Table 2. Notable stepwise multiple regression results

1


Principles of Recovery An Evaluation of Consumer
Inclusion and Recovery Outcomes in Nebraska
Emily B. H. Treichler, B.S., Feiyu Li, B.A.,
William D. Spaulding, Ph.D. University of
Nebraska Lincoln

Recent state and federal reforms of the public
mental health system have focused on developing
recovery-oriented services and increasing
consumer involvement in service planning and
advocacy. Mental health recovery is defined as
the development of new meaning and purpose in
ones life, beyond the impact of mental illness.
The most common elements that are included in
this notion are the importance of renewing hope
and meaning overcoming stigma and other sources
of trauma associated with serious mental
illnesses and assuming control over ones life.
The evolving notion of consumer involvement,
including becoming meaningful members of their
community and impact the delivery of services
they receive, is considered to be essential to
quality of life. However, little research has
been conducted to understand how these two
constructs are related to each other in the
context of consumers lives, including their
interactions with service systems. This study
examined how consumers view their own involvement
and recovery at this point in Nebraskas mental
health reform, and how secondary aspects of a
consumers life and mental health service system
impacts their recovery experience.
Figure 1.
Table 1. Correlations among recovery and related
constructs
 
Measure Recovery Resilience Empowerment CIM Resilience xCIM
Recovery 1 .649 -.593 .606 .701
Resilience .649 1 -.600 .615 .918
Empowerment -.593 -.600 1 -.496 -.598
CIM .606 .615 -.496 1 .844
ResiliencexCIM .701 .918 -.598 .844 1
Correlation analyses were performed in
preparation for the multiple regressions
presented below (see Table 1). A stepwise
multiple regression examined the relationship
between recovery and constructs found to be
correlated with recovery. Results revealed that
empowerment, resilience and CIM significantly
predicted recovery, R2 .532, F (3, 258)
97.861, p lt .001. A further regression model
including the interactions among those factors
revealed that the interaction between resilience
and CIM significantly predicted recovery (Figure
1). This interaction improved the variance
accounted for the model, R2? .007, F change (1,
257) 4.135, p lt .05 (Table 2). According to the
final model, empowerment and the interaction
between resilience and consumer involvement
significantly predicted recovery. The findings
revealed that as individuals report feeling more
empowered, they also report feeling more
recovered. Additionally, there was an interaction
between resilience and consumer involvement such
that among consumers with high resilience feeling
more connected to their community was related to
feeling more recovered whereas among consumers
with low resilience feeling more connected to
their community was related to feeling less
recovered.
. Correlation is significant at the 0.01 level
(2-tailed)

• Feeling more empowered is related to feeling more
  recovered
• Feelings of autonomy, community activism,
  optimism and righteous anger are important to
  consumers recovery experience
• There is a complex relationship between recovery,
  psychological involvement, and resilience
• Psychological involvement is positively related
  to recovery for those who are high in resilience
• However, for consumers who are low in resilience,
  feeling more involved is related to feeling less
  recovered
• For many consumers, resilience and psychological
  involvement affect their recovery experience
• Empowerment can be increased through treatment
  and by creating empowering service environments
• Resilience can also be increased through
  treatment and through improved social support
• Identifying aspects of consumers communities
  that are related to decreases in their feelings
  of recovery can be used to create changes
• This may include structuring services toward
  recovery, increasing resources and consumers
  autonomy in using resources, as well as education
  about self-stigma and other aspects of mental
  illness
• This study only included service users of day
  facilities, which does not account for all ranges
  of service use and severity of illness.
  Additionally, researchers did not have access to
  diagnosis and related functional issues, which
  could have affected outcomes. Considering a
  greater population and taking into account
  diagnosis in future studies will assist in
  examining how these constructs interact in
  consumers recovery experiences.

Table 2. Notable stepwise multiple regression
results
Criterion Significant Predictors r (with criterion) p (for r) ? p (for ß)
Recovery Empowerment -.593 .000 -.270 .000
  Resilience .649 .000 .009 .960
  CIM .606 .000 .060 .626
  ResiliencexCIM .701 .000 .481 .049