In mental health, recovery does not always refer to the process of complete recovery from a mental health problem in the way that we may recover from a physical health problem.
For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. Professionals in the mental health sector often refer to the 'recovery model' to describe this way of thinking.
Putting recovery into action means focusing care on supporting recovery and building the resilience of people with mental health problems, not just on treating or managing their symptoms.
There is no single definition of the concept of recovery for people with mental health problems, but the guiding principle is hope - the belief that it is possible for someone to regain a meaningful life, despite serious mental illness.
Recovery is often referred to as a process, outlook, vision, conceptual framework or guiding principle.
The recovery process:
- provides a holistic view of mental illness that focuses on the person, not just their symptoms
- believes recovery from severe mental illness is possible
- is a journey rather than a destination
- does not necessarily mean getting back to where you were before
- happens in 'fits and starts' and, like life, has many ups and downs
- calls for optimism and commitment from all concerned
- is profoundly influenced by people's expectations and attitudes
- requires a well organised system of support from family, friends or professionals
- requires services to embrace new and innovative ways of working.
The recovery model aims to help people with mental health problems to look beyond mere survival and existence. It encourages them to move forward, set new goals and do things and develop relationships that give their lives meaning.
Recovery emphasises that, while people may not have full control over their symptoms, they can have full control over their lives. Recovery is not about 'getting rid' of problems. It is about seeing beyond a person's mental health problems, recognising and fostering their abilities, interests and dreams.
Mental illness and social attitudes to mental illness often impose limits on people experiencing ill health. health professionals, friends and families can be overly protective or pessimistic about what someone with a mental health problem will be able to achieve. Recovery is about looking beyond those limits to help people achieve their own goals and aspirations.
Recovery can be a voyage of self-discovery and personal growth. Experiences of mental illness can provide opportunities for change, reflection and discovery of new values, skills and interests.
Research has found that important factors on the road to recovery include:
- good relationships
- financial security
- satisfying work
- personal growth
- the right living environment
- developing one's own cultural or spiritual perspectives
- developing resilience to possible adversity or stress in the future.
Further factors highlighted by people as supporting them on their recovery journey include:
- being believed in
- being listened to and understood
- getting explanations for problems or experiences
- having the opportunity to temporarily resign responsibility during periods of crisis.
In addition, it is important that anyone who is supporting someone during the recovery process encourages them to develop their skills and supports them to achieve their goals.
"Too many services fail to empower their users to 'get their life back on track' and get back into the community."
There is a strong link between the recovery process and social inclusion. A key role for services is to support people to regain their place in the communities where they live and take part in mainstream activities and opportunities along with everyone else. There is a growing body of evidence that demonstrates that taking part in social, educational, training, volunteering and employment opportunities can support the process of individual recovery.
Three approaches that may help are:
WRAP (Wellness Recovery Action Planning)
WRAP is a self-management and recovery system developed in the US by people with mental health difficulties. People are supported to create their own wellness recovery action plan, setting out their goals, what help they need to get there, what helps keep them well, and what puts their mental health at risk. WRAP aims to:
- increase the person's sense of control over their mental health problems
- increase personal empowerment
- improve quality of life
- assist people in achieving their own life goals and dreams.
A WRAP will also state how the person wants others to respond when symptoms have made it impossible for them to continue to make decisions safely for themselves and take care of themselves.
You can find out more about WRAP on the Mental Health Recovery and WRAP website.
DREEM (Developing Recovery Enhancing Environments Measure)
DREEM is an outcome measure and research tool to see how 'recovery-oriented' a service is. It is a self-report instrument that gathers information about mental health recovery from people who using mental health services. The DREEM asks people where they are in their process of mental health recovery and what markers of recovery they are currently experiencing.
You can find out more about DREEM on the Recovery Devon website.
This is tool for people using services to enable them to measure their own recovery progress, with the help of mental health workers or others. The 'star' contains ten areas covering the main aspects of people's lives, including living skills, relationships, work and identity and self-esteem. Service users set their personal goals within each area and measure over time how far they are progressing towards these goals. This can help them identify their goals and what support they need to reach them, and ensure they are making progress, however gradual, which itself can encourage hope.
You can find out more about Recovery Star on the Mental Health Providers Forum website.
Checklist of Good Practice
Service users have written extensively about the approaches to recovery which they would like mental health professionals to take. For an example which represents the views of service users from both dominant and marginalised communities, see the Checklist of Good Practice (PDF).