Significant differences in the Civic Recovery Composite Index as a Patient-Reported Outcome Measure (PROM): Implications for Research and Primary Care

Author(s):

Jean-Francois Pelletier*

Background: Recovery is the current leading paradigm in the transformation of mental health systems throughout the world. Recovery principles and values can apply from mental health to physical health for more holistic and personalized care and self-care. A key feature of a recovery-oriented system is to have patients or former patients involved as recovery mentors in the provision of care. We question whether such an approach could be decoupled to meet the specific needs of various categories of patients who are being monitored in primary care settings. Methods: Two-tailed independent samples t-tests were performed to explore differences to two patient-generated and patient-centered outcome measures, namely the Citizenship Measure (CM: 23 items) and the Recovery Assessment Scale (RAS: 24 items). Participants were recruited in social economy enterprises that provide supported employment for people with psychiatric disorders (N=173). They were successively divided in three binary sub-groups: sex (male/female), age (≤ 46 years/old ≥ 47 years old), and marital status (single/married). Results: The most significant difference is for the RAS I ask for help when I need it item, within the marital status sampling (p = 0.00). We found p = 0.01 for sex (two CM items: You have the right to be in a relationship with a partner of your choice and you have privacy), and for marital status (one RSA item: I can handle stress). Then, p = 0.02 for marital status (again: You have the right to be in a relationship with a partner of your choice). Five other differences were found at p ≤ 0.05. Discussion: Several people may seek help and support from their immediate informal network and in more natural settings than formal health services, while some others will remain reluctant to seek help from anyone for their distress. Recovery mentors who have “been there” might probably be best placed to show such reluctant people how to use community resources to become and stay well. Conclusion: Sex- and gender-specific information on community-based and recoveryoriented self-help groups could be handed to patients in primary care settings, without having first to ask for it.