Recovery in England: transforming statutory services?

Area of Science:

• Mental Health Services Research
• Health Policy Analysis
• Organizational Psychology

Background:

• English mental health policy has prioritized recovery, social inclusion, employment, and well-being since 2001.
• Drivers include a shift in health services' role towards life enhancement, increased individual empowerment (personal budgets), and NICE guidelines.
• A significant gap persists between stated recovery-oriented policies and actual clinical practices, which often remain symptom-focused.

Purpose of the Study:

• To review the evolution of English mental health policy towards recovery and social inclusion.
• To identify the gap between policy and practice in mental health services.
• To describe initiatives aimed at organizational transformation for a recovery focus.

Main Methods:

• Review of English mental health policy documents and initiatives.
• Description of the ImROC (Implementing Recovery and Outcomes) national initiative.
• Outline of the REFOCUS multi-site cluster randomized controlled trial.

Main Results:

• Policy explicitly supports recovery, social inclusion, employment, and well-being.
• Organizational policies and team re-branding often mask continued focus on symptomatic treatment.
• Two initiatives (ImROC and REFOCUS) are described to facilitate organizational transformation towards recovery.

Conclusions:

• Bridging the policy-practice gap requires organizational transformation in mental health services.
• The ImROC initiative aims to foster a pro-recovery organizational climate nationally.
• The REFOCUS trial investigates a team-level intervention to promote recovery.