Utility of a multidimensional recovery framework in understanding lived experiences of Chilean and Brazilian mental health service users

Utility of a multidimensional recovery framework in understanding lived experiences of Chilean and Brazilian mental health service users

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Silvia Alves Nishioka
PhuongThao D Le
Gabriella Dishy
Catarina Magalhães Dahl
Norha Vera San Juan
Franco Mascayano
María Tavares Cavalancti
Robert Whitley
Eliecer Valencia
Ruben Alvarado Muñoz
Lawrence H. Yang
Ezra Susser
Abstract

The understanding and application of recovery, despite its potential benefits for mental health services, is still in its incipient development in Latin America. Psychiatric reform in the region has been broadly known and discussed; yet, the recovery framework requires further exploration. Whitley and Drake (2010) suggested a recovery framework including five dimensions: clinical, existential, functional, physical, and social, offering a comprehensive perspective of the recovery process. The present study aimed to explore Chilean and Brazilian users’ perspectives on recovery identifying their endorsement of these five dimensions. Twenty-four users and six peer support workers were interviewed on their experiences with the Critical Time Intervention-Task Shifting (CTI-TS) carried out in Santiago (Chile) and in Rio de Janeiro (Brazil). Using a framework analysis approach focused on the users’ recovery process, we examined the utility of Whitley & Drake’s recovery framework in Chile and Brazil. Results showed that: 1. The framework was applicable to this population; 2. For Chilean and Brazilian users, dimensions were intertwined and influenced by salient processes (i.e., continuum of care, centrality of functioning and social life); and 3. Cultural values, stigma, and social determinants (e.g., housing, welfare) were mentioned as crucial factors affecting  treatment and recovery but had not been sufficiently accounted for in the framework. A reinterpretation of the framework was proposed based on Chilean and Brazilian users’ lived experiences. Findings add to the international literature on recovery by increasing the social validity of the multidimensional framework and expanding its utility to diverse populations.

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