Personal and Societal Recovery in Depression-A Qualitative Study

抑郁症患者的个人和社会康复——一项定性研究

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Abstract

There is growing attention for personal and societal recovery in mental health care. Existing research in this area is primarily focused on populations with Severe Mental Illness (SMI), while the development of personal and societal recovery in depression remains largely unstudied. This study explored the development of personal and social recovery, barriers and facilitators, and ways in which the recovery process can be supported for people with depression. Fourteen semi-structured interviews were conducted with individuals who experienced at least two episodes of depression and were in remission at the time of the interview (except for two deviant cases). Data were analysed using a constructivist grounded theory (CGT) informed approach combined with elements of reflexive thematic analysis (RTA). Purposeful sampling was applied to gather a heterogenous sample and data collection continued until theoretical saturation was reached. COREQ guidelines were followed. Participants described personal recovery as an intrapersonal, retrospective process of self-discovery. Societal recovery was described as an interpersonal, prospectively oriented process centred around developing belonging. These processes are bi-directional, as societal recovery created further opportunities for personal recovery. Participants described a preliminary step of 'societal participation' involving low demanding tasks to rebuild functional capacity and self-esteem. During personal recovery, participants need empathetic support which transitions to pragmatic support as individuals progress towards societal recovery. Our findings underscore the interrelatedness of personal recovery and societal recovery. Self-insight, developed through personal recovery, is applied during societal recovery. This occurs through the alignment of activities with personal values and meaning. Belonging in society through meaningful participation is what drives people towards societal recovery. Societal recovery often develops through an important step of societal participation.

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