Introduction
Recovery means something different for every individual with a mental health condition, but every person can achieve some level of recovery in their lives. For some people recovery means they will be able to work; for others that they will be able to live independently; for others that they will be able to have a relationship; and for some it will involve any combination of those or other changes in their lives.
Each person with a mental health condition must define what recovery means for his or her life. A common misperception of what recovery means, however, is that a person no longer has any signs or symptoms of a mental illness. Whereas many individuals in recovery will have no signs or symptoms, this will not be the case for everyone, and regardless of a person’s level of functioning, relapses can still happen. Like everyone in the world, most people in recovery from a mental health problem will always have certain challenges that they have to face in life, and some of them may require learning to handle symptoms without allowing the symptoms to control their lives.
The Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services assembled an expert panel to develop a consensus definition of recovery. Over 110 panelists, including consumers, family members, providers, researchers, and other stakeholders were involved. The definition was not designed to capture what recovery means for each individual person, but designed to give a broad definition to help people understand what recovery is about.
The Recovery Journey
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. (Available at: http://mentalhealth.samhsa.gov/publications/allpubs/sma05-4129/)
The time that it takes to recover is different for each person and an important concept here is that each person must take responsibility for his or her own recovery. Family members, peers, providers, and others can help or motivate an individual, but recovery cannot be done to or for a person, it must be achieved by a person. Even developing the motivation to strive towards recovery is often challenging for individuals with mental health conditions, who often must cope with sedating medications, societal stigma, people telling them that they cannot recover, and other barriers. Motivation and hope are some of the best help that family members and other consumers can provide to individuals working on recovery.
There are ways to better orient mental health systems to help consumers in their journeys through the recovery process. A number of recovery-oriented best practices have been identified by experts (including consumers, family members, providers, clinicians, researchers and others) as particularly helpful in improving a mental health system’s recovery orientation and operations. Some include:
Person-Driven Planning:
Consumers can benefit if the mental health staff understand the vision, philosophy, values, and procedures necessary to ensure the full inclusion of consumers in developing their own individual plans of care. This approach looks at a number of aspects of a mental health system that may need to be addressed so that consumers can become full partners in developing their own plans of care.
Development of the Acute Care Service System:
A state’s mental health emergency and acute care service system may not be operating as efficiently and effectively as it could to meet the needs of people in crisis. An evaluation of the system can help suggest ways to improve its accessibility and ability to meet the needs of diverse consumer populations.
Co-Occurring Disorders Programming:
People with Co-Occurring Mental Health and Substance Use Disorders have unique needs that cannot effectively be met in a system that is designed to serve people with only one of the two disorders. Use of integrated treatment methods that treat both concerns at the same time can help a service delivery system design an approach that more effectively meets the unique needs of dually diagnosed individuals.
Formal Consumer Inclusion and Overall Involvement in Services:
Without having consumers involved in decisions about the service delivery process, it will be difficult for any one else to truly know what is best for them. This approach, which is highly adaptable to a system’s individual needs, is designed to help more fully involve consumers in a variety of roles and functions throughout the process of service delivery.
Trauma Informed Care:
This practice is in the form of a training to help providers, the general public, family members, and others understand the prevalence of past traumatic life experiences in the lives of consumers. The training then helps attendees to understand how trauma can affect peoples’ lives well past the event, and how and why service delivery systems must be designed so as to be sensitive to these experiences, if the goal of recovery is to be realized.
Evidence-Based Practices:
There are many different practices that work for different consumers, but there are also many practices that have been identified as consistently beneficial, and they are known as Evidence Based Practices. Mental health systems can be helped to identify and implement one or more of these practices by looking at the state’s resources and infrastructure, and assessing what needs to change to make a particular practice widespread.
Consumers must be able to make decisions for themselves about their own care. But providers, based on their clinical experience, have a responsibility to provide education about the possible outcomes that may result from various decisions. The reality is in most systems that consumers, particularly those with more chronic and disabling mental health conditions, are commonly instructed as to what treatments they need, with minimal if any effort to involve them in decisions. A recovery-oriented mental health system acknowledges and encourages consumer involvement and decision-making. Furthermore, a recovery-oriented mental health system is structured in ways that support consumers in their journeys of recovery.
Most individuals will need assistance to figure out what they need to do in order to move forward in the recovery process. The recovery process can take years; it is a journey, with both ups and downs, but it is a journey that is both possible and worthwhile for all consumers.
For more information on recovery or on how your state can obtain assistance with one of these or other recovery models, contact the author at timothy.tunner@nasmhpd.org.
