Mental Health “Recovery”: Users and Refusers (Wellesley Institute, 2009) is a look at recovery mined from peer-led focus groups of psychiatric survivors. (The label was hotly debated then as now, but they went with “survivor” for this article.) They were asked what recovery means to them, and what building blocks are needed. The findings were analyzed and the paper written by a team of academic researchers who self-identify as having mental health issues. It’s a wonderful example of the new trend of participatory research.
The mental health recovery movement has roots in earlier movements (like addiction recovery), but became popular after What Recovery Means to Us (Mead & Copeland, 2000) was published. It spread like a viral video through clinical offices around the world, shifting budgets and responsibilities, gaining fans but few vocal critics. Mary Ellen Copeland was recently honoured with a Lifetime Achievement Award by SAMHSA for her pioneering work.
But what does recovery mean, and has it made a real difference? The President’s New Freedom Commission Report on Mental Health (2003) defined it as “the process in which people are able to live, work, learn, and participate fully in their communities.” In 2005 SAMHSA described the 10 fundamental components of recovery as “self-direction, individualized and person-centered approaches, empowerment, holistic views, nonlinearity, strengths-based, peer support, respect, responsibility, and hope.”
Mental Health “Recovery”: Users and Refusers digs deeper and gets more practical, deconstructing recovery into three areas. “Personal journey” includes symptom management, health and nutrition, and faith. “Social process” needs housing, employment, education, and other social supports. Recovery can also be “critique” of the mental health system: asserting rights, being informed and an active partner in your personal health care.
The recovery model has been criticized for ignoring people with severe mental health issues, and those living in poverty. Professionals using the copyrighted recovery manuals are most helpful to those who can pay for secure housing, therapy, good nutrition, recreation and social activities.
Many people who see a therapist, psychiatrist or counselor now get a “Wellness Recovery Action Plan” with some cheerful clip art and personal notes. But once those notes are made there can be a lack of practical supports to back them up. The consumer has the burden of looking after their own health without all the resources they might need.
This article is refreshing not only because it’s from researchers who receive mental health services, but because it’s peer-led participatory research. It’s local to Toronto, and the Canadian authors identified points of “inclusion, community, critique and resistance” that the people who popularized “recovery” didn’t discuss. With this cross-cultural analysis, the concept of mental health recovery is enriched. Social supports beyond vague ideas like “it’s about creating the life one wants to live” are revealed as cornerstones of health and wellness. They provide hope: vital to any process of recovery.
Mental Health “Recovery” Study Working Group. 2009. Mental Health “Recovery”: Users and Refusers, Toronto: Wellesley
Institute. CC 2.5 [PDF]
What Recovery Means to Us: Consumers’ Perspectives, Mead & Copeland, Community Mental Health Journal, 2000
SAMHSA’s National Consensus Statement on Mental Health Recovery (2005) [PDF]