a closer examination of the literature reveals a plurality of theories and ways about how changes related to the recovery occur and how to evaluate them.
Aims: This narrative review explores the different definitions of recovery available in the literature, by investigating the adjectives that qualify it and the theoretical construct the adjective refers to.
Method: From the online databases PubMed, Scopus, Google Scholar and PsycINFO, 43 articles were selected for the review.
Results: Seven definitions of recovery emerged, each supported by specific theoretical perspectives: clinical, personal, narrative, social, family, cultural and relational recovery. The adjectives refer to theoretical frameworks often very distant from each other and in epistemological competition; nevertheless, many papers assume a reconcilability and possible integration. The authors critically discuss the advantages and risks of considering such different constructs as complementary.
Conclusions: Keeping theoretical descriptions and models of healing open and plural means enabling mental health practitioners not to monopolize discourses of change by imposing their point of view on users. It means supporting users to authentically seek their healing pathways without conforming to clinicians’ expectations. It also means abandoning misleading and naive simplifications and strictly using the appropriate terms relevant to the specific healing construct that researchers refer to from time to time. This is particularly important when it comes to the relational component, which seems to be receiving more and more attention in the literature, and about which there is more confusion.
Patient or Public Involvement: The study involved two experts by experience, or peer support specialists, in a more than active role as components of the research team. They participated equally with the other team members in all phases of the work: the design and conduct of the study, the discussion of findings and advice about implications and dissemination.

ix)  Asher, M., Roe, D., Tuval-Mashiach, R. et al. (2025) “Choosing your Own Path”: Patterns of use of psychiatric medication among individuals with serious mental illness. Community Mental Health Journal, 61, 1269–1279.
https://doi.org/10.1007/s10597-025-01465-w

Abstract
Most individuals with serious mental illness (SMI) are advised to take psychiatric medication, but about half of them do not take it as prescribed. The binary concepts of “adherence” and “non-adherence” do not seem to capture the actual patterns of medication use. The current study mapped the different patterns of medication use among people with SMI and explored the characteristics of each pattern. Sixteen participants diagnosed with an SMI that used psychiatric medications for at least one year, were interviewed, and data were analysed using ideal-type analysis. Analysis revealed four patterns of medication use: (1) adherence without doubt; (2) adherence after attempts to stop/reduce; (3) flexible use over time; and (4) tapering off medication. Individuals may shift between these different patterns in their recovery journey, creating the need for tailored therapeutic interventions that adapt to individuals’ evolving needs, beliefs, and preferences.

x)  Morelli, N. M., Straub, D. & Hong, K. et al (2025) Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for youth with complex trauma exposure: A systematic review. Trauma, Violence & Abuse, 0(0)
https://doi.org/10.1177/1524838025138393

Abstract
Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the most widely used treatments for children and adolescents presenting with posttraumatic stress. Despite strong rationale for its use with youth exposed to complex trauma (traumatic experiences that are chronic, repeated, prolonged, and interpersonal in nature), few studies have investigated its effectiveness in this population. The present review systematically synthesized and evaluated the existing empirical evidence for the effectiveness, feasibility, and acceptability of TF-CBT among youth with complex trauma. Twenty-three articles reporting on findings from 21 non-overlapping samples met the inclusion criteria for the current review (total N = 1,728). Articles were included if they were published after 1990, evaluated branded TF-CBT (four or more out of the five components), measured psychosocial and/or behavioral functioning pre-/post-TF-CBT, and included a sample of young people (mean age <20) exposed to complex trauma. This work supported TF-CBT as a “probably efficacious intervention” for reducing posttraumatic stress disorder (PTSD) symptoms among youth with complex trauma histories, according to the Division 12 Task Force on Psychological Interventions; at present, TF-CBT should be considered “Possibly Efficacious” for reducing International Classification of Diseases, 11th Revision (ICD-11) complex PTSD symptoms. TF-CBT was generally found to be feasible and acceptable, though qualitative and case studies illustrated challenges inherent to working with youth with complex traumatic experiences. Qualitative work also provided useful recommendations for enhancing feasibility and acceptability in this population. Overall, the literature provides a solid empirical foundation for TF-CBT’s use in youth exposed to complex trauma.

Other News /Resources

i) The McPin Foundation
The Winter 2025 edition of the McPin Foundation quarterly newsletter has recently been published.  As noted previously in this ebulletin, their newsletter is a good way of keeping up to speed with projects and events, news and views from the mental health research sector.  To sign up to the McPin newsletter, please see here.

ii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula:   s.ramon@herts.ac.uk
Tony:   a.sparkes@bradford.ac.uk