Perspective matters in recovery From fragmented to collaborative care in complex psychosis

People with a hard to manage psychosis and complex co-occurring challenges (“complex psychosis”) and their families often go through long and difficult care trajectories in mental healthcare, including admission to long-term inpatient mental health rehabilitation services. Arguably, they face a complicated (personal) recovery process. People with a complex psychosis, families and professionals often hold diverging views on the problem, and what should happen, which complicates their collaboration for recovery. Unfortunately, research on complex psychosis is scarce, due to the very complexity of problems and potential unwillingness and/or inability to consent to research. This thesis explored perspectives that potentially help to improve care for people with a complex psychosis and their families. Part I discusses prerequisites to do research in this hard-to-access group. Part II focuses on preventing cumbersome trajectories, including the role of familial cognitive vulnerability, long-term outcome prediction and hypotheses on ways to care delivery to people with complex psychosis. Part III focuses on the needs people with a complex psychosis, their family and mental health professionals have to effectively collaborate for recovery, based on their personal perspectives. In conclusion, participatory research, early identification of vulnerabilities of those with complex psychosis, and collaborative care that tolerates diverging perspectives, with continuity of those involved, should go together, to prevent fragmentation and foster growth in people with a complex psychosis, their family and professionals.