Eliciting recovery narratives in global mental health: Benefits and potential harms in service user participation.

Abstract

OBJECTIVE:The engagement of peers and service users is increasingly emphasized in mental health clinical, educational, and research activities. A core means of engagement is via the sharing of recovery narratives, through which service users present their personal history of moving from psychiatric disability to recovery. We critically examine the range of contexts and purposes for which recovery narratives are elicited in global mental health. METHOD:We present 4 case studies that represent the variability in recovery narrative elicitation, purpose, and geography: a mental health Gap Action Programme clinician training program in Nepal, an inpatient clinical service in Indian-controlled Kashmir, a recovery-oriented care program in urban Australia, and an undergraduate education program in the rural United States. In each case study, we explore the context, purpose, process of elicitation, content, and implications of incorporating recovery narratives. RESULTS:Within each context, organizations engaging service users had a specific intention of what "recovery" should constitute. This was influenced by the anticipated audience for the recovery stories. These expectations influenced the types of service users included, narrative content, and training provided for service users to prepare and share narratives. Our cases illustrate the benefit of these coconstructed narratives and potential negative impacts on service users in some contexts, especially when used as a prerequisite for accessing or being discharged from clinical care. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE:Recovery narratives have the potential to be used productively across purposes and contexts when there is adequate identification of and responses to potential risks and challenges. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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10.1037/prj0000384

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Kaiser, Bonnie N, Saiba Varma, Elizabeth Carpenter-Song, Rebecca Sareff, Sauharda Rai and Brandon A Kohrt (2019). Eliciting recovery narratives in global mental health: Benefits and potential harms in service user participation. Psychiatric rehabilitation journal. 10.1037/prj0000384 Retrieved from https://hdl.handle.net/10161/19473.

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Kohrt

Brandon A. Kohrt

Adjunct Associate Professor in the Department of Psychiatry and Behavioral Sciences

Brandon Kohrt is a medical anthropologist and psychiatrist who completed his MD-PhD at Emory University in 2009. He is currently Assistant Professor of Psychiatry, Global Health, and Cultural Anthropology at Duke University. Dr. Kohrt has worked in Nepal since 1996 researching and aiding victims of war including child soldiers. Since 2006 has worked with Transcultural Psychosocial Organization (TPO) Nepal. Dr. Kohrt has been a consultant to The Carter Center Mental Health Program Liberia Initiative since 2010. Dr. Kohrt is the component lead for the Grand Challenges Canada funded Mental Health Beyond Facilities (mhBeF) program in Nepal, Liberia, and Uganda. Dr. Kohrt has published scientific articles and book chapters about mental health among conflict- and disaster-affected populations in Nepal, Liberia, and Haiti. Dr. Kohrt has collaborated on numerous documentary films about human rights and global health including Returned: Child Soldiers of Nepal’s Maoist Army.  


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