132 Chapter 7 Table 1: [continued] Persons with SMI (n=39a) Family (n=14b) Professionals (n=21c) N/ median1 %/ range1 N/ median1 %/ range1 N/ median1 %/ range1 Work experience in mental healthcare (years)* 8 1-44 Profession - Mental health nurse - Psychologist - Psychiatrist - Spiritual counsellor, Experience worker, Clinical support worker 9 3 5 4 43 14 24 19 Legend: SMI: severe mental illness; illness duration measured as time between first contact with mental health services and study inclusion; an=28 interview respondents and n=11 focus group participants; bn=10 interview respondents and n=4 focus group participants; cn=14 interview respondents and n=7 focus group participants; 1Median and Range (min-max) reported for continuous measures, which are marked with asterisk*; 2Missing data. Age: n=1 (SMI) n=3 (family) n=1 (professionals); education level (family) n=1; Clinical staging n=6; family years involved in care: n=4; family years of collaboration with current professional n=8; 3Following ISCED 2011 criteria (37); 4Based on DSM-5 diagnosis in case file; 5Including gambling disorder in two respondents. Excluding nicotine use; 6Following DSM-5 criteria for schizophrenia spectrum disorders (36). RESULTS From the stories of persons with severe mental illness, family and professionals on their (perspective on the) recovery process, we developed two main themes, and introduced subthemes to clarify their content. They represent what a person with severe mental illness, family member or professional does in the triad during collaboration for recovery: (1) attributing roles to members of the triad , which had two mutually influential parts (subthemes): (1.1) “unconditional” and (1.2) “problem oriented” part, including the experience of (mis)alignment over “problem oriented” role; and (2) interacting with the others in the triad during the process of recovery, which we describe as a process with four elements (subthemes) which influence each other, not necessarily in a fixed order: (2.1) “Having expectations”; (2.2) “(not) Informing”, (2.3) “Taking/Attributing agency (to change)” and (2.4)“Experiencing (dis)agreement, collaboration or struggle”. Attribution of roles influenced how interaction was perceived, and vice versa. Figure 2 shows a graphic representation of these processes, and show contextual factors influencing collaboration. We elaborated on the main themes and subthemes in separate sections below. In the running text, we mainly used quotes that illustrate the experience of diverging perspectives on problem and role and resulting interaction, to focus on the challenge of collaboration. We listed additional illustrative quotes from all three perspectives in tables 2 and 3, illustrating the experience of alignment over roles, and positive interaction.
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