William Anthony has written perhaps the best description of mental health recovery: …a person with mental illness can recover even though the illness is not “cured” . . . . [Recovery] is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness (Anthony, 1993).
Mental health recovery is based on scientific studies, self-help movements, the writings of professionals, who are often people who have experienced recovery themselves, and advances in pharmacology, including using lower doses which may not completely alleviate symptoms but leave the individual still able to function.
Mary Ellen Copeland’s Wellness Recovery Action Plan (WRAP) is a synthesis of many of the ideas and may be the best working program.
Mary Ellen Copeland at her foundation’ website MentalHealthRecovery.com states: There are five key recovery concepts that provide the foundation of effective recovery work. They are:
•Hope. With good symptom management, you will experience long periods of wellness.
•Personal Responsibility. It’s up to you, with the assistance of others, to take action and do what needs to be done to keep your moods stabilized.
•Self Advocacy. Become an effective advocate for yourself so you can get the services and treatment you need, and to make your life the way you want it to be.
•Education. Learning all you can about depression and manic depression allows you to make good decisions about all aspects of your treatment and life.
•Support. While working toward your wellness is up to you, receiving support from others – and giving support to others – is essential to maintaining your stability and enhancing the quality of your life.
Campaigns to protect the civil rights of people and fund their needs have made tremendous differences in people’s lives.
The New Freedom Commission on Mental Health http://en.wikipedia.org/wiki/New_Freedom_Commission_on_Mental_Health led to the Substance Abuse and Mental Health Administrations –SAMHSA- consensus statement on recovery, which is:
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
SAMHA’s 10 Fundamental Components of Recovery are:
Self-Direction: Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.
Individualized and Person-Centered: There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health.
Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.
Holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services, addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.
Non-Linear: Recovery is not a step-by-step process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery.
Strengths-Based: Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward through interaction with others in supportive, trust-based relationships.
Peer Support: Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community.
Respect: Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives.
Responsibility: Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.
Hope: Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process. Mental health recovery not only benefits individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life. America reaps the benefits of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation.
Mental health recovery not only benefits individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life. America reaps the benefits of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation.
Resources at www.samhsa.gov
The seminal figures of the recovery movement and their key contributions include the following:
William Anthony’s definition of recovery: Anthony (1993) identifies recovery as ” a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” http://www.mhrecovery.com/definition.htm
Lori Ashcroft of RecoveryInnovations.org describes recovery as follows:
•Shifted from clinical interventions to education (creating the Recovery Education Center)
•Began to teach self-help skills using Wellness Recovery Action Planning (WRAP), Wellness and Empowerment in Life and Living (WELL), and a variety of self-directed planning tools
•Developed peer support as a core service by creating a well trained peer workforce that provided a range of peer-run services
•Created a recovery culture in all our services by integrating Peer Support Specialists in complimentary roles on all our teams
This quote from an article by Patricia E. Deegan PH.D. is one of a number of scientific studies which disproved the idea that serious mental illness was chronic and incurable: “The recovery rate in these seven long term studies ranged from 46% to 68%. That is, half to two thirds of people diagnosed with major mental illnesses including schizophrenia were found to show significant or complete recovery over time. Even in the second or third decade after being diagnosed, people still go on to significant or full recovery. We should never lose hope. Recovery as a Self-Directed Process of Healing and Transformation, Patricia E. Deegan PH.D. copyrighted 2001 citing Harding and Zahniser 1994. -http://intentionalcare.org/articles/articles_trans.pdf
For mainstream mental health clinics, the assumption of roles and functions is the goal of recovery. Essential Learning.