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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Written plans: an overlooked mechanism to develop recovery-oriented primary care for depression?

Victoria J. Palmer A B , Caroline L. Johnson A , John S. Furler A , Konstancja Densley A , Maria Potiriadis A and Jane M. Gunn A
+ Author Affiliations
- Author Affiliations

A Primary Care Research Unit, The Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia.

B Corresponding author. Email: vpalmer@unimelb.edu.au

Australian Journal of Primary Health 20(3) 241-249 https://doi.org/10.1071/PY12128
Submitted: 5 October 2012  Accepted: 2 April 2013   Published: 7 May 2013

Abstract

There is a global shift to foster patient-centred and recovery-oriented mental health services. This has resulted from the expansion of how the concept of recovery is understood in mental health literature and practice. Recovery is now more than a return to function or reduction in symptoms; it is a subjective, individualised and multi-faceted experience. To date there has not been investigation of how recovery-oriented services can be translated and implemented into the primary mental health care system. This paper presents the results of a survey from a prospective cohort of primary care patients with probable depression about the importance of written plans to recover. The benefits of having a written plan to recover from depression, as outlined by the participants, were analysed using Leximancer software. The findings provide insights into how written plans may be an important mechanism for implementing a recovery-oriented primary mental health care system. We conclude that the benefits of a written plan provide insight into how patients conceptualise recovery.

Additional keywords: patient experience, primary mental health care, qualitative research.


References

Anderson LA, Dedrick RF (1990) Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychological Reports 67, 1091–1100.

Bachman J, Swenson S, Reardon M, Miller D (2006) Patient self-management in the primary care treatment of depression. Administration and Policy in Mental Health and Mental Health Services Research 33, 76–85.
Patient self-management in the primary care treatment of depression.Crossref | GoogleScholarGoogle Scholar | 16215659PubMed |

Blashki G, Hickie IB, Davenport TA (2003) Providing psychological treatments in general practice: how will it work? The Medical Journal of Australia 179, 23–25.

Bodenheimer T, Lorig K, Halsted H, Grumbach K (2002a) Patient self-management of chronic disease in primary care. Journal of the American Medical Association 288, 2469–2475.
Patient self-management of chronic disease in primary care.Crossref | GoogleScholarGoogle Scholar | 12435261PubMed |

Bodenheimer T, Wagner E, Grumbach K (2002b) Improving primary care for patient with chronic illness. Journal of the American Medical Association 288, 1775–1779.
Improving primary care for patient with chronic illness.Crossref | GoogleScholarGoogle Scholar | 12365965PubMed |

Bodenheimer T, Wagner E, Grumbach K (2002c) Improving primary care for patients with chronic illness, part 2. Journal of the American Medical Association 288, 1909–1914.
Improving primary care for patients with chronic illness, part 2.Crossref | GoogleScholarGoogle Scholar | 12377092PubMed |

Bolger-Harris H, Schattner P, Saunders M (2008) Using computer based templates for chronic disease management. Australian Family Physician 37, 285–288.

Brown W (2008) Narratives of mental health recovery. Social Alternatives 27, 42–48.

Commonwealth of Australia (2010) National Mental Health Strategy: National Standards for Mental Health Services 2010. Canberra, Commonwealth of Australia.

Cook JA, Copeland ME, Jonikas JA, Hamilton MM, Razzano L, Floyd CB, Hudson WB, Macfarlane RT, Grey DD (2009) Initial outcomes of a mental illness self-management program based on wellness recovery action planning. Psychiatric Services (Washington, D.C.) 60, 246–249.
Initial outcomes of a mental illness self-management program based on wellness recovery action planning.Crossref | GoogleScholarGoogle Scholar |

Cook JA, Copeland ME, Corey L, Buffington E, Jonikas JA, Curtis LC, Grey DD, Nicholas WH (2010) Developing the evidence base for peer-led services: changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal 34, 113–120.
Developing the evidence base for peer-led services: changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives.Crossref | GoogleScholarGoogle Scholar | 20952364PubMed |

Cook JA, Copeland ME, Floyd CB, Jonikas JA, Hamilton MM, Razzano L, Carter TM, Hudson WB, Grey DD, Boyd S (2012) A randomized controlled trial of effects of wellness recovery action planning on depression, anxiety, and recovery. Psychiatric Services (Washington, D.C.) 63, 541–547.
A randomized controlled trial of effects of wellness recovery action planning on depression, anxiety, and recovery.Crossref | GoogleScholarGoogle Scholar |

Cretchley J, Gallois C, Chenery H, Smith A (2010) Conversations between carers and people with schizophrenia: a qualitative analysis using leximancer. Qualitative Health Research 20, 1611–1628.
Conversations between carers and people with schizophrenia: a qualitative analysis using leximancer.Crossref | GoogleScholarGoogle Scholar | 20675536PubMed |

Department of Health and Ageing (2010) National Mental Health Report 2010: Summary of 15 Years of reform in Australia’s Mental Health Services under the National Mental Health Strategy 1993–2008. DoHa Ageing. Canberra: 179.

Department of Health and Ageing (2011a) Medicare Benefits Schedule – Explanatory Notes GP Mental Health Care Items. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/0F524516E75E5662CA2573D30015164F/$File/Expl%20Notes.pdf [Verified 23 May 2011]

Department of Health and Ageing (2011b) Medicare Benefits Schedule effective 01 July 2011, Items: 271, 2712. Canberra, Department of Health and Ageing: 1–49.

Dowrick C, May C, Richardson M, Bundred P (1996) The biopsychosocial model of general practice: rhetoric or reality? The British Journal of General Practice 46, 105–107.

Fletcher J, Pirkis J, Bassilios B, Kohn F, Blashki G, Burgess P (2009) Australian primary mental health care: improving access and outcomes. Australian Journal of Primary Health 15, 244–253.
Australian primary mental health care: improving access and outcomes.Crossref | GoogleScholarGoogle Scholar |

Fukui S, Starnino VR, Susana M, Davidson LJ, Cook K, Rapp CA, Gowdy EA (2011) Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery. Psychiatric Rehabilitation Journal 34, 214–222.
Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery.Crossref | GoogleScholarGoogle Scholar | 21208860PubMed |

Gunn JM, Gilchrist GP, Chondros P, Ramp M, Hegarty KL, Blashki GA, Pond DC, Kyrios M, Herrman HE (2008) Who is identified when screening for depression is undertaken in general practice? Baseline findings from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) longitudinal study. Medical Journal of Australia 188, S119–S125.

Gunn JM, Palmer VJ, Dowrick CF, Herrman HE, Griffiths FE, Kokanovic R, Blashki GA, Hegarty KL, Johnson CL, Potiriadis M, May CR (2010) Embedding effective depression care: using theory for primary care organisational and systems change. Implementation Science 5, 62

Harris MF, Chan BC, Dennis S (2009) Coordination of care for patients with chronic disease. Medical Journal of Australia 191, 85–86.

Hickie IB, McGorry PD (2007) Increased access to evidence-based primary mental health care: will implementation match the rhetoric? Medical Journal of Australia 187, 100–103.

Johnson C, Gunn J, Kokanovic R (2009) Depression recovery from the primary care patient’s perspective: ‘hear it in my voice and see it in my eyes’. Mental Health in Family Medicine 6, 49–55.

Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9. Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine 16, 606–613.
The PHQ-9. Validity of a Brief Depression Severity Measure.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrhtVWnsQ%3D%3D&md5=14e80d327c84e3ac27371b5ab2728295CAS | 11556941PubMed |

Leximancer (2012) Academia. Available at https://www.leximancer.com/academia/.

Meehan TJ, King RJ, Beavis PH, Robinson JD (2008) Recovery-based practice: do we know what we mean or mean what we know? The Australian and New Zealand Journal of Psychiatry 42, 177–182.
Recovery-based practice: do we know what we mean or mean what we know?Crossref | GoogleScholarGoogle Scholar | 18247191PubMed |

Palmer V, Gunn J, Kokanovic R, Griffiths F, Shrimpton B, Hurworth R, Herrman H, Johnson C, Hegarty K, Blashki G, Butler E, Johnston-Ata’ata K, Dowrick C (2010a) Diverse voices, simple desires: a conceptual design for primary care to respond to depression and related disorders. Family Practice 27, 447–458.
Diverse voices, simple desires: a conceptual design for primary care to respond to depression and related disorders.Crossref | GoogleScholarGoogle Scholar | 20378630PubMed |

Palmer V, Forsdike K, Furler J, Gunn M (2010b) i-CCAaN Final Report - Improving Community Coordination, Access and Networks primary care for depression, related disorders and co-existing chronic physical illnesses. beyondblue. Melbourne, Victoria Centre for Excellence in Depression, Anxiety and Related Disorders: 62.

Penn-Edwards S (2010) Computer aided phenomenography: the role of leximancer computer software in phenomenographic investigation. Qualitative Report 15, 252–267.

Pilgrim D (2008) ‘Recovery’ and current mental health policy. Chronic Illness 4, 295–304.
‘Recovery’ and current mental health policy.Crossref | GoogleScholarGoogle Scholar | 19091938PubMed |

Pirkis J, Harris M, Hall W, Ftanou M (2011) Evaluation of the Better Access to Pyschiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule Initiative. Melbourne, Centre for Health Policy, Programs and Economics: 60.

Radloff LS (1977) The CES-D scale: a self report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.
The CES-D scale: a self report depression scale for research in the general population.Crossref | GoogleScholarGoogle Scholar |

Ramon S, Healy B, Renouf N (2007) Recovery from mental illness as an emergent concept and practice in Australia and the UK. The International Journal of Social Psychiatry 53, 108–122.
Recovery from mental illness as an emergent concept and practice in Australia and the UK.Crossref | GoogleScholarGoogle Scholar | 17472085PubMed |

Ridge D (2009) ‘Recovery from depression using the narrative approach: a guide for doctors, complementary therapists and mental health professionals.’ (Jessica Kingsley Publishers: London and Philadelphia)

Ridge D, Ziebland S (2006) “The old me could never have done that”: how people give meaning to recovery following depression. Qualitative Health Research 16, 1038–1053.
“The old me could never have done that”: how people give meaning to recovery following depression.Crossref | GoogleScholarGoogle Scholar | 16954524PubMed |

Rosenberg S, Hickie I (2010) How to tackle a giant: creating a genuine evaluation of the Better Access Program. Australasian Psychiatry 18, 496–502.
How to tackle a giant: creating a genuine evaluation of the Better Access Program.Crossref | GoogleScholarGoogle Scholar | 21117835PubMed |

Rutter M (2005) Treatment planning for Person-Centred Care: the road to mental health and addiction recovery. Pyschiatric Services 56, 1464–1465.
Treatment planning for Person-Centred Care: the road to mental health and addiction recovery.Crossref | GoogleScholarGoogle Scholar |

Schreiber R (1996) (Re)Defining my self: women’s process of recovery from depression. Qualitative Health Research 6, 469–491.
(Re)Defining my self: women’s process of recovery from depression.Crossref | GoogleScholarGoogle Scholar |

Smith AE, Humphreys MS (2006) Evaluation of unsupervised semantic mapping of natural language with Leximancer concept mapping. Behavior Research Methods 38, 262–279.
Evaluation of unsupervised semantic mapping of natural language with Leximancer concept mapping.Crossref | GoogleScholarGoogle Scholar | 16956103PubMed |

Starnino VR, Mariscal S, Holter MC, Davidson LJ, Cook KS, Fukui S, Rapp CA (2010) Outcomes of an illness self-management group using wellness recovery action planning. Psychiatric Rehabilitation Journal 34, 57–60.
Outcomes of an illness self-management group using wellness recovery action planning.Crossref | GoogleScholarGoogle Scholar | 20615846PubMed |

StataCorp (2011) Stata Statistical Software: Release 12. College Station, TX, SataCorp LP.

Ware JJ, Kosinski M, Keller S (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care 34, 220–233.

Watson M, Smith A (2005) Leximancer concept mapping of patient case studies. In ‘Knowledge-based intelligent information and engineering systems, 9th International Conference Proceedings Part III, 14–16 September 2005, Melbourne’, (Eds R Khosla, R Howlett, L Jain) pp. 1232–1238. (Springer)