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Abstract:

The Belgian mental health care is currently reforming towards a balanced care that is more community based. The realization of this reform requires specific attention to self‐care, empowerment, participation and full‐citizenship of people with a psychiatric vulnerability. All these elements are part of the vision and practice of recovery. With this research we aim to evaluate the extent to which residential services for long stay operate according to recovery oriented practices. Methods: We performed a Recovery Oriented Practices Index (ROPI) in eight residential services in Belgium. This ROPI instrument provides an overall view on several aspects of the functioning of a service with respect to the attitude towards recovery: such as the degree of fulfilling basic care needs or participation of patients in the development of the treatment plan. A ROPI consists of four interviews with different panels (patients, managers, practitioners and members of the accompaniment team) as well as a study of service documents (brochures etc.) and anonymous treatment plans. An integration of the collected data allows the scoring of eight scales for each service. Results: Most team members spend a sufficient amount of time and personal attention to the residents. However, in some cases the perspective of the patient himself is not taken into account in the determination of patient needs. Patient participation is rather exceptional in the ins accompaniment plans, in the determination of the wishes and good qualities of the patient and in the use of crisis measures. Furthermore, none of the services used shared decision making in the illness management of the patients. The organization of groups of recovery work or mutual support, knowing to improve empowerment, is rare. Discussion: There is still work to be done to ensure patient participation, empowerment and respect for the patient perspective in the residential services. A possible intervention is to offer training in recovery oriented practices to team members and managers of residential services for long stay. FPS Health, Food Chain Safety and Environment –As part of the scientific evaluation ‘Towards a Better Mental Health Care (Article 107)’²