INTRODUCTION
In the mental health services we are used to thinking about people's experience in tenns of the supports and interventions that mental health workers provide. We think in terms of in-patient facilities, outreach services, medication, occupational therapy, art therapy, and 'psychosocial interventions'. We think of symptom reduction and discharge as indices of success. This is the wrong place to start.
Everyone who experiences mental health problems faces the challenge of recovery, i.e. rebuilding a meaningful and valued life. Whether a person's problems are time-limited or ongoing, whether or not their symptoms can be eliminated, they face the task of living with, and growing beyond, what has happened to them. The help offered by mental health workers needs to be considered in terms of the extent to which they facilitate, or hinder, this process of recovery.
If we are to facilitate recovery, then we must think about the challenges people face and the impact of what we do on a person's particular journey. An understanding of the process of recovery is essential to the development of effective treatment, support and rehabilitation (Farkas et al 1999).
This can only be gained from the accounts of people who have themselves faced the challenge of recovery. Such accounts are widely available and essential reading for mental health workers. Stories of recovery are increasingly related at conferences, in academic journals, and in specific collections.
WHAT IS RECOVERY?
Recovery refers to the lived or real life experience of people as they accept and overcome the challenge of the disability ... they experience themselves as recovering a new sense of self and of purpose, within and beyond the limits of the disability. (Deegan 1988)
Unlike so many ideas in the mental health arena, the concept of recovery from mental health problems did not come from academics and professionals Instead, it emerged from the writing of people who themselves face the challenge of life with mental health problems (e.g. Houghton 1982, Lovejoy 1982, Deegan 1988, 1993, 1996, 1999, Leete 1988 a, 1989, Unziker 1989, 1997b, Reeves 1998, May 2000. Drawing on these accounts, Anthony (1993) has described recovery as:
'... a deeply personal, unique process of changing one's attitudes, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with 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'.
Experiencing serious mental health problems is a catastrophic and life changing experience. There is no going back to how life was before the problems started. Those bridges are burnt. But it is not the end of life – there is a way forward. Recovery is possible.
- Recovery is not the same as cure:
One of the biggest lessons I have had to accept is that recovery is not the same thing as being cured. After 21 years of living with this thing it still hasn't gone away. (Deegan 1993).
- Recovery is about growth:
Recovery to me is not only coming to terms with what has happened in my own life, the dark side of me and the things I have done, but having grown as an individual because of my experiences. Focusing on this experience as a source of growth has been the source of inspiration for recovery. I can now look back in time and know that everything that happened... helped me to become the person I am today , ... (Reeves 1998)
It is all too easy for a person to become nothing other than their 'illness': `a schizophrenic; `a manic depressive': - 'Schizophrenia is an °I am" illness; one which may take over and redefine the identity of a person' (Estroff 1989 ). People with mental health problems are more than embodiments of their 'illness'. Recovery involves redefining identity in a way which includes, but moves beyond, that 'illness.' Recovery is important whether or not a persons's symptoms can be cured. It involves overcoming not only the challenge of mental health difficulties themselves, but also the effects of the discrimination and exclusion which accompany them.
Recovery is a process, not an end point or destination. Recovery is an attitude, a way of approaching the day and the challenges I face ....
'I know I have certain limitations and things I can't do. But rather than letting these limitations be occasions for despair and giving up, I have learned that in knowing what I can't do, I also open up the possibilities of all I can do,' (Deegan 1993)
- Recovery can, and does, occur without professional intervention:
A person's own resources and those available to him/her outside the mental health system are central to the process. There are many paths to recovery, including choosing not to be involved with the mental health system (Anthony 1993). Recovery is not a professional intervention, like medication or therapy, and mental health workers do not hold the key. Many people have described the enormous support they have received from others who have faced a similar challenge (Chamberlin 1995, May 2000). The challenge faced by us as practitioners is to facilitate recovery, but we can also hinder it.
- A recovery vision is not limited to a particular theory about the nature and causes of mental health problems:
Some writers (e.g. Chamberlin 1995, May 1999) have spoken eloquently about the disabling impact of the traditional 'organic' models. However, as Anthony (1993) points out, a recovery vision does not commit one to a social, a psychological, a spiritual, or an organic understanding of distress and disability, nor to the use or non-use of medical interventions. Whatever understanding of their situation a person comes to, recovery is an equally important process.
- Recovery is not specific to people with mental health problems:
Everyone experiences the challenge of recovery at some point in life, e.g. when someone we love dies, or when we experience losses, traumas, illnesses, or injuries.
Recovery is a process of healing physically and emotionally, of adjusting one's attitudes, feelings, perceptions, beliefs, roles and goals in life. It is a painful process, yet often one of self-discovery, self-renewal and transformation. Recovery is a deeply emotional process. Recovery involves creating a new personal vision for one's self. (Spaniol et al 1997)
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