Psychiatric Recovery & Rehabilitation

HopeWhat is Psychiatric Recovery?

Sometimes people think that psychiatric “recovery” means a mental illness is cured. However, mental illness is a chronic condition. To better understand the concept of psychiatric recovery, think in terms of recovering of one’s life after diagnosis.

Psychiatric recovery focuses on strengthening abilities and assisting individuals identify and achieve personal, social, educational and vocational goals, allowing them to achieve their fullest potential. Recovery Innovations, Inc (a peer-run agency) defines recovery as “Remembering who you are and using your strengths to become all that you were meant to be” (Ashcraft, L., Zeeb, M. & Martin, C. 2007).

How is it possible?

Recovery is possible for anyone with a psychiatric diagnosis if they have the proper support. Finding services based on the Recovery Model is essential. Recognizing that while counseling and medicine are part of recovery, Recovery happens when all aspects of the Recovery Model are in place.

What is the Recovery Model?

The Recovery Model was created by people with mental illness. It is not theoretical, nor was it begun by academia. For that reason it can be challenging to assimilate into an educational model. In fact, peers don’t refer to is as a model. It is not grounded in a clinical environment, although, depending on the person, clinical participation can be an important component. The Recovery Model is a cultural paradigm shift. It is not established based on diagnosis or prognosis, recognizing such for only two purposes, billing and prescribing.  Greater emphasis is placed upon trained peer support specialists who act as mentors and guides on Recovery’s Road. This model’s foundation draws its strength from the experiences of hundreds of thousands of people living their lives with mental illness. The Recovery Model recognizes the person with the diagnosis as the expert of living with their symptomology.

What are the Peer-based principles of Recovery?

Many peers (people with lived experience with mental illness) feel that the term “Principles” is too clinical and therefore too impersonal for Recovery purposes. Instead, peers prefer to use the term “Recovery Pathways.”  How one finds and explores these Recovery Pathways will be unique to each individual. According to Ashcraft, Zeeb, Martin (2007), Recovery is comprised of five pathways:

  1. Hope
  2. Choice [& Accountability]
  3. Empowerment
  4. Recovery Environment and using Recovery Language
  5. Spirituality/Meaning & Purpose

The dilemma arises because clinicians and other providers prefer to define ambiguous unquantifiable terms. For that reason, in 2010 United States’ Substance Abuse and Mental Health Administration (SAMHSA) began striving to understand Recovery from a peer perspective in an effort to quantify recovery and develop evidence-based best practices. For a year they gathered the opinions of peers and providers via meetings and public forums and then synthesized the data. Since their initial definition published in 2011,  SAMHSA continued the dialogue, updating their definition in August 2012. Currently they define “recovery from* mental illness and substance abuse” in the following terms:

The Substance Abuse and Mental Health Services (SAMHSA) recognizes there are many different pathways to recovery and each individual determines his or her own way. SAMHSA engaged in a dialogue with consumers, persons in recovery, family members, advocates, policy-makers, administrators, providers, and others to develop the following definition and guiding principles for recovery.  The urgency of health reform compels SAMHSA to define recovery and to promote the availability, quality, and financing of vital services and supports that facilitate recovery for individuals.  In addition, the integration mandate in title II of the Americans with Disabilities Act and the Supreme Court’s decision in Olmstead v. L.C., 527 U.S. 581 (1999) provide legal requirements that are consistent with SAMHSA’s mission to promote a high-quality and satisfying life in the community for all Americans.

Recovery from* Mental Disorders and/or Substance Use Disorders:  A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

Through the Recovery Support Strategic Initiative, SAMHSA has delineated four major dimensions that support a life in recovery: health, home, purpose & community.

Guiding Principles of Recovery according to SAMHSA:

  • Emerges from hope
  • Person-driven
  • Occurs via many pathways
  • Holistic
  • Supported by peers and allies
  • Supported through relationship and social networks
  • Culturally-based and influenced
  • Supported by addressing trauma
  • Involves individual, family, and community strengths and responsibility
  • Based on respect

* Stating that a person can recover from mental illness is misleading. Mental illnesses are chronic and ebb and flow. While a person can experience a remission of symptoms, that illness is still an underlying current in a person’s life.

Substance Abuse and Mental Health Administration (SAMHSA) launched a committee to define Recovery from a provider’s perspective in an effort to support measurable outcomes.

In helping someone embrace psychiatric recovery and rehabilitation, the goal is to help that person rediscover and strengthen every aspect of their personal identity. In doing so, their quality of life naturally begins to improve.

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