International differences in understanding recovery: systematic review

Abstract

Aims. Mentalhealthpolicyinternationallyvariesinitssupportforrecovery.Theaimsofthisstudyweretovalidatean existing conceptual framework and then characterise by country the distribution, scientific foundations and emphasis in published recovery conceptualisations. Methods. Update and modification of a previously published systematic review and narrative synthesis of recovery conceptualisations published in English. Results. Atotalof7431studieswereidentifiedand429fullpapersreviewed,fromwhich105conceptualisationsin115 papers were included and quality assessed using established rating scales. Recovery conceptualisations were identified from 11 individual countries, with 95 (91%) published in English-speaking countries, primarily the USA (47%) and the UK (25%). The scientific foundation was primarily qualitative research (53%), non-systematic literature reviews (24%) and position papers (12%). The conceptual framework was validated with the 18 new papers. Across the different countries, there was a relatively similar distribution of codings for each of five key recovery processes. Conclusions. Recovery as currently conceptualised in English-language publications is primarily based on qualitative studies and position papers from English-speaking countries. The conceptual framework was valid, but the develop- ment of recovery conceptualisations using a broader range of research designs within other cultures and non-majority populations is a research priority.