Measurement of Recovery for Persons with Serious Mental Illness

Tuesday, 31 July 2012: 3:50 PM

Linda E. Jensen, PhD, RN, MN
Clarkson College, Omaha, NE

Learning Objective 1: 1. To describe some challenges of recruitment and retention of subjects with severe mental illness while measuring recovery outcomes.

Learning Objective 2: 2. To compare and contrast qualitative and quantitative methods that could be used for measurement of recovery outcomes in persons with severe mental illnesses.

The concept of recovery  may seem unusual for people with severe and persistent mental illnesses (SPMI) as over 2/3 are unemployed, and it is estimated that in the U.S., 240,000 are homeless, and 283,000 are incarcerated (NAMI, 2011).  Recovery has been typically defined as a complete remission of symptoms or a return to a life as it was before the illness however, people with SPMI are advocating for a change in the understanding and measurement of recovery to include progress made in coping and living with  mental illness, and not always a complete cure.  Several evidence based studies of people with SPMI have been completed finding some of the following challenges in measurement of recovery outcomes. 

There were challenges in recruiting people with SPMI for evidence based studies including lack of trust, difficiulty with symptoms and other health problems, legal perspectives of obtaining permission with guardians, and irregularities in attendance at services. 

Several quantitative instruments were utilized. Challenges included readability levels, subjects not understanding the terminology or being triggered by certain words into symptomatology, skipping items on surveys, and tiring easily.  It was often necessary to read surveys to the participants, and to check carefully for understanding of the items.   

It  was found to be  important to use qualitative data obtained by listening to the perspectives of persons with SPMI. There were difficulties with recording interviews, along with other challenges of qualitative data transription, analysis, theme development, and checking with the participants for validation of themes. 

Conclusions:  Mixed methods combining both quantitative and qualitative methods of collecting data will yield more information  about assesment and measurement of recovery for people with SPMI.   Many factors must be considered including: health, medical treatment,  employment, family relationships,  social services, and meaningful activity, along with the person's own perspective of their recovery.