Post-traumatic growth in mental health recovery: qualitative study of narratives

Slade, Mike; Rennick-Egglestone, Stefan; Blackie, Laura E.R.; Llewellyn-Beardsley, Joy; Franklin, Donna; Hui, Ada; Thornicroft, Graham; McGranahan, Rose; Pollock, Kristian; Priebe, Stefan; Ramsay, Amy; Roe, David; Deakin, Emilia

Abstract

Objectives
Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems.

Design
Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery.

Setting
England.

Participants
Participants were adults aged over 18 and: (i) living with psychosis and not using mental health services (n=21); (ii) using mental health services and from black and minority ethnic communities (n=21); (iii) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (iv) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) White British.

Results
Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (Self-discovery) leading to a new sense of who one is (Sense of self) and appreciation of life (Life perspective). Observable positively-valued changes comprise a greater focus on self-management
(Wellbeing) and more importance being attached to relationships (Relationships) and spiritual or religious engagement (Spirituality). Categories are non-ordered and individuals may start from any point in this process.

Conclusions
Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of wellbeing. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental health care could use the six identified categories as a basis for new approaches to supporting recovery.

Citation

Slade, M., Rennick-Egglestone, S., Blackie, L. E., Llewellyn-Beardsley, J., Franklin, D., Hui, A., Thornicroft, G., McGranahan, R., Pollock, K., Priebe, S., Ramsay, A., Roe, D., & Deakin, E. (2019). Post-traumatic growth in mental health recovery: qualitative study of narratives. BMJ Open, 9(6), Article e029342. https://doi.org/10.1136/bmjopen-2019-029342

• Journal Article Type: Article
• Acceptance Date: May 31, 2019
• Online Publication Date: Jun 28, 2019
• Publication Date: Jun 28, 2019
• Deposit Date: Jun 4, 2019
• Publicly Available Date: Jun 4, 2019
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 6
• Article Number: e029342
• DOI: https://doi.org/10.1136/bmjopen-2019-029342
• Keywords: Post-traumatic growth; Mental health; Recovery
• Public URL: https://nottingham-repository.worktribe.com/output/2134409
• Publisher URL: https://bmjopen.bmj.com/content/9/6/e029342
• Contract Date: Jun 4, 2019