title: Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions.
abstract: The Internet is transforming mental health care services by increasing access to, and potentially improving the quality of, care. Internet-based interventions in mental health can potentially play a role in transitions from biomedical to recovery-oriented research and practices, but an overview of what this may entail, current work, and issues that need addressing, is lacking. The objective of this study is to describe Internet-based recovery-oriented interventions (referred to as e-recovery) and current research, and to identify gaps and issues relevant to advancing recovery research and practices through opportunities provided by the Internet.
  
  
  
  Five iterative stages of a scoping review framework were followed in searching and analyzing the literature. A recovery framework with four domains and 16 themes was used to deductively code intervention characteristics according to their support for recovery-oriented practices. Only Internet-based interventions used in conjunction with ongoing care were included.
  
  
  
  Twenty studies describing six e-recovery interventions were identified and originated in Australia, Finland, the Netherlands, Norway and USA. The domain supporting personal recovery was most clearly reflected in interventions, whereas the last three domains, i.e., promoting citizenship, organizational commitment and working relationship were less evident. Support for the formulation and follow-up of personal goals and preferences, and in accessing peer-support, were the characteristics shared by most interventions. Three of the six studies that employed a comparison group used randomization, and none presented definitive findings. None used recovery-oriented frameworks or specific recovery outcome measures. Four of the interventions were specific to a diagnosis.
  
  
  
  Research about how technologies might aid in illuminating and shaping recovery processes is in its formative stages. We recommend that future e-recovery research and innovation attend to four dimensions: evidence-supported interventions, new knowledge about personal recovery, values-based approaches and Internet as a facilitator for organizational transformation. The incremental changes facilitated by e-recovery may help propel a shift in mental health care toward recovery-oriented practices.
authors.affiliation: Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway. monica.strand@rr-research.no.|Department of Psychiatry Blakstad, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Asker, Norway. monica.strand@rr-research.no.|Faculty of Medicine, University of Oslo, Oslo, Norway. monica.strand@rr-research.no.
authors.forename: Monica
authors.identifier: 0000-0001-5376-3325
authors.initials: M
authors.lastname: Strand
authors.affiliation: Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway.|Norwegian Centre for Integrated Care and Telemedicine, University Hospital in North Norway, Tromsø, Norway.
authors.forename: Deede
authors.initials: D
authors.lastname: Gammon
authors.affiliation: Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ruland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005387:Finland; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D020407:Internet; D008134:Long-Term Care / Q000458:organization & administration; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009426:Netherlands; D009664:Norway; D011369:Professional-Patient Relations; D019114:Remote Consultation / Q000379:methods*; D012944:Social Support; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Internet; Long-term mental illness; Patient-physician relationship; Recovery-oriented care; Secure email; Service user involvement; Values-based research and practices