This thesis aimed to explore personal definitions and experiences of recovery from psychosis for service users (SUs) and general practitioners (GPs), as well as indentify factors which might promote or hinder recovery in a primary care context, and identify interventions which might be required to enhance the promotion of recovery in primary care. A review of existing literature pertaining to the concept of 'recovery' was undertaken, and differing conceptualisations of 'recovery' were analysed and synthesised through the use of a Critical Interpretive Synthesis. Semi-structured interviews were conducted with 24 GPs and 20 SUs. Two mixed focus groups were also carried out as follow-ups with 5 GPs and 5 SUs. The data was analysed using a modified grounded theory approach. Factors reported to promote recovery in primary care included: autonomy, choice, and empowerment for SUs in treatment decisions; signposting of peer-supported groups and services by GPs; enhancement of SUs' social support networks by GPs; advocacy and independent analysis provided by GPs; a whole-person approach to recovery (social and biomedical); less stigmatising environment of primary care; and families of SUs and GPs working together in collaboration, often having built up a trusting relationship over time through continuity of care. The following potential interventions for enhancing recovery in primary care were identified: SU-led training for GPs regarding psychosis knowledge and attitudes; raising GPs' awareness of local services and groups by encouraging service managers and group organisers to visit GP practices; establishing GP peer supervision forums; improving access to GPs with a Special Interest in Mental Health (GPwSIs); shifting a greater degree of responsibility for recovery from psychosis to primary care from secondary care; reinforcing amongst GPs an awareness of the important role which primary care can play in promoting recovery; facilitating continuity of care within large practices where feasible; and encouraging GPs to alert SUs to seriousness of potential side-effects of medication before and during treatment. The implications of the findings for policy, practice, and future research were discussed.

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The purpose of this study was to examine parents’ management styles when caring for adult children with serious mental illness (SMI), as well as parents’ perspectives on what type of community-based mental health interventions would support and/or enhance overall family functioning. This qualitative descriptive study was undergirded by Knafl and Deatrick’s Family Management Style Framework. Thirty parents (N = 30) caring for adult children with SMI over age 18 were recruited as participants. Demographic data included age, gender, ethnicity, educational level, annual income, and National Alliance on Mental Illness membership. Parents were interviewed in their homes or other private setting. Verbal informed consent was obtained. Audio-recorded, individual, semistructured interviews were conducted until redundancy was achieved. Data were analyzed using qualitative content analysis. Four major themes emerged from the data. These themes described prolonged, difficult, and confusing phases that parents and the family undergo in caring for an adult child with SMI. These phases have a progressive nature, moving from parents recognizing that their child has a SMI to redefining family life as a result of caring for an adult child with SMI. Successful management of these phases must include increasing access to mental health information, mental health screening, early interventions, violence prevention, and various treatment options for adult children and their families.

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The aim of this qualitative study was to explore hospital-counselors view on collaboration in thedischarge-process from inpatient psychiatric care regarding individuals with comorbidity in form ofserious mental illness and substance abuse. Six hospital-counselors from different psychiatric in-patient wards in Stockholms county participated in the study. All participants had a degree in socialwork and five of them had earlier experience working in the municipality as social workers. Theresearch process was conducted using qualitative interviews, further applying a systemic view oncollaboration which consisted of three levels: structural-, organizational- and individual, which wasbased on the core concepts of integrated care and person-centered care. The results showed that thehospital-counselors acted as a “link” between the health care, municipality, and patient duringcollaboration. Collaboration itself was described as a process involving different actors andorganizations within the two main principal sectors. The complexity of the differences in economicinterests, view on support needs and responsibilities regarding treatment and further care seemed to becentral aspects influencing collaboration. Although the results largely confirm previous research, it hasbrought attention to specific claims on what facilitates collaboration and what undermines it.