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 Experience.
In general medicine and psychiatry, recovery has long been used to refer to the end of a particular experience or episode of illness. The broader concept of "recovery" as a general philosophy and model was first popularized in regard to recovery from substance abuse/drug addiction, for example within twelve-step programs.
Application of recovery models to psychiatric disorders is comparatively recent. By consensus the main impetus for the development came from the within the consumer/survivor/ex-patient movement, a grassroots self-help and advocacy initiative, particularly within the United States during the late 1980s and early 1990s. The professional literature, starting with the psychiatric rehabilitation movement in particular, began to incorporate the concept from the early 1990s in the United States, followed by New Zealand and more recently across nearly all countries within the "First World". Similar approaches developed around the same time, without necessarily using the term recovery, in Italy, the Netherlands and the UK.
Developments were fueled by a number of long term outcome studies of people with "major mental illnesses" in populations from virtually every continent, including landmark cross-national studies by the World Health Organization from the 1970s and 1990s, showing unexpectedly high rates of complete or partial recovery, with exact statistics varying by region and the criteria used. The cumulative impact of personal stories or testimony of recovery has also been a powerful force behind the development of recovery approaches and policies. A key issue became how service consumers could maintain the ownership and authenticity of recovery concepts while also supporting them in professional policy and practice.
Increasingly, recovery became both a subject of mental health services research and a term emblematic of many of the goals of the Consumer/Survivor/Ex-Patient Movement. The concept of recovery was often defined and applied differently by consumers/survivors and professionals. Specific policy and clinical strategies were developed to implement recovery principles although key questions remained.
In 1881, researchers at Massachusetts’ Worcester Asylum for the Insane learned about recovery when they surveyed 1,157 people who had been discharged dating back to 1840. Of the patients who were discharged as “recovered,” 58 percent remained well for the remainder of their lives.
The idea of recovery in the United States is also closely connected to the recovery movement in the substance abuse field, particularly with Alcoholics Anonymous, which began in the 1930s as a fellowship of people focused on sobriety.
The normal process of recovery was often stilted in the United States throughout the 1940s and 1950s as state hospitals sought more to confine patients than to help them recover. Even throughout the years of deinstitutionalization that began in the 1970s, people with mental health disorders were frequently told that they would likely get worse and even lose their jobs and their friends. Despite these falsehoods, people with mental health disorders have continued to believe in themselves and in one another and to help one another recover.
The Consumer/Survivor Movement of the 1980s and 1990s brought the recovery model to the forefront and inspired change throughout the mental health system. These grassroots advocates modeled recovery themselves and effectively argued for change.
By 2002 the President’s New Freedom Commission on Mental Health paved the way for a systemwide paradigm shift. As a result, quality mental health service systems today embrace a recovery model.
This article by Mary O'Hagan provides an interesting account of the development of the term 'recovery' in New Zealand. It presents concerns and worries using the word 'recovery' by service users and describes some of the historical events of the early development of the concept.
Living Well: Mary O'Hagan describes how recovery has been defined in New Zealand (2002) by Mary O'Hagan Published in Openmind 118, Nov/Dec, pp. 16-17
This fascinating article, presents the historical development of recovery across New Zealand, America and England. Presenting some of the challenges and pitfalls, it provides an understanding of the development of recovery across the western world.
An Update on Recovery: For Mental Health Today (2009) by Mary O'Hagan Download - Pdf