Resilience in people with severe mental illness and cancer, a qualitative study

PURPOSE: The purpose of this study was to explore the lived experiences of people with severe mental illness (SMI) who are also diagnosed with cancer. The research sought to understand the lived experiences of this population, focusing on physical and mental health comorbidity. METHODS: This research was underpinned by a relativist ontological stance and a constructivist epistemological position and adopted a constructivist grounded theory methodology. Research was undertaken in England and data were generated through 11 in-depth one-to-one interviews with people with lived experience of SMI and cancer. Grounded theory methods of initial, focused, and theoretical coding were adopted alongside constant comparative methods and memoing. RESULTS: Several interrelated categories describe participants' experiences of coping with SMI and cancer. This paper focuses on one of the four categories-resilience. Resilience was derived as a main category, highlighting that people with a pre-existing SMI draw on existing strategies when diagnosed with cancer. Through this mechanism, participants' previous experiences of living with SMI shaped the way in which resilience was enacted when receiving a cancer diagnosis. Resilience was expressed through four interrelated processes: deploying known strategies, self-advocacy, finding positives, and reimagining future me. Findings resonate with existing evidence on resilience, while also offering new insights in the context of SMI and cancer. CONCLUSIONS: People living with SMI draw on established, prior strategies for resilience to support coping when diagnosed with cancer. These findings suggest that supportive care for people with SMI and cancer may benefit from taking an asset-based, personalised approach to support enactment of their existing strategies for resilience. Recognising and supporting existing strategies for resilience may improve coping and experiences of care in this population.