Recovery from Psychosis in a Forensic Service: Assessing Staff and Service Users' Perspectives Using Q Methodology

Recovery has become a guiding principle for mental health service delivery. However, the implementation of recovery-oriented services is hindered by conceptual multiplicity, and forensic services in particular face additional challenges. The perspectives of both those receiving and providing services are central in understanding how the recovery approach can best be supported in practice. Therefore, this study used Q methodology to explore staff and service-users' views regarding factors deemed important to recovery from psychosis in a forensic service. Ten service-users and 13 mental health professionals completed a 60-item Q-sort to obtain their idiosyncratic views about recovery in this context. Q analysis produced a four-factor solution (accounting for 60% of the variance), revealing four distinct perspectives. The first placed emphasis on "personal growth and psychosocial aspects of recovery," the second on "gaining insight and reducing recidivism," the third placed importance on "self-focused aspects of recovery," and the final factor highlighted "making amends & service engagement" as important to recovery. The heterogeneity of recovery beliefs indicated that multiple dimensions of recovery are important in clinical practice. The bio-medical model of care appeared most prominent, suggesting the need for greater choice in alternative treatments and improved access to alternative models of care. To better apply recovery values, service-users and mental health professionals require a better understanding of the various recovery dimensions, and this broad conceptualisation of recovery should be reflected in service provision.