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Post-traumatic growth in mental health recovery: qualitative study of narratives

2019; BMJ; Volume: 9; Issue: 6 Linguagem: Inglês

10.1136/bmjopen-2019-029342

2044-6055

Mike Slade, Stefan Rennick‐Egglestone, Laura E. R. Blackie, Joy Llewellyn‐Beardsley, Donna Franklin, Ada Hui, Graham Thornicroft, Rose McGranahan, Kristian Pollock, Stefan Priebe, Amy Ramsay, David Roe, Emilia Deakin,

Mental Health Treatment and Access

Objectives Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems. Design Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery. Setting England. Participants Participants were adults aged over 18 and: (1) living with psychosis and not using mental health services (n=21); (2) using mental health services and from black and minority ethnic communities (n=21); (3) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (4) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) white British. Results Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (self-discovery) leading to a new sense of who one is (sense of self) and appreciation of life (life perspective). Observable positively valued changes comprise a greater focus on self-management (well-being) and more importance being attached to relationships (relationships) and spiritual or religious engagement (spirituality). Categories are non-ordered and individuals may start from any point in this process. Conclusions Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of well-being. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental healthcare could use the six identified categories as a basis for new approaches to supporting recovery. Trial registration number ISRCTN11152837