Systematic review of qualitative studies of the lived experience of severe mental illness

The experiences of people with severe and persistent mental illness (SMI) are neglected by the multidisciplinary therapeutic team or are not included in the treatment plan. Thus a systematic literature review and critical assessment of selected papers was undertaken in relation to qualitative studies of the lived experiences of severe mentally ill persons. The riger of the included studies was assessed by the standardized tool Critical Appraisal Skills Programme (CASP). The literature review was made between May and July 2014. The search took place in the databases CINAHL, Medline, PubMed, PsycInfo and Psychology and Behavioral Science Collection. This review, which integrated the findings from 13 papers, revealed that severely mentally ill persons experience conflict between their self-identity prior to illness and the limitations pased by their illness, loss of their personal and social role identity, diminished self-esteem and insecurity. These experiences may be conceptualized as an ongoing and painful struggle to regain self-identity and integration into society. Recognition of the significance of personal identity in the continuum of SMI could lead to the development of targeted psychosocial interventions. In addition, the review highlights the need for the empowerment of the mentally ill persons in order to enhance their engagement into the therapeutic process.