title: The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness.
abstract: Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.
authors.affiliation: Champalimaud Clinical Centre, Champalimaud Centre for the UnknownLisboa, Portugal; Champalimaud Research, Champalimaud Centre for the UnknownLisboa, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal.
authors.forename: Albino J
authors.initials: AJ
authors.lastname: Oliveira-Maia
authors.affiliation: Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal.
authors.forename: Carina
authors.initials: C
authors.lastname: Mendonça
authors.affiliation: Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Pessoa
authors.affiliation: Champalimaud Research, Champalimaud Centre for the Unknown Lisboa, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gago
keywords: needs assessment; quality of life; recovery; schizoaffective disorder; schizophrenia