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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

Authors

MIKE SLADE M.SLADE@NOTTINGHAM.AC.UK
Professor of Mental Health Recovery and Social Inclusion

Donna Franklin

ADA HUI Ada.Hui@nottingham.ac.uk
Assistant Professor

Graham Thornicroft

Rose McGranahan

Stefan Priebe

Amy Ramsay

David Roe

Emilia Deakin



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., …Deakin, E. (2019). Post-traumatic growth in mental health recovery: qualitative study of narratives. BMJ Open, 9(6), 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