Transforming specialized mental health practice: Insights from clients’ perspectives on how to support recovery

To better address clients' needs, specialized mental health care (MHC) is changing to recovery-oriented, person-centered network care. This study was part of a broader Peer-supported Open Dialogue (POD) project and explores the experiences of clients living with severe mental illness (SMI) in a POD practice. The objective is to deepen the understanding of clients' lived experiences with POD to identify the specific behaviors, skills, and organizational elements they consider beneficial to their recovery. These insights offer practical guidance within a transformative care context, fostering the transformation at the personal level of MHC professionals committed to recovery-oriented, person-centered network care. Ultimately, this study aims to contribute to the development of new approaches for supporting the recovery of clients living with SMI. We conducted semi-structured interviews with 13 clients with SMI and one relative. In addition, we included data from five conversations held with clients with SMI within the POD project, two of whom were also interviewed in this study, as well as one relative. We used a hybrid analysis approach that combined deductive and inductive thematic analyses. We found that, at its core, the role of MHC professionals in clients' recovery revolves around strengthening three interrelated building blocks: promoting self-determination, creating and strengthening human connection, and establishing and facilitating reciprocal need- and ability-adapted collaboration. Underlying aspects of the building blocks revealed necessary competencies and supportive organizational elements, highlighting the complexities of power dynamics. Based on clients' experiences within a transforming specialized MHC practice, this study sheds light on the attitudes and behaviors of specialized MHC professionals that clients identify as supportive of recovery. Rather than fixed roles, the guiding role of MHC professionals in the recovery process requires a dynamic balance. This involves active engagement, navigating power dynamics and aligning with the needs and capabilities of everyone involved in the treatment.