The relationship between clinical and recovery dimensions of outcome in mental health

Rob Macpherson

The relationship between clinical and recovery dimensions of outcome in mental health

Rob Macpherson

NHS Foundation Trust, UK

: Int J Ment Health Psychiatry

Abstract

Little is known about the empirical relationship between clinical and personal recovery. As part of a wider exploration of the value of the recovery model in working with severe mental illness, we examined whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. Standardized outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. We identified 3 factors: Patient-rated personal recovery, patient-rated clinical recovery and staff rated clinical recovery. Only the personal recovery factor improved after 1 year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. The identification of 3 rather than 2 factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time. This desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need.