Qualitative comparative analysis (QCA) is a relatively new method that examines causal complexity. Its use in mental health research is nascent. In low-income and fragile settings, with weak mental health service provision, identifying pathways of recovery from psychological distress can inform the appropriate deployment of scarce community and public resources. This paper examines the use of QCA to identify predictors of recovery in Sierra Leone. Our study explored lay perceptions of the signs of recovery from psychological distress caused by such events as the loss of a family member, severe sickness, and loss of a relationship. The data drew upon 75 interviews with women and men, across four districts of Sierra Leone, who described the signs of recovery from psychological distress they have observed in one person known to them. The truth table generated through QCA software indicated two signs of recovery— work/study and healthy relations—to be the most prevalent across different combinations of predictive factors. Further analysis of the truth table and sub-set relations suggested that work/study and healthy relations frequently served as sufficient conditions for reported recovery from distress to occur. QCA provided a means to identify sufficient predictive factors for recovery from psychological distress to occur. The findings suggest that to enable recovery from psychological distress, support needs to be broad and bring together services that will enable individuals to improve their social and relational wellbeing. Responses to distress need to involve a wide range of community-based stakeholders who will help individuals to engage in constructive activity and strengthen relations with their family members, friends, and the broader community. QCA is potentially well-positioned to unpack complexity in mental health research.

定性比较分析 (QCA) 是一种检查因果复杂性的相对较新的方法。它在心理健康研究中的应用刚刚起步。在低收入和脆弱的环境中，精神卫生服务供应薄弱，确定从心理困扰中恢复的途径可以为稀缺的社区和公共资源的适当部署提供信息。本文研究了使用 QCA 来确定塞拉利昂恢复的预测因素。我们的研究探讨了外行对因失去家庭成员、严重疾病和失去关系等事件引起的心理困扰恢复迹象的看法。该数据来自对塞拉利昂四个地区的 75 名女性和男性的采访，他们描述了他们在他们认识的一个人身上观察到的心理困扰的恢复迹象。通过 QCA 软件生成的真值表显示了两种复苏迹象——工作/学习和健康关系——在不同预测因素组合中最为普遍。对真值表和子集关系的进一步分析表明，工作/学习和健康的关系经常成为报告从困境中恢复的充分条件。QCA 提供了一种方法来确定从心理困扰中恢复的充分预测因素。研究结果表明，为了从心理困扰中恢复过来，需要提供广泛的支持，并整合各种服务，使个人能够改善他们的社会和关系福祉。应对困境需要广泛的社区利益相关者参与，他们将帮助个人参与建设性活动并加强与家人、朋友和更广泛社区的关系。QCA 有可能很好地解决心理健康研究的复杂性。