Mental health recovery

What is mental health recovery?

If a person develops a mental health condition, it can lead to significant distress and a number of difficulties. Mental health recovery is the process of reclaiming one's life beyond mental illness and distress.

In this blog post, we will explore the framework and concepts for recovery oriented services, as well as the personal recovery process, the recovery process for different mental health conditions, the latest research on the recovery model, and the limitations of this approach. Additionally, there is a movement away from the terms mental illness.

Recovery oriented practice and strengths based orientation

The recovery model is a person-centered, strengths-based approach that emphasises the hope, empowerment, and resilience for anyone with mental health challenges, including more serious and chronic conditions.

Consider the idea of working with strengths towards recovering mental health. That might be building connections with people, cultivating positive emotions or improving self-care practices and reducing harmful behaviours.

Clinical recovery vs personal recovery

Mental health recovery involves a tension between clinical recovery and personal recovery. It is not straightforward, and also not black and white. On one hand, we have the term ‘clinical recovery’ which generally refers to an individual’s restoration to their pre-existing state prior to the onset of mental health issues or other medical conditions.

Clinical Recovery

This type of recovery typically involves outcome measurements used by health professionals for people with mental disorders. Clinical intervention seeks to address for mental health difficulties diagnostically, which often leads to the use of psychotropic medications and/or therapeutic strategies to restoring normality, specifically by reducing symptoms.

Rather than focusing solely on symptom reduction, the recovery approach recognises that individuals with mental health conditions can and do recover and lead fulfilling lives.

The key principles of the recovery approach include:

• Person-centred: The individual is at the centre of their recovery journey, and their needs and goals are the primary focus.

• Strengths-based: Recovery is viewed as a process of building on an individual's strengths, resources, and abilities, rather than just addressing deficits and weaknesses.

• Empowering: Recovery emphasises the importance of self-determination and active participation in decision-making and goal-setting.

• Holistic: Recovery recognises the interconnections between mental health, physical health, and social well-being, and seeks to address all aspects of an individual's life.

• Hopeful: Recovery emphasises that it is possible to overcome mental health challenges and lead a fulfilling life, even in the face of ongoing difficulties.

The recovery approach differs from traditional mental health approaches in several ways. Traditional approaches often focus on diagnosing and treating symptoms of mental illness with a primary goal of reducing or eliminating symptoms. The recovery approach, on the other hand, recognises that individuals can experience mental health challenges but can still lead meaningful lives.

The focus is on community participation, building resilience, developing coping strategies, and improving overall well-being rather than just symptom reduction. Additionally, the recovery approach involves a partnership between the individual and mental health providers, rather than a hierarchical relationship where the provider has all the power and control. Finally, the recovery approach recognises that recovery is a unique and ongoing process that may look different for each individual.

Recovery goals

Mental health recovery goals are centered around improving a person's life and well-being. Recovery plans are tailored to individual needs, and may include strategies to improve self-esteem, develop coping skills, and build social connections. Support groups and peer networks can be valuable sources of support and encouragement, as individuals work towards a self-directed life and increased social inclusion.

Recovery is a holistic process, taking into account all aspects of a person's life, and emphasising the importance of an active role in one's own recovery. Support people, such as mental health professionals, family members, and friends, can play a critical role in helping individuals achieve their recovery goals and live fulfilling lives.

Recovery approach in services

Recovery-oriented services focus on individual needs and goals, with people who have lived experience of mental health challenges involved in service design and delivery. Implementing the recovery approach in mental health services can be challenging, and requires collaboration between providers, individuals with lived experience, and the community.

Benefits of recovery-oriented services include promoting hope, empowerment, and resilience, while challenges include the need for adequate funding, staffing, and training. Overall, the recovery approach is a valuable addition to mental health services that can help individuals with mental health challenges live meaningful and fulfilling lives.

Wellness Recovery Action Plans

Wellness Recovery Action Plans (WRAP) were developed by Mary Ellen Copeland, a mental health advocate and researcher who has lived with bipolar disorder for many years. WRAP is a self-management tool that helps individuals to identify and manage triggers and symptoms of mental health challenges.

It provides a structured framework for developing a plan for wellness that includes personalised wellness tools, crisis planning, and advance directives. WRAP has been widely adopted in mental health programs and is recognised as an evidence-based practice. Mary Ellen Copeland's work has been instrumental in advancing the understanding of personal recovery and empowering individuals with mental health challenges to take control or responsibility of their lives.

Personal recovery

Reclaiming a life beyond mental illness and distress

Personal recovery in mental health aims to restore purpose and identity beyond mental illness by developing skills, coping strategies, and resources. It involves rediscovering oneself, characterised by hope, empowerment, and resilience. Hope is about having a positive outlook, empowerment involves gaining control over one's life, and resilience helps bounce back from setbacks.

Personal recovery involves acquiring new skills, coping mechanisms, and connecting with peers. While unique to each individual, with perseverance and support, individuals can achieve a self-directed life with social inclusion and a holistic view of themselves.

Mental health conditions

The recovery process

The recovery process for common mental health problems (or conditions) such as depression, anxiety, and bipolar disorder often involves a combination of medication, therapy, and self-care. Mood stabilisers and antipsychotic medications can help with bipolar disorder, while antidepressants can help with depression and anxiety.

Therapy can address underlying issues that may contribute to the condition and develop coping strategies. Self-care strategies such as exercise, a healthy diet, and stress reduction techniques can also be helpful. Peer support can also be valuable in the recovery process.

Other mental health conditions, including eating disorders, PTSD, schizophrenia, OCD, personality disorders, and adjustment disorders may also require medication, therapy, self-care, and peer support. The recovery process should be individualised to address the unique needs of each person.

Research to inform recovery-oriented practice

Research shows the recovery approach to mental health is effective, improving outcomes and reducing hospitalisations. Incorporating key recovery principles, such as peer support, may have advantages over a fully professionally oriented treatment system.

This has led to the inclusion of peer support in mental health programs and the development of culturally sensitive approaches. More research is needed to evaluate the effectiveness of recovery-oriented interventions and ensure accessibility to all who need it. This research is informing the development of recovery-oriented practices and policies.

Limitations of the recovery approach

The recovery approach to mental health has limitations and critics argue that it may place unrealistic expectations on individuals and overlook social determinants of mental health. Additionally, it may promote individualism and victim-blaming instead of addressing systemic issues, despite the fact that it is very much about the problems in the system.

Trauma, survivorship and healing

One of the other criticisms heard from people who have attended therapy or hospital services has been the context of the word doesn’t suit their process. The original context may be somewhat dated and not representative of more progressive ideas. For example, people who may have had trauma and complex or relational trauma often use the word survivor or describe a process of healing.

Conclusion

The recovery approach to mental health emphasises hope, empowerment, and resilience and has been shown to improve outcomes. Involving people with lived experience, addressing systemic issues, and prioritising individual needs can help improve mental health care. Many resources, including therapy and peer support, are available for those struggling with mental health, and seeking support is a brave step towards healing.

References

Copeland, M. E. (2008). The WRAP Story: First Person Accounts of Personal and System Recovery and Transformation. Peach Press.

Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., & Whitley, R. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry, 13(1), 12-20. https://doi.org/10.1002/wps.20084