'Recovery' approach in mental health is idea 'whose time has come'

March 20, 2008
by Chris George

The “recovery” approach in mental health is an idea “whose time has come”, says a charity.

Making Recovery A Reality is authored by Professor Geoff Shepherd, a clinical psychologist and visiting professor in the health service and population research department at the Institute of Psychiatry; Dr Jed Boardman, a consultant psychiatrist and senior lecturer in social psychiatry at South London and Maudsley Trust; and Dr Mike Slade, a consultant clinical psychologist and reader in health services research at the Institute of Psychiatry.

Read for yourself:
Making Recovery A Reality

See also:
Service provision

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Recovery? It's about getting people to work at any cost

Comment from: Sara Stanton, mental health activist and project co-ordinator, Mind, UK
Date: March 22, 2008

I think what’s most concerning about all this is there is no critique of 'recovery' agendas and how it services so many political expediencies.

There’s a whole discussion that could be had that disability rights, social inclusion and rehabilitation are not areas that can sit easily side by side, let alone under the same umbrella.

And what do we mean when we talk about social inclusion? Recovery is now all about getting people into work at any cost – even to the detriment of their health, wellbeing and, in some cases, lives. Maybe we need to think about if the system needs reviewing rather than trying to include square pegs into round holes.

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Recovery not for everyone

Comment from: Fenella Lemonsky, Expert by Experience, North London Hub, UK Mental Health Research Network, Imperial College, London
Date: March 26, 2008

I have concerns that those with more complex illnesses like PTSD, personality disorder and treatment-resistant eating disorders are being "pushed out" well before these people are ready.

I have nothing against people moving on, but the evidence base for more complex mental health illnesses is that they need time, skill and support consistently. Using the Recovery Model is a nice idea but only if you are not a square peg trying to fit in a round hole.

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Recovery approach limited to white, middle classes

From: Suman Fernando, hon. senior lecturer in mental health, European Centre for Migration & Social Care (MASC), University of Kent; visiting professor in the Department of Applied Social Sciences, London Metropolitan University sumanfernando.com
Date: April 4, 2008

The 'recovery approach' is far too centred on the individual and tends to ignore the political and social context of 'mental illness'.

As such its relevance may be limited to a small group of service users - white middle-class mainly.

It's use widely is likely to add to social exclusion.

The journey for many black people in a racist society to escape from the aftermath of a major life disruption requires a holistic approach, where community is more important than 'self' and one that is inseparable from dealing with racism and discrimination in many aspects of their lives.

In my view, recovery is far too mild a word to encompass such a journey towards a respectable and fulfilling life.

The journey (which many black people caught up in the system never complete) is better represented by 'liberation' or 'struggle' (see my article in Openmind magazine, published by Mind, January/February 2008.)

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Recovery also excludes white, working class

From: Louise Pembroke, mental health activist, London
Date: April 8, 2008

I agree with you Suman that this "recovery" bandwagon does indeed ignore the political and social context of mental distress.

However, as a white working class service user I have to say I don't feel it applies to me either. It's a very elite circle of those who promote recovery and a lucrative gravy train.

So, although I would agree that 'recovery' as it is espoused excludes black people, I think it excludes a lot of us.

As for social inclusion, have you noticed how "recovery" has appropriated many concepts including social inclusion under its umbrella? It's scooped up everything and anything which looks good and rebranded it and relaunched it as new improved super-duper recovery. It's as though people need some new religion to follow.

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It does not ring my bell

From: Peter Campbell, Mind 2007 Champion of the Year, London
Date: April 9, 2008

I share many of the misgivings expressed above. Although I think there are helpful aspects of the "recovery approach", one real stumbling block for me is that, despite receiving mental health services regularly for many years, I have never thought of my life in terms of recovering from a catastrophic event or events.

Recovering, attempting to recover, being in recovery, being recovered, ring no bells for me at all. I suspect there are other service users around who feel the same. Viewing parts or all of your past and future life in terms of "recovery" may be helpful but it is by no means the only useful framework for looking at your experience and prospects.

The fact that concepts of recovery mean little to me is not because I am a bit thick or because the notion of recovering from adversity had not entered human consciousness at the time I had my first acute admission. There are other ways of looking at things.

In my opinion, the last thing we need to be doing at the moment is replacing an old orthodoxy with a new orthodoxy, even if the new one is more influenced by the lives and contributions of service users.

I hope we never reach the stage where the inability or unwillingness of service users to fit their lives into a "recovery narrative" is used as a way of marginalising what they have to say.

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Medical recovery

Comment from: Sara Stanton, project manager, Mind, UK
Date: April 22, 2008

Good points Peter. I never understood or utilised the recovery model within my own existence, and for a lot of the time it’s been generally pretty miserable rather than any traceable traumatic event.

A huge body of work exists around recovery but as an approach it seems to lack any fresh and challenging understandings to that of the medical model.

I recently heard colleagues talking about 'recovery - how not to relapse'....this would seem somewhat contradictory and highly revealing about where things are really at in frontline mental health services around recovery. In the UK recovery does seem to be the latest buzz word, serving a range of political and financial expediencies for some people.

Every approach now becomes swept up as the latest treatment option bolted on to the medical model (which is still very much in existence and persuasive within frontline mental health services) Since when did Marius Romme’s body of work around working with people who hear voices become a recovery model?)

So much of recovery is very much embedded within a medical understanding of distress, which dictates and limits the way professionals work with people in distress and the treatment they will receive. I cannot ignore, that come Oct 2008 two pieces of bloody awful draconian legislation will come completely into force in the UK- the Mental health Act 2007 and the new DWP ESA rules for people on Income Support and Incapacity Benefit - absolutely terrifying laws which fly in the face of our somewhat light-hearted (if not maverick) attempts at supporting people through a recovery based approach. How can we talk about recovery in light of these huge legislative changes that will have all sorts of consequences on the lives of people who fall within their remit?

I don’t know if it’s just me, but a lot of the language and direction of recovery leaves me thinking and feeling that somewhere along the line something is becoming lost. Particularly in times, when the recovery agenda in mental health is all persuasive and people are taking their eyes off the medical model as they forget it is still very much there as the core supporting structure underlying the recovery agenda. (Again let’s just consider the impact of what’s going down in Oct 2008!) I have not yet come across any work that has been produced recently (by anyone) around recovery that is able to truly and honestly disentangle itself from the medical model. And for the various authors, particularly those from a service user/survivor perspective, the personal profiling and financial rewards from buying into the recovery agenda.

Sara Stanton – inadequate voice hearer (i.e. not recovered)

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