Stories of Recovery from the Bush: Unravelling the Experience of Mental Illness, Self and Place: Research Report

A major mental illness will be experienced by almost half of the Australian population during their lifetime (ABS 2007). People with mental illness are at greater risk of poor physical health, co-morbidity and decreased life expectancy (Harker and Cheeseman 2016). They are also more likely to experience suicide, social isolation, discrimination, homelessness, and unemployment (Lee et al 2013). Those living with severe and persistent mental illness are among the most disadvantaged and stigmatised in society (Henderson, Evans-Lacko and Thornicroft 2013). The Partners in Recovery (PIR) initiative aims to better support people living with severe and persistent mental illness by providing a more coordinated system response to their mental health needs (DoH a). However, community-managed mental health organisations are 'not well described in current data collections' (AIHW 2014:386) which implies that what they do and how effective they are may not be well understood. As can be seen from the data cited above, dominant cultural stories about mental illness tend to be problem-centred. They speak of burden, difficulty, hopelessness and sometimes death. The Stories of Recovery project aimed to uncover less dominant stories to learn more about what works in the service system and wider community to support people experiencing severe and persistent mental illness. Twenty six participants of the Western NSW Partners in Recovery (PIR) program contributed to this study. In qualitative interviews people were asked how their identity, relationships and experiences of social inclusion are shaped by their lived experience of mental illness; how that lived experience is impacted by living in regional and rural NSW; and what they have found helpful and supportive in their recovery journeys. The research was funded by Marathon Health and conducted by Western Sydney University in partnership with The Benevolent Society. The aim was to learn more about what works in the service system and wider community to support people experiencing severe and persistent mental illness and who have complex needs. In doing so, the project uniquely brought together the principles of recovery, trauma-informed practice and collective impact to inform the design and conduct of the research. Participant's knowledge and experience was made the centre of the research through the use of visual research methods. The photovoice methodology provided participants with a means of creatively exploring the research questions so they could tell their stories of recovery and living in the community; explore their experiences of the service system; and, more broadly, tell us what works to support people on their journey. Overwhelmingly, the research findings provide evidence which supports the Recovery model. These findings are articulated under four key themes that demonstrate the centrality to wellbeing of: connections and belonging; skills of survival and resilience; contributing to the social fabric; and person-centred services in both clinical and non-clinical settings. The findings provide unique perspectives offering innovative possibilities for policy development and service provision. In particular the findings enlarge current understandings of connection and social inclusion to include nature, animals and family history, however troubled that may be. While supportive of the recovery model the findings also call for increased community capacity building; a focus on measuring the recovery practices of a service rather than client outcomes; and working towards minimising the clash of cultures people often experience as they move between clinical and non-clinical settings. Our findings also support a move away from a deficit approach to people experiencing mental illness. The data demonstrates they contribute to social capital in communities and families through the ups and downs of illness. Highlighting this could significantly contribute to reducing stigmatisation and discrimination. Furthermore, the findings show that the inclusive and creative research design enhanced a sense of positive identity for the participants who spoke about what they believe is necessary, important and sometimes unhelpful from service providers. The knowledge that a person is making a contribution to improving service provision and challenging stigmatisation can, in itself, be a contribution to their wellbeing. Most powerfully the findings show that participants want the opportunity to tell their stories and be heard: the positive impact of this on wellbeing, regardless of complexity of illness, cannot be overstated. Based on the findings generated by the Stories of Recovery research, this Report makes clear and achievable recommendations for regional communities and service systems to better support people experiencing severe and persistent mental illness.