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Post-traumatic growth in mental health recovery: qualitative study of narratives
  1. Mike Slade1,
  2. Stefan Rennick-Egglestone1,
  3. Laura Blackie2,
  4. Joy Llewellyn-Beardsley1,
  5. Donna Franklin3,
  6. Ada Hui1,
  7. Graham Thornicroft4,
  8. Rose McGranahan5,
  9. Kristian Pollock6,
  10. Stefan Priebe5,
  11. Amy Ramsay4,
  12. David Roe7,
  13. Emilia Deakin1
  1. 1 Institute of Mental Health, University of Nottingham School of Health Sciences, Nottingham, UK
  2. 2 Department of Psychology, University of Nottingham, Nottingham, UK
  3. 3 Institute of Mental Health, NEON Lived Experience Advisory Panel, Nottingham, UK
  4. 4 Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
  5. 5 Unit of Social and Community Psychiatry, Queen Mary University of London, London, UK
  6. 6 School of Health Sciences, University of Nottingham, Nottingham, UK
  7. 7 Department of Community Mental Health, University of Haifa, Haifa, Israel
  1. Correspondence to Professor Mike Slade; m.slade{at}nottingham.ac.uk

Abstract

Objectives Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems.

Design Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery.

Setting England.

Participants Participants were adults aged over 18 and: (1) living with psychosis and not using mental health services (n=21); (2) using mental health services and from black and minority ethnic communities (n=21); (3) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (4) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) white British.

Results Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (self-discovery) leading to a new sense of who one is (sense of self) and appreciation of life (life perspective). Observable positively valued changes comprise a greater focus on self-management (well-being) and more importance being attached to relationships (relationships) and spiritual or religious engagement (spirituality). Categories are non-ordered and individuals may start from any point in this process.

Conclusions Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of well-being. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental healthcare could use the six identified categories as a basis for new approaches to supporting recovery.

Trial registration number ISRCTN11152837

  • post-traumatic growth
  • mental health
  • recovery

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Footnotes

  • Contributors MS and LB made a substantial contribution to the conception or design of the work. MS, SR-E, LB, JL-B, DF, AH, GT, RM, KP, SP, AR, DR and ED contributed to the acquisition, analysis or interpretation of data for the work. MS, SR-E, LB, JL-B, DF, AH, GT, RM, KP, SP, AR, DR and ED were involved in drafting the work or revising it critically for important intellectual content, and gave final approval of the version to be published. MS, SR-E, LB, JL-B, DF, AH, GT, RM, KP, SP, AR, DR and ED agree to be jointly accountable for all aspects of the work.

  • Funding This article is independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Narrative Experiences ONline (NEON) Programme, RP-PG-0615-20016).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or other supporting funders.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.

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