approach in mental health is idea 'whose time has come'
by Chris George
“recovery” approach in mental health is an idea “whose
time has come”, says a charity.
Making Recovery a Reality, a policy
document by the Sainsbury Centre For Mental Health, is a bid to
present key principles behind the “empowering” recovery
approach and the implications for services if they are to steer
away from a traditional medical model.
A recovery approach prioritises a social model of understanding
and alleviating mental illness. Its roots stretch back to other
less medical approaches, such as the 18th century "moral treatment”
of the Quakers' York Retreat.
is probably the most important new direction for mental health services,”
reads Making Recovery A Reality.
"Recovery represents the convergence
of a number of ideas (empowerment, self-management, disability rights,
social inclusion and rehabilitation) under a single heading that
signals a new direction for mental health services."
Several mental health trusts say
they are incorporating recovery into service delivery. These include
Devon Partnership NHS Trust, South London & Maudsley NHS Foundation
Trust, 2007, and South West London and St George’s Mental
Health NHS Trust.
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.
Recovery A Reality
not for everyone
Lemonsky, Expert by Experience, North London Hub, UK Mental Health
Research Network, Imperial College, London
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.
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.
approach limited to white, middle classes
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
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'.
such its relevance may be limited to a small group of service users
- white middle-class mainly.
use widely is likely to add to social exclusion.
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
my view, recovery is far too mild a word to encompass such a journey
towards a respectable and fulfilling life.
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.)
also excludes white, working class
Louise Pembroke, mental health activist, London
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.
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.
It does not
ring my bell
Peter Campbell, Mind 2007 Champion
of the Year, London
April 9, 2008
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
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.
to realise recovery?
From: Mike Stean, approved social worker, NHS Recovery
and Independent Living Team and also Forensic Services
Date: August 28, 2008
'recovery' as with the medical model, surely the criterion for improvement
is whether someone going through the process has more real control
over what happens?
The fault with the old way and the risk in the new is that reality
is redefined away from personal experience, creating just another
analogy in housing provision would be 'voluntarily homeless'. We
could end up with recalcitrant ex-service users who are too stubborn
to realise they have recovered!
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