Recovery in mental health: An international Delphi study from a recovery-oriented professional perspective

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.