Reciprocity membership: A potential pathway towards recovery from mental illness in a Middle Eastern context

While recovery has become a popular framework for mental health services, there is limited understanding of its applicability outside of Western countries. In fact, recent studies in non-Anglophone populations suggest that recovery is contextually dependent and that the implementation of mainstream recovery models risks imposing inappropriate values. We used classic grounded theory to explore the main concerns of mental health service users in a Middle Eastern context and the strategies they use to resolve those concerns. The theory of 'reciprocity membership', a process involving ongoing mutual exchange with a group or community, was developed. Reciprocity membership becomes balanced when an individual is satisfied with their 'contribution to' the group, the 'acknowledgement from' other group members, the 'expectations of' the group, and their 'alignment with' the values of the group. Balance among these conditions is appraised by a sub-process called 'valuing', and developed or maintained by two further sub-processes called 'positioning' and 'managing relationships'. Balanced reciprocity membership seems to be associated with recovery. This study is the first in-depth exploration of people's experience of mental illness in a Middle Eastern context; findings provide evidence for a novel potential pathway towards recovery.