Recovery-oriented mental health training interventions: An integrative review

Background Whilst the concept of personal recovery in the mental health field, supporting people with mental illness in finding purpose and meaning in their lives, is gaining international recognition, many healthcare providers remain more familiar with clinical recovery, which focuses on medication and symptom management. In this review, we focused on personal recovery-oriented training interventions designed to improve recovery-related knowledge, attitudes, and competency among healthcare professionals and peer support workers caring for people with mental illness within mental health and substance misuse services. We have conceptualised key components and evaluated the effects of personal recovery-oriented training interventions to build a solid foundation of knowledge about these interventions, providing insight for enhancing recovery-oriented research and practices. Aims To categorise recovery-oriented training interventions for healthcare professionals and peer support workers; to evaluate their effects on staff, service users, organisations; and to identify barriers and enablers influencing the implementation of recovery-oriented training programmes. Study design An integrative review, registered to PROSPERO (CRD42023493803). Methods We utilised eight databases (ASSIA, CINAHL, Medline, PsycINFO, Web of Science, Eric, TCI, and ThaiJo). The Template for Intervention Description and Replication (TIDieR) checklist and Kirkpatrick’s four level of training evaluation model were used in data extraction, then a narrative synthesis was used for the data synthesis review stages. Results We analysed 33 studies and identified seven categories of recovery-oriented training interventions, based on their core attributes and underlying theories. Key components of the training included understanding recovery concepts, addressing staff and team attitudes, fostering supportive and collaborative relationships, and promoting patients' autonomy, hope, and motivation. Most interventions showed a positive impact on healthcare professionals' knowledge and attitudes towards recovery, as well as on patient recovery outcomes. However, a failure to establish effectiveness of recovery-oriented training interventions can also be attributed to inadequate implementation, rather than to the content of training. Barriers to effective implementation included organisational structure changes, workload, professional constraints (such as time limitations and philosophical opposition), and service users’ conditions. Conclusions We suggest that recovery-oriented training interventions have the potential to improve recovery knowledge and attitudes among healthcare professionals and thus improve patients’ recovery outcomes. To address implementation challenges, the content and format of the training interventions should be tailored to the context and audience by adjusting the intensity and duration to better suit the needs of the participants or organisations.