Perspectives of Jordanian service users and their families on Recovery-Orientation at acute inpatient mental health units: a mixed-methods study

This study evaluated the recovery-orientation of Acute Inpatient Mental Health Units (AIMHUs) from the perspective of both service users and their family members. A sequential explanatory mixed-methods approach, involving a standardised measures phase (quantitative phase) followed by a qualitative interviewees phase, was used to provide a solid base and guide for the research operations within this study. The INSPIRE and Recovery Self-Assessment-Revised (RSA-R) measures were employed to collect the quantitative data from 98 service users and 98 family members respectively, randomly selected from three mental health sectors in Jordan. The generated data were analysed using different parametric and nonparametric statistical methods. Quantitative findings indicated that service users felt to some extent satisfied with the support provided by their Mental Health Workers (MHWs) in their recovery (mean=2.10, SD=0.73). It also indicated slight disagreement by family members that MHWs at AIMHUs provided their loved ones with the necessary support to develop and maintain their recovery (mean=2.79, SD=0.96). Additionally, the findings revealed that MHWs at the pilot units, female units and the university sector tended to support the recovery of people with mental illness more than those in the traditional units, male units and government and military sectors. To explain and provide more in depth understanding of the quantitative findings, semi-structured interviews were undertaken with 16 service users and 16 family members purposefully selected from the sample of the first phase. The qualitative data were analysed using thematic and cross-thematic analysis approaches. Six main themes and related sub-themes emerged, including 1) the conceptualisation of recovery, 2) facilitative factors of recovery, 3) barriers to recovery, 4) staff support for personal recovery: perspectives of service users, 5) quality of therapeutic relationships between service users and MHWs, and 6) staff support for personal recovery: perspectives of family members. These themes provided in-depth insight and understanding on how service users and their family members perceived the meaning of recovery and its influencing factors, the nature of the MHW-service user therapeutic alliance, the quality and nature of the staff support of personal recovery, the differences across the selected units and mental health sectors in the extent of providing recovery-supporting care, and the reasons behind the lack of such care in such units and sectors. Finally, a mixed-methods analysis was conducted to reach a final conclusion for the study, and several recommendations and suggestions were provided to inform service development around recovery-oriented practice within AIMHUs in Jordan.