What Matters: Factors Impacting the Recovery Process Among Outpatient Mental Health Service Users

Objective: Understanding factors that promote and hinder the recovery process for people living with serious mental illness remains of critical importance. We examine factors, including limited literacy, associated with mental health recovery among public mental health service users. Method: This study uses data from a mixed-methods, service-user informed project focused on the impact of limited literacy in the lives of people with serious mental illness. Data from structured interviews evaluate perceptions of recovery as assessed with the Recovery Assessment Scale (RAS). Regression models examine factors related to recovery controlling for sociodemographic factors, literacy, neurocognition, mental health status, perceived social support, and stigma. Results: Despite bivariate relationships between RAS and limited literacy, the full models suggest that other factors account for this relationship. These include mental health status, higher social support, higher self-reported community status, and higher stigma consciousness, as well as race for some models. Conclusions and Implications for Practice: Our findings that social support and perceptions of community status are associated with higher scores on the RAS echo prior work demonstrating the importance of social connection and context in mental health recovery. Though literacy was not a predictor of recovery, further research should examine the relationship between literacy and recovery given the deep literature on literacy on health outcomes. In order to better support people in the recovery process it is important that more research is done to examine the complex relationship between stigma consciousness and recovery as well as understand the racial disparities that exist within the recovery subscales. Impact and Implications Limited literacy was not significantly associated with recovery attitudes; however, individual and social level factors, mental health status, social support, perception of community status, and stigma consciousness were found to positively impact one's recovery attitudes. These factors need to be understood so they can be leveraged to help people move toward recovery.