Exploring Barriers to Recovery Amongst Women with Psychosis: A Qualitative Secondary Analysis

Experiencing psychosis can impact all areas of a person's life, causing significant changes to thoughts, perceptions, mood, behaviour, and sense of self. Details of the specific barriers to recovery experienced by women with psychosis and how these barriers may relate to both sex and gender remain unknown. To identify and conceptualise barriers to recovery, a qualitative secondary analysis was undertaken of 31 semi-structured interviews from a primary anthropological study focused on women's lived experiences of a first episode of psychosis. Participants were recruited from Early Intervention Services in England, UK, between 2010 and 2015. Reflexive thematic analysis demonstrated various barriers to recovery, including internal conflicts with identity, the constraining of moral agency, inadequate support to address past traumas, structural factors, and stigma. Each of these barriers intersects with both sex and gender norms in a number of ways. Barriers to recovery must be addressed within mental health services to ensure that women have the best chance of moving forward with, and finding new meaning in, their lives after psychosis. Consideration of past experiences as well as normative gender roles, and other structural barriers is needed. Future research should develop and evaluate sex- and gender-specific interventions and consider integrating these into clinical practice.