Table 6 Characteristics of Individuals: themes and examples from each innovation group

E-innovations

Variability in knowledge about recovery

Some doctors in an e-innovation study showed more interest in less-recovery-oriented aspects of the innovation, such as the tool’s capacity for clinical monitoring of sleep and symptoms [86].

Family-focused innovations

Variability in knowledge about recovery

In one study of a family-focused innovation, nurses tended to confound personal and clinical recovery (e.g. they referred to recovery as the clinical improvement of symptoms and a process of regaining physical and mental health to a point where the client could be discharged) [92].

Peer workers

Variability in knowledge about recovery

Some peer workers felt strongly that recovery and the roles of peer workers had been misunderstood and co-opted in the mental health system, that they were being asked to do tasks and roles that contradicted the recovery approach or that trivialized their role (being a clerk or a driver), and that some clinicians misused the term and confused clinical recovery with concepts of personal recovery [94, 99, 102].

Characteristics of recovery-oriented service providers

Personal attributes of peer workers that facilitated or optimized their work and impact included: patience [99, 111], being warm and understanding [106, 109], dependable and trustworthy [106, 111], professional, a good communicator and listener, respectful (didnʼt dictate), empathetic, positive, and optimistic [111].

Personal recovery planning

Variability in knowledge about recovery

Staff and clients showed familiarity with the facts and truths about the recovery plan when they expressed understanding that it was both process and outcome [122], owned by clients [117] and personalized [109]. However, some staff made judgements about their service usersʼ goals, such as not being realistic or not meaningful [119] and some clients did not understand the underlying concept of mental health recovery and thought the plan was a once-off thing [121].

Characteristics of recovery-oriented service providers

Positive experiences were related to finding facilitators supportive, respectful, encouraging, helpful, collaborative, and warm [109, 117, 124]. Negative experiences were related to perceiving facilitators as patronizing in their approach, not genuine in their compassion or formulaic and generic in their approach, or having done an inadequate job discussing recovery [109, 121, 122].

Recovery colleges

Variability in knowledge about recovery

Some service provider students in recovery colleges felt that service users needed to be well enough mentally to participate [129].

Service navigation and coordination

Variability in knowledge about recovery

Even when state officials are very clear on the distinction between dependency-producing case management and self-managed recovery, and providers excited by the new model and open to client empowerment, in practice the two can become blurred [134].

Characteristics of recovery-oriented service providers

Success of service navigation and coordination innovations appeared closely tied to personal characteristics of staff, in particular the ability to develop strong individual connections, trust, and rapport with both clients and other services through a personal approach, addressing competitive or defensive responses, empowering themselves, being hardworking, and having the skills to navigate fragmented systems [130, 131, 133].

Staff training

Variability in knowledge about recovery

While the centrality of hope and recovery-oriented language was understood, some, despite training still thought of recovery as a linear journey with a start and end point, or as a type of care, or something they did for clients [135]. Some staff were concerned that many service users may not be at a level of recovery necessary to engage in a recovery training process [137].