Background: Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months. Methods: A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups. Results: Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators. Mechanisms of impact concerned (1) a new perspective on mental health, well-being and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users' thoughts and feelings on recovery, sharing narratives and influencing care and goals. Conclusions: The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved. Patient and Public Contribution: The current study involved stakeholders including a service user organization, the public, first-line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All authors have their own lived experiences of mental health problems as a service user or as a relative.
Bibliographical noteFunding Information:
The authors would like to thank the participants who greatly contributed with their perceptions of the Recovery Guide intervention to improve service delivery. The authors also acknowledge all stakeholders involved, in particular the reference group and public referral group, and principal leader of the MHS of Region Skåne, Katarina Hartman, and managers who initiated the idea and currently support the provision of the Recovery Guide intervention within inpatient services. The implementation of the Recovery Guide was financially supported by the Swedish General Inheritance Fund, and the MHS in Region Skåne. Research wages were funded by Jan Hains Foundation award for Scientific Clinical Research in Region Skåne.
© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.
- mental health
- process evaluation
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health