What we talk about when we talk about recovery: A systematic review and best-fit framework synthesis of qualitative literature

Background: The recovery approach is increasingly popular among mental-health services, but there is a lack of consensus about its applicability and it has been criticised for imposing professionalised ideas onto what was originally a service-user concept (Beresford, 2015).

Aims: To carry out a review and synthesis of qualitative research to answer the question: ‘What do we know about how service users with severe and enduring mental illness experience the process of recovery?’ It was hoped that this would improve clarity and increase understanding.

Method: A systematic review identified 15 peer-reviewed articles examining experiences of recovery. Twelve of these were analysed using best-fit framework synthesis (Carroll et al., 2013), with the CHIME model (Leamy et al., 2011) providing the exploratory framework.

Results: The optimistic themes of CHIME accounted for the majority of people’s experiences, but more than 30% of data were not felt to be encapsulated. An expanded conceptualisation of recovery is proposed, in which difficulties are more prominently considered.

Conclusions: An overly optimistic, professionally imposed view of recovery might homogenise or even blame individuals rather than empower them. Further understanding is needed of different experiences of recovery, and of people’s struggles to recover.