# Understanding the Mechanisms that Operate within CHIME: A Realist Review Protocol

## TL;DR

This paper outlines a realist review protocol to explore how the CHIME framework supports mental health recovery by examining the underlying mechanisms involved.

## Contribution

The study introduces a realist review to investigate the internal mechanisms of CHIME in mental health recovery, addressing a gap in existing literature.

## Key findings

- The realist review will explore how and why CHIME mechanisms operate in individuals recovering from mental health challenges.
- The review will follow a six-phase methodology to analyze and synthesize evidence on recovery mechanisms.
- The findings will inform future research on mental health recovery frameworks in Ireland.

## Abstract

Recovery originated from the civil rights movement of the 1960s/70s. However, no universally accepted definition of recovery had been constructed until 1993 when William A. Anthony suggested that recovery involved living one’s best life even with mental health difficulties. In 2011, Leamy
et al. created CHIME [
Connectiveness,
Hope,
Identity,
Meaning and purpose and
Empowerment]. A concept that represents the key characteristics of recovery. It derived from a literature review into recovery from psychosis. Since 2011, the literature has examined these concepts individually and collectively to understand what they are in reality. However, few studies have investigated the internal mechanisms that causes a person to move from unwellness to recovery via CHIME. As such this proposed realist review will explore how and why the mechanisms within CHIME operate in individuals recovering from mental health challenges.

This review forms work package one of a PhD study into CHIME and mental health recovery in Ireland. It complies with relevant guidelines relating to realist reviews including Pawson
et al’s. updated methodology, which consists of six phases: 1) setting up the review advisory panel and constructing initial programme theories; 2) searching for evidence; 3) selecting and appraising evidence; 4) extracting data; 5) analysing and synthesising data; and 6) ethics and dissemination.

This proposed review will address a gap in the literature on the mechanism involved in recovery from mental health challenges. Unlike other review types, a realist review is theory orientated, allowing one to answer this review question by exploring how, why, and through what circumstances individuals reach recovery through CHIME. This review will inform future work packages of this PhD study. The proposed review will be written up and submitted to a peer-reviewed journal. Dissemination outside academia will be considered.

CRD420251038961