Valuing recovery-oriented practice at the interface between mental health services and communities: The role of organisational characteristics and environments

Background: Implementing recovery-oriented mental health services is a policy priority in many countries. In addition, some governments have prioritised new forms of organising, financing and governing the provision of mental health services with a stronger focus on co-delivery and involving communities. Most research in the recovery field has focused on interventions. There is limited knowledge about the role of organisational characteristics and environments in which people experience recovery. Aim: To understand the organisational characteristics of initiatives that implement recovery-oriented practice at the interface between mental health services and communities, as well as the mechanisms they employ to alter the conditions in which they operate. Method: Semi-structured interviews and a focus group workshop with managers of five initiatives in England that implemented recovery-oriented practice at the interface between mental health services and communities. Results: Our cross-sector initiatives shared a range of characteristics and employed mechanisms that created favourable conditions for recovery-oriented practice: strong social value and process (rather than performance) orientation; participatory approaches and shared decision-making; flat hierarchies; creating and seizing business opportunities; utilising networking and (social) marketing opportunities; risk-taking; valuing and supporting all members of their organisations; entrepreneurial and value-driven leadership. Conclusion: Recovery-oriented practice takes place in certain organisational environments that importantly influence an individual's recovery. Our research highlights the need to consider organisational characteristics when evaluating recovery interventions as well as a broader shift of research towards understanding the environments in which people experience recovery as members of society, and how those can be altered.