Staff attitudes to recovery

We read the paper by Gudjonsson et al ¹ with interest. We wish to highlight the findings of our study in Ireland, which examined the knowledge and attitudes of mental health professionals (n = 153, nurses, doctors, social workers, occupational therapists and psychologists) to the concept of recovery in mental health across both in-patient and community settings. ² We used the Recovery Knowledge Inventory (RKI), ³ an instrument developed in the USA but which we found useful for an Irish population, and which has also been found to be of use in European and Australian populations. ⁴ The RKI was developed to gauge recovery-oriented practices among providers. It assesses four domains of understanding: roles and responsibilities in recovery; non-linearity of the recovery process; roles of self-definition and peers in recovery; and expectations regarding recovery. It comprises 20 items, each of which is rated on a 5-point Likert scale.

Our study findings concurred with Gudjonsson et al in finding that respondents viewed recovery positively as a philosophy of care for delivering mental health services. Participants in our study indicated their positive approach to recovery and expressed a need for more training, acknowledging the need for interprofessional learning as a team and the need for a multidisciplinary team approach to care. Respondents were less comfortable with encouraging healthy risk-taking.

However, whereas Gudjonsson et al report that experience of working in forensic services was not significant to total scores, in our study less experienced staff scored higher in having more positive attitudes and knowledge regarding recovery. Also of interest was that females and non-nursing professionals scored higher than nursing professionals in our study. We found no significant difference between in-patient or community-based staff; 22% of our staff had received training in recovery, compared with 37% in Gudjonsson et al's study. We did not compare results of those with training and those without, sharing the concern that those who had received training may have been positive about recovery before training.

Both studies discuss decision-making and its challenges around choice and control, and both are in strong agreement regarding hope and optimism being central to the process. Finally, both studies support the idea that irrespective of the specialty (or indeed country), the delivery of a recovery approach to care can be implemented, and knowledge and attitudes of mental health professionals are key in this process.

We look forward to the findings of the prospective study on the recovery approach currently under investigation by Gudjonsson and colleagues, and further discussion on this important topic.