Measures of mental health consumer recovery : systematic review of measurement properties and consumer perspectives : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand. EMBARGOED to 2 Sept 2027.

Abstract

Consumers, service providers, and policymakers have advocated for recovery-oriented mental health care. Recovery-oriented practice is mandated in mental health policy globally and in Aotearoa New Zealand. However, there is a gap between the recovery-oriented practice mandate and what happens in practice. A review of the quality of consumer recovery measures is needed to support the application of recovery-oriented practice. Selecting which measures to use in practice and research is complex and requires consideration of the measurement properties and acceptability of the measures, in addition to the needs and preferences of the consumer. The current research aimed to identify measures of consumer recovery developed using consumer leadership or co-production, evaluate the measurement properties of the measures, synthesise consumer perspectives of the measures, and make recommendations on the measures for use in practice and research, particularly in relation to supporting and promoting consumer recovery. An innovative mixed methods systematic review design was used. Two systematic reviews were conducted: a systematic review which quantitatively evaluated the measurement properties of consumer-led or co-produced consumer recovery measures, and a systematic review of qualitative evidence on consumer perspectives of these measures. The evaluation of quantitative information on measurement properties was conducted according to the Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN), which is a cutting edge and comprehensive methodology for the evaluation of measurement properties. Findings from qualitative studies on consumer perspective of consumer recovery measures were analysed using a thematic synthesis framework, including findings on whether measures were acceptable, user-friendly, and included domains of recovery relevant to consumers. Findings from the quantitative and qualitative systematic reviews were integrated to develop recommendations on measures which were driven by information on measurement properties and the perspectives of consumers (e.g., measures which have sufficient measurement properties and are acceptable to consumers). Findings establish a comprehensive and updated overview of consumer-led and co-produced consumer recovery measures, which is critical for implementing and evaluating recovery-oriented practice, service development, and research. Research on the quality of consumer recovery measures is needed to support the embedding of recovery-oriented practice.