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Exploring the meaning of recovery in a Community Mental Health Team. An ethnographic study using semi structured interv
 

Angela Quigley
Charge Nurse
Submitted Date: 06/04/2011
Review Date: 16/02/2011
Overview
Research with aims are to provide an explanation of the significant issues pertaining to recovery in a Community Mental Health Team from the perspective of the practitioners, and to draw some tentative conclusions about how the results can be applied in practice.
Local Area
Lanarkshire
Care Setting
Community care, Education and Training
Care Group
Adults
Evidence Base for Practice
Barriball, K . L. and While, A (1994) Collecting data using a semi-structured interview: a discussion paper. Journal of Advanced Nursing 19 pp328 - 335

Barton, T. D. (2008) Understanding Practitioner Ethnography. Nurse Researcher 15 (2) pp 7 – 18

Brown, W and Kandirikiria (2007) Recovering mental health in Scotland. Report on narrative investigation of mental health recovery. Glasgow: Scottish Recovery Network

Jacobson, N (2004) In Recovery: The Making of Mental Health Policy Nashville: Vanderbilt University Press

Scottish Executive (2006) Rights, Relationships and Recovery. The Report of the National Review of Mental Health Nursing in Scotland. Edinburgh: Scottish Executive

Scottish Executive (2003a) An introduction to the Mental Health (Care and Treatment) Scotland Act 2003 Edinburgh: Scottish Executive, Scotland

Scottish Executive (2003b) National Programme for improving Mental Health and Well-being action plan 2003-2006 (September Ed): Scottish Executive

Scottish Executive (2006) Delivering for Mental Health. The mental health delivery plan for Scotland Edinburgh: NHS Scotland

Scottish Recovery Network (2006) Journerys of Recovery Glasgow: Scottish Recovery Network

Spradley, J. P. (1979) The Ethnographic Interview New York: Holt, Rhinehart and Winston
Quality assurance/impact of practice
Ethical approval to conduct the study was granted by the ethics committee following a formal application on the IRAS system, and an end of study report submitted. The research was conducted using an established method (Spradley’s DSR model), using multiple sources of data and analysis to strengthening the reports findings. The research was commenced prior to the Realising Recovery, 10 Essential Shared Capabilities Learning Materials being done within the team. This has been reported to have contributed to the raised awareness and reflection of the team and individual practitioners.

Practice Summary
Recovery, although not a new concept in the mental health field, has come to the forefront in recent years. This has been driven by the consumers of mental health services and their influence is now becoming apparent at policy making levels. The research aims are to provide an explanation of the significant issues pertaining to recovery in a Community Mental Health Team from the perspective of the practitioners, and to draw some tentative conclusions about how the results can be applied in practice.
Practice Detail
An ethnographic design was implemented and the principle method of data collection was the semi structured interview. Ten informants were randomly chosen and invited to participate, of which seven were interviewed on more than one occasion. Data was analysed using Spradley’s Developmental Research Sequence model. The researcher also used extracts from her research diary as a critical and reflexive tool to counter issues of reliability and validity. The results of the analysis identified various domains of cultural knowledge, of which three were selected for further investigation and include; ways to describe recovery, ways to encourage recovery in an individual and ways to strengthen recovery orientated practice. These were presented and contextualised using direct quotations from the informants. A discussion of how this relates to the existing literature and knowledge surrounding recovery is explored. It raises issues regarding the compatibility of the recovery ideology and present systems of working.
Challenges
These were more of a personal nature and reflect the naivety of what the research would entail. As well as the usual personal sacrifices of time, I experienced periods of confusion and anxiety regarding the research direction and quality of the report. However these feelings were calmed by following the design and maintaining fidelity to the established analytical model, as well as the appropriate use of supervision.

I also had concerns about being critical of the team despite providing a full and frank information sheet and obtaining proper informed consent for the work. I would suggest that these feelings are normal as I am part of the team and respect and feel loyal to my colleagues. Where less favourable issues are highlighted, I have reconciled this by respecting the honesty of their accounts and I am aware this illustrates that they are open and focused on the needs of the service user. I am heartened that we recognise that systems and working practices are not perfect and we are willing to be critical and reflective of team and individual working, whilst respecting the teams’ efforts.
Additional Comments
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