Skip to main content Accessibility help
×
Home

Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness

  • Bronte McLeod (a1), Denny Meyer (a2), Greg Murray (a3), Fiona Foley (a4), Nev Jones (a5) and Neil Thomas (a6)...

Abstract

Background

Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery.

Aims

To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery.

Method

Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales.

Results

Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact.

Conclusions

Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence: Neil Thomas, Mail H99, Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, Victoria, 3122, Australia. Email: neilthomas@swin.edu.au

Footnotes

Hide All

Declaration of interest: D.M., G.M. and N.T. report a grant from the Victorian State Government Department of Health and Human Services and B.M. reports personal fees from the Australian Government Research Training Program Scholarship during the conduct of the study.

Footnotes

References

Hide All
1Commonwealth of Australia. Fourth National Mental Health Plan. Department of Health, 2009.
2UK Department of Health. No health without mental health. Department of Health, 2011.
3US Department Health and Human Services. Achieving the Promise. Commission on Mental Health, 2003.
4Anthony, WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J 1993; 16: 11.
5Australian Health Ministers’ Advisory Council. A National Framework for Recovery-Oriented Mental Health Services: Guide for Practitioners and Providers. Commonwealth of Australia, 2013.
6Morgan, VA, Waterreus, A, Carr, V, Castle, D, Cohen, M, Harvey, C, et al. Responding to challenges for people with psychotic illness: updated evidence from the Survey of High Impact Psychosis. Aust N Z J Psychiatry 2017; 51: 124–40.
7Mancini, MA, Hardiman, ER, Lawson, HA. Making sense of it all: consumer providers’ theories about factors facilitating and impeding recovery from psychiatric disabilities. Psychiatr Rehabil J 2005; 29: 4855.
8Hughes, R, Hayward, M, Finlay, WML. Patients’ perceptions of the impact of involuntary inpatient care on self, relationships and recovery. J Ment Health 2009; 18: 152–60.
9Tew, J, Ramon, S, Slade, M, Bird, V, Melton, J, Le Boutillier, C. Social factors and recovery from mental health difficulties: a review of the evidence. Br J Soc Work 2011; 42:443–60.
10Corrigan, PW, Watson, AC. The paradox of self-stigma and mental illness. Clin Psychol Sci Pract 2002; 9:3553.
11Link, BG, Struening, EL, Neese-Todd, S, Asmussen, S, Phelan, JC. Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv 2001; 52: 1621–6.
12Castelein, S, Bruggeman, R, Van Busschbach, JT, Van Der Gaag, M, Stant, A, Knegtering, H, et al. The effectiveness of peer support groups in psychosis: a randomized controlled trial. Acta Psychiatr Scand 2008; 118: 6472.
13Verhaeghe, M, Bracke, P, Bruynooghe, K. Stigmatization and self-esteem of persons in recovery from mental illness: the role of peer support. Int J Soc Psychiatry 2008; 54: 206–18.
14Mancini, MA. The role of self-efficacy in recovery from serious psychiatric disabilities: a qualitative study with fifteen psychiatric survivors. Qual Soc Work 2007; 6: 4974.
15Corrigan, PW, Larson, JE, Ruesch, N. Self-stigma and the ‘why try’ effect: impact on life goals and evidence-based practices. World Psychiatry 2009; 8: 7581.
16Bandura, A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977; 84: 191.
17Kleim, B, Vauth, R, Adam, G, Stieglitz, R-D, Hayward, P, Corrigan, P. Perceived stigma predicts low self-efficacy and poor coping in schizophrenia. J Ment Health 2008; 17: 482–91.
18Vauth, R, Kleim, B, Wirtz, M, Corrigan, PW. Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Res 2007; 150: 7180.
19Thomas, N, Farhall, J, Foley, F, Rossell, SL, Castle, D, Ladd, E, et al. Randomised controlled trial of a digitally assisted low intensity intervention to promote personal recovery in persisting psychosis: SMART-Therapy study protocol. BMC Psychiatry 2016; 16: 312.
20First, MB, Spitzer, RL, Gibbon, M, Williams, JB. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. American Psychiatric Press, 2002.
21Holdnack, J. WTAR: Wechsler Test of Adult Reading manual. Psychological Corporation, 2001.
22Boyd Ritsher, J, Otilingam, PG, Grajales, M. Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 2003; 121: 3149.
23Villagonzalo, K-A, Leitan, N, Farhall, J, Foley, F, McLeod, B, Thomas, N. Development and validation of a scale for self-efficacy for personal recovery in persisting mental illness. Psychiatry Res 2018; 269: 354–60.
24Leamy, M, Bird, V, Le Boutillier, C, Williams, J, Slade, M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry 2011; 199: 445–52.
25Neil, ST, Kilbride, M, Pitt, L, Nothard, S, Welford, M, Sellwood, W, et al. The questionnaire about the process of recovery (QPR): a measurement tool developed in collaboration with service users. Psychosis 2009; 1:145–55.
26Kay, SR. Positive and Negative Syndromes in Schizophrenia. Brunner/Mazel, 1991.
27Livingston, JD, Boyd, JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 2010; 71: 2150–61.
28Rüsch, N, Müller, M, Lay, B, Corrigan, PW, Zahn, R, Schönenberger, T, et al. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. Eur Arch Psychiatry Clin Neurosci 2014; 264: 3543.
29Hayes, AF. Introduction to Mediation, Moderation, and Conditional Process Analysis, Second Edition : A Regression-Based Approach. Guilford Publications, 2017.
30Hayes, AF. Partial, conditional, and moderated moderated mediation: quantification, inference, and interpretation. Commun Monogr 2018; 85: 440.
31Preacher, KJ, Hayes, AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40: 879–91.
32Hayes, AF, Montoya, AK, Rockwood, NJ. The analysis of mechanisms and their contingencies: PROCESS versus structural equation modeling. Aust Mark J 2017; 25: 7681.
33Yanos, PT, Roe, D, Markus, K, Lysaker, PH. Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatr Serv 2008; 59: 1437–42.
34Solomon, P. Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatr Rehabil J 2004; 27: 392.
35Corrigan, PW, Rowan, D, Green, A, Lundin, R, River, P, Uphoff-Wasowski, K, et al. Challenging two mental illness stigmas: personal responsibility and dangerousness. Schizophr Bull 2002; 28: 293309.
36Simoni, JM, Franks, JC, Lehavot, K, Yard, SS. Peer interventions to promote health: conceptual considerations. Am J Orthopsychiatry 2011; 81: 351.
37Bellack, AS. Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull 2006; 32: 432–42.
38Lloyd-Evans, B, Mayo-Wilson, E, Harrison, B, Istead, H, Brown, E, Pilling, S, et al. A systematic review and meta-analysis of randomised controlled trials of peer support for people with severe mental illness. BMC Psychiatry 2014; 14: 39.
39Woods, A, Hart, A, Spandler, H. The Recovery Narrative: politics and possibilities of a genre. Cult Med Psychiatry 2019; March 21 (Epub ahead of print).

Keywords

Type Description Title
WORD
Supplementary materials

McLeod et al. supplementary material
McLeod et al. supplementary material

 Word (58 KB)
58 KB

Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness

  • Bronte McLeod (a1), Denny Meyer (a2), Greg Murray (a3), Fiona Foley (a4), Nev Jones (a5) and Neil Thomas (a6)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness

  • Bronte McLeod (a1), Denny Meyer (a2), Greg Murray (a3), Fiona Foley (a4), Nev Jones (a5) and Neil Thomas (a6)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *