title: Staff understanding of recovery-orientated mental health practice: a systematic review and narrative synthesis.
abstract: BACKGROUND
  Mental health policy is for staff to transform their practice towards a recovery orientation. Staff understanding of recovery-orientated practice will influence the implementation of this policy. The aim of this study was to conduct a systematic review and narrative synthesis of empirical studies identifying clinician and manager conceptualisations of recovery-orientated practice.
  
  
  METHODS
  A systematic review of empirical primary research was conducted. Data sources were online databases (n = 8), journal table of contents (n = 5), internet, expert consultation (n = 13), reference lists of included studies and references to included studies. Narrative synthesis was used to integrate the findings.
  
  
  RESULTS
  A total of 10,125 studies were screened, 245 full papers were retrieved, and 22 were included (participants, n = 1163). The following three conceptualisations of recovery-orientated practice were identified: clinical recovery, personal recovery and service-defined recovery. Service-defined recovery is a new conceptualisation which translates recovery into practice according to the goals and financial needs of the organisation.
  
  
  CONCLUSIONS
  Organisational priorities influence staff understanding of recovery support. This influence is leading to the emergence of an additional meaning of recovery. The impact of service-led approaches to operationalising recovery-orientated practice has not been evaluated.
  
  
  BACKGROUND
  The protocol for the review was pre-registered (PROSPERO 2013: CRD42013005942 ).
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. clair.c.le_boutillier@kcl.ac.uk.
authors.forename: Clair
authors.initials: C
authors.lastname: Le Boutillier
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. agneschevalier@hotmail.com.
authors.forename: Agnes
authors.initials: A
authors.lastname: Chevalier
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. vanessa.c.lawrence@kcl.ac.uk.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Lawrence
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. mary.leamy@kcl.ac.uk.
authors.forename: Mary
authors.initials: M
authors.lastname: Leamy
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. victoria.bird@kcl.ac.uk.
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Bird
authors.affiliation: 2Gether NHS Foundation Trust, Gloucestershire, UK. rob.macpherson@glos.nhs.uk.
authors.forename: Rob
authors.initials: R
authors.lastname: Macpherson
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. julie.b.williams@kcl.ac.uk.
authors.forename: Julie
authors.initials: J
authors.lastname: Williams
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK. mike.slade@kcl.ac.uk.
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
mesh_terms: D005060:Europe; D019317:Evidence-Based Medicine; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D010465:Perception; D036301:Qualitative Research