What is Recovery?

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Introduction
Publications
Research and Practice
Videos and Presentations
Organisations
Links


Introduction

The concept of the recovery approach for service users is founded in human values and their application by the service user, professionals and the service itself. Its objective is to achieve health and wellbeing regardless of the degree of disability or distress of the individual.

It requires a paradigm shift in thinking from pathology and illness to self determination, life stories, human strengths, hopes and dreams, peer support and control by the user with support from professionals as partners, mentors and advocates.

TheIt should be rooted in cultural, social, religious and ethnic diversity that gives meaning to the persons identity, belief and circumstance.

To promote the recovery approach staff should reevaluate their role in the treatment process to one of negotiation, partnership and trial and error.

Service organisations need to allow and support staff in practicing in this way by adopting a culture of creativity, innovation, openness, encouragement for diversity and recognition for good practice.


What is recovery?

For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. Professionals in the mental health sector often refer to the ‘recovery model’ to describe this way of thinking.
Putting recovery into action means focusing care on supporting recovery and building the resilience of people with mental health problems, not just on treating or managing their symptoms.

There is no single definition of the concept of recovery for people with mental health problems, but the guiding principle is hope – the belief that it is possible for someone to regain a meaningful life, despite serious mental illness. Recovery is often referred to as a process, outlook, vision, conceptual framework or guiding principle.

The recovery process:

  • provides a holistic view of mental illness that focuses on the person, not just their symptoms
  • believes recovery from severe mental illness is possible
  • is a journey rather than a destination
  • does not necessarily mean getting back to where you were before
  • happens in 'fits and starts' and, like life, has many ups and downs
  • calls for optimism and commitment from all concerned
  • is profoundly influenced by people’s expectations and attitudes
  • requires a well organised system of support from family, friends or professionals
  • requires services to embrace new and innovative ways of working.

The recovery model aims to help people with mental health problems to look beyond mere survival and existence. It encourages them to move forward, set new goals and do things and develop relationships that give their lives meaning.

Recovery emphasises that, while people may not have full control over their symptoms, they can have full control over their lives. Recovery is not about 'getting rid' of problems. It is about seeing beyond a person’s mental health problems, recognising and fostering their abilities, interests and dreams. Mental illness and social attitudes to mental illness often impose limits on people experiencing ill health. health professionals, friends and families can be overly protective or pessimistic about what someone with a mental health problem will be able to achieve. Recovery is about looking beyond those limits to help people achieve their own goals and aspirations.

Recovery can be a voyage of self-discovery and personal growth. Experiences of mental illness can provide opportunities for change, reflection and discovery of new values, skills and interests.
What supports recovery?

Research has found that important factors on the road to recovery include:

  • good relationships
  • financial security
  • satisfying work
  • personal growth
  • the right living environment
  • developing one’s own cultural or spiritual perspectives
  • developing resilience to possible adversity or stress in the future.

Further factors highlighted by people as supporting them on their recovery journey include:

  • being believed in
  • being listened to and understood
  • getting explanations for problems or experiences
  • having the opportunity to temporarily resign responsibility during periods of crisis.

In addition, it is important that anyone who is supporting someone during the recovery process encourages them to develop their skills and supports them to achieve their goals.

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Publications (date ordered)

 Oranga Ngākau: Getting the most out of mental health services A recovery resource for service users (2003) Published by Mental Health Commission, New Zealand. Oranga Ngakau refers to a person reclaiming himself or herself, by seeking what is needed to be content with who they are, so that they can nurture their own self determination by taking care of themselves and fulfil their own dreams and desires. Click here to download

Personal Assistance in Community Existence: A Recovery Guide by Laurie Ahern and Daniel Fisher (2004) Published by the National Empowerment Centre, MA. This inspiring document, provides an introduction on how PACE (Personal Assistance in Community Existence) can facilitate people’s recovery.  Exploring issues including medical/rehabilitation model; self building vs self-destroying cycles; and personal stories; the document draws on research on recovery and the Empowerment Model. Click here to download

100 Ways to Support Recovery by Slade, M. (2009) Published by Rethink.This paper uses the 'Personal Recovery Framework', based on accounts of people's experiences.  It includes '100 Action Point' to support recovery. Go to website

Finding Strength from Within This report highlights the experiences of mental health, wellbeing and recovery at three local Edinburgh projects in black and minority ethnic communities. Go to website

Recovering Mental Health in Scotland Report on Narrative Investigation of Mental Health Recovery by Wendy Brown and Niki Kandirikiria (2007) Published by Scottish Recovery NetworkThis research was undertaken to understand Scottish people’s experiences and perspectives of recovery from mental health problems. The report highlights that recovery is possible even for people with the most serious and long term mental health problems.  Several common elements were identified that were helpful for recovery – positive identity and view of self; meaningful activities and purpose in life; supportive relationships; and having choice of treatments and support. Go to website

Recovering Mental Health in Scotland (Presentation) by Simon Bradstreet and Wendy Brown (2007) Published by Scottish Recovery Network. Recovering Mental Health in Scotland research drew on 64 people across Scotland’s experiences of recovery from long term mental health problems.  The findings looked at what helped and hindered recovery.  This presentation outlines the research and the findings.  Go to website 

Rights, Relationships and Recovery the report of the National Review of Mental Health Nursing in Scotland by NHS Education for Scotland (2006) The report gathered evidence from a variety of sources to examine the current and future contribution of mental health nurses in Scotland.  Concluding the need to work in relation to rights, relationships and recovery. Go to website

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Research and Practice

Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems Slade M, Amering M, Farkas M, Hamilton B, O'Hagan M, Panther G, Perkins R, Shepherd G, Tse S, Whitley R (2014)  World Psychiatry, 13, 12-20. An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered.

Recovery from mental illness: the guiding vision of the mental health system in the 1990s, Bill Anthony, Psychosocial Rehabilitation Journal, 16(4), April 1993, 11-23.) he implementation of deinstitutionalization in the 1960s and 1970s, and the increasing ascendance of the community support system concept and the practice of psychiatric rehabilitation in the 1980s, have laid the foundation for a new 1990s vision of service delivery for people who have mental illness. Recovery from mental illness is the vision that will guide the mental health system in this decade. This article outlines the fundamental services and assumptions of a recovery-oriented mental health system. As the recovery concept becomes better understood, it could have major implications for how future mental health systems are designed. 

Changes in Schizophrenia Across Time: Paradoxes, Patterns and Predictors by Courtenay M. Harding – published by American Psychiatric Publishing In this chapter, the history of schizophrenia is described.  Providing initial research undertaken, the chapter later explores ways to develop recovery. Go to website

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Videos and Presentations

 

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Organisations

Recovery research team at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) research team is officially known as the Section for Recovery. The Section is based in the Centre for Innovation and Evaluation in Mental Health within the Health Service and Population Research Department at the Institute of Psychiatry, Psychology & Neuroscience.

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Links

Centre for Mental Health (UK) (formerly the Sainsbury Centre for Mental Health): recovery pages
The Centre for Mental Health is a partner in the 'Implementing Recovery through Organisational Change' (ImROC) programme and there are many publications about recovery available from this website.

Implementing Recovery through Organisational Change (ImROC) programme (England)
ImROC is run by the NHS Confederation's Mental Health Network and the Centre for Mental Health. Nearly 30 NHS organisations are taking part in this programme, which started in 2011. Some have hired paid peer support workers – people with personal experience of mental health problems – to work alongside mental health professionals. Others are developing 'Recovery Colleges.'

Mental Health Foundation (UK) – information about recovery.

National Coalition for Mental Health Recovery (USA)

Peer Worker Research Project (UK) Information about a research project being run by a team at St George's, University of London.

Recovery Devon (UK) The website includes personal stories and resources.

Recovery In-Sight Centre (UK)  A 'service user-led socially-orientated company that offers training, peer support, research and advice on practice and service development in the field of recovery.'

Rethink Mental Illness (UK) – recovery information This section of the website contains information about what recovery can mean; recovery challenges; tools for recovery; and how mental health professionals can support recovery.

Scottish Recovery Network The SRN is funded by the Scottish government and has project income from NHS Education for Scotland. The Network is hosted by the voluntary sector organisation Penumbra. The website contains information about the Network's activities and projects and personal stories of recovery.

Social Perspectives Network (UK)  The Network (in England and Wales) includes service users, family members, policy makers, academics, students and practitioners who are 'interested in how social factors both contribute to people becoming distressed and play a crucial part in promoting people's recovery.'

WRAP® (Wellness Recovery Action Plan®) and Recovery Books This website has information about the Wellness Recovery Action Plan®, developed by people who have personal experience of mental health problems.

Recovery approach From Wikipedia A recovery model (or recovery approach) to mental disorder or substance dependence emphasizes and supports a person's potential for recovery. Recovery is generally seen in this approach as a personaljourney rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. "The concept of recovery can be traced back as far as 1830, when John Perceval, son of one of England’s prime ministers, wrote of his personal recovery from the psychosis that he experienced from 1830 until 1832, a recovery that he obtained despite the “treatment” he received from the “lunatic” doctors who attended him. His remarkable experiences are chronicled in the book Perceval's Narrative

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