Discovering Ways to Keep Life on Track: A Grounded Theory Study of Consumers and Workers Jointly Using an E-mental Health Resource in Community Mental Health

Submission note: A thesis submitted in total fulfilment of the requirements for the degree Doctor of Philosophy (PhD) to the School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria, Australia.

E-mental health resources are becoming increasingly available for people who experience severe mental illness. However, most existing research has focused on the acceptability, feasibility and benefits of e-mental health resources used with minimal human support. The potential for consumers and workers to use these resources together in community mental health practice has not been considered. This constructivist grounded theory study explored the experiences of people living with severe mental illness and mental health workers in Victoria, Australia, who jointly used a purpose-built website known as Self-Management And Recovery Technology (SMART). The website included videos where people shared their lived experience of self-management and recovery. Data were collected in individual semi-structured interviews with 37 consumers and 15 workers after they had used the SMART website together for two to six months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling and consultation with a range of stakeholders to support the study’s credibility and resonance. A substantive grounded theory: ‘discovering ways to keep life on track’ was developed. This process arose from ‘choosing to use the website’, ‘revealing’ and ‘exploring experiences’, and ‘gaining new perspectives’ on how consumers did or could keep their lives on track. The findings indicate that jointly using an e-mental health resource can elicit recovery-supportive processes and interactions between consumers and mental health workers. Consumers gained a sense of connection with peers and hope for the future, while workers experienced more expansive and recovery-focused interactions with consumers. Using the website together enhanced the experience of using an e-mental health resource for consumers and supported consumers and workers to discover a shared understanding of the consumer’s life, self-management and personal recovery. These findings suggest that further work to develop and integrate this novel way of using e-mental health resources into community mental health practice is warranted.