Recovery snapshots : A photographic exploration of Romanian mental health service users’ experience of recovery

Milasan, Lucian and Limmer, Mark and Bingley, Amanda (2020) Recovery snapshots : A photographic exploration of Romanian mental health service users’ experience of recovery. PhD thesis, Lancaster University.

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Abstract

Background: Following post-communist social and economic changes, Romania is currently transitioning from institutionalised mental health services to a recovery-focused approach. Within this context, it is important to understand the perspective of Romanian service users on recovery from mental distress, an aspect that appears to be under-researched in this country. Aim: This study aimed to explore the lived experience of recovery from mental distress and identify the meanings that Romanian mental health service users attach to recovery, along with investigating potential socio-economic, cultural, and historical particularities of recovery in their accounts. Method: The theoretical core of this study was the recovery framework that conceptualises mental distress as a human, rather than a medicalised, experience. For this reason, a qualitative phenomenological design was employed to explore recovery from the perspective of fifteen adults with mental health problems selected purposively from a community day centre in Romania. The phenomenological methodology was enriched with elements of photography (workshops and photo-elicitation interviews) to elicit experiences and meanings of recovery. Findings: The outcome of this study was a better understanding of the experience of recovery in Romanian adults living with mental distress, as a complex and multi-dimensional phenomenon including medical, psychological, social, spiritual, existential, and occupational aspects. The key recovery themes (and subthemes) identified through Interpretative Phenomenological Analysis corroborated with participant-generated photography were: awakening (overcoming sedation, emergence of self beyond illness, and liberation), healing (medical, psychological, and spiritual), and reconstructing life (keeping busy, rebuilding social networks, and cultivating hope). Discussion: This study revealed a cultural dimension of recovery in Romanian mental health service users that adds to the knowledge emerging from the current recovery frameworks. Additionally, it showed that recovery cannot be fully understood unless situated in a socio-political, cultural, and historical context, a dimension insufficiently evidenced in the recovery models. The use of participant-generated photography was crucial to capturing the picture of recovery through deep insights and visual representations that elicited rich narrative accounts. The role of photographs in facilitating and supporting recovery from mental distress was also discussed, along with limitations and challenges, and recommendations for photography-based recovery research and practice. Therefore, although conducted in Romania, this study may inform recovery research and practice in international contexts.