This study explores the perspectives of Irish Travellers, an ethnic minority group in Ireland, on the service improvements needed to implement culturally appropriate recovery approaches in mental health services.

A community-based participatory research approach was employed. Seventeen Traveller peer researchers conducted thirteen qualitative participatory workshops and five individual interviews across Ireland. Eighty-seven adult members of the Traveller community (83% female, mean age = 33, 56.3% not in education or employment) were recruited through convenience sampling. Participatory thematic analysis was employed.

Travellers’ ideas about improvements in mental healthcare involve practitioners in creating a trusting environment, increasing representation of Travellers within mental healthcare staff and working in partnership with Traveller service users to co-produce strategies that are owned by the community. Study participants emphasised the importance of Traveller cultural awareness, strengthening trauma-informed care, and embedding an ethos of cultural humility within mainstream services. The findings indicate the need for increased collaboration between mental health service providers and non-mental health agencies, and a reorientation of care towards empowering Traveller service users to achieve their social aspirations and building a positive self-identity.

This study demonstrates that implementing a recovery approach for Travellers requires a reorientation of services, in line with Travellers’ definition of culturally appropriate mental healthcare. This study calls for an expanded mandate for mental health services beyond individual care and towards intersectoral action in addressing the social determinants of Travellers’ mental health. This will help to shape an equitable and inclusive healthcare setting that promotes Travellers’ mental health and recovery.

The optimal duration of antipsychotic treatment following remission of first-episode psychosis (FEP) is uncertain, considering potential adverse effects and individual variability in relapse rates. This study aimed to investigate the effect of antipsychotic discontinuation compared to continuation on recovery in remitted FEP patients.

CENTRAL, MEDLINE (Ovid), Embase, and PsycINFO databases were searched on November 2, 2023, with no language restrictions. RCTs evaluating antipsychotic discontinuation in remitted FEP patients were selected. The primary outcome was personal recovery, and secondary outcomes included functional recovery, global functioning, hospital admission, symptom severity, quality of life, side effects, and employment. Risk of bias was assessed using the Cochrane risk-of-bias tool 2, and the certainty of evidence was evaluated with GRADE. Meta-analysis used a random-effect model with an inverse-variance approach.

Among 2185 screened studies, 8 RCTs (560 participants) were included. No RCTs reported personal recovery as an outcome. Two studies measured functional recovery, and discontinuation group patients were more likely to achieve functional recovery (RR 2.19; 95% CIs: 1.13, 4.22; I2 = 0%; n = 128), although evidence certainty was very low. No significant differences were found in hospital admission, symptom severity, quality of life, global functioning, or employment between the discontinuation and continuation groups.

Personal recovery was not reported in any antipsychotic discontinuation trial in remitted FEP. The observed positive effect of discontinuation on functional recovery came from an early terminated trial and an RCT followed by an uncontrolled period. These findings should be interpreted cautiously due to very low certainty of evidence.

No co-productive narrative synthesis of system-level facilitators and barriers to personal recovery in mental illness has been undertaken.

To clarify system-level facilitators and barriers to personal recovery of people with mental illness.

Qualitative study guided by thematic analysis. Data were collected through one focus group, which involved seven service users and three professionals. This group had 11 meetings, each lasting 2 h at a local research institute, between July 2016 to January 2018.

The analysis yielded three themes: barriers inhibiting positive interaction within personal relationship networks, roots of barriers from mental health systems and the social cultural context, and possible solutions to address the roots. Barriers were acknowledged as those related to sense of safety, locus of control within oneself and reunion with self. The roots of barriers were recognised within mental health services, including system without trauma sensitivity, lack of advocacy support and limited access to psychosocial approaches. Roots from social cultural context were also found. There were no narratives relating to facilitators. A possible solution was to address the roots from systems. Social cultural change was called for that makes personalised goals most valued, with an inclusive design that overcomes stigma, to achieve an open and accepting community.

The analysis yielded system-level barriers specific to each recovery process. Roots of barriers that need transformation to facilitate personal recovery were identified within mental health services. Social interventions should be further explored to translate the suggested social cultural changes into action.