Year

2018

Degree Name

Doctor of Philosophy

Department

School of Nursing

Abstract

Background: Self-determination has arisen as an area of importance in mental health care, as people with a mental illness report significantly low levels of this construct. Self-determination has been associated with positive health behaviours and personal recovery. As 1 in 4 people will experience a mental illness in their lifetime, it is crucial to explore methods of enhancing self-determination for people living with mental illness, and how this links to personal recovery.

Methods: Twenty-nine people with a lived experience of mental illness who attended a five day therapeutic recreation initiative called Recovery Camp completed two self-report, Likert scale questionnaires, measuring components of self-determination. Responses were collected pre-camp, post-camp, and at three-month follow-up, and were compared to a group of 26 people with a lived experience of mental illness who went about their lives ‘as usual.’ Fifteen Recovery Camp participants also participated in semi-structured interviews, exploring self-determination and personal recovery in the context of Recovery Camp. Member checking was conducted via a focus group of six participants.

Findings: Participants who attended Recovery Camp reported a statistically significant increase in autonomy, relatedness, perceived choice, and awareness of self post-camp, however the increase in autonomy was not maintained at three-month follow-up. Moreover, competence did not show significant change over time for either the Recovery Camp or comparison group. Analysis of interview and focus group findings using van Kaam’s psychophenomenological method of analysis explored self-determination and personal recovery in the context of Recovery Camp, and revealed key themes such as autonomy, competence, relatedness, confidence, and purpose. The most significant finding of the present study, was the importance of relatedness for the personal recovery journey. Concepts of connectedness and relatedness were apparent across both interview and survey findings.

Conclusion and implications for practice: These findings underscore how participation in therapeutic recreation experiences such as Recovery Camp can foster the development of certain key components of self-determination among people living with a broad range of mental illnesses. Given the importance of self-determination to the personal recovery journey, it is important to consider therapeutic recreation for all individuals experiencing mental illness, across all mental health care contexts. Fostering social connection and relatedness should be at the forefront of any treatment or therapeutic approach for people living with mental illness.

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