Recovery for mental health consumers is a personal and unique process; everyone with personal experience of mental health issues develops his/her own definition of recovery. It is living consciously and fully despite life’s burdens. There is not one model of recovery as it is a person-centred approach in which individual differences are considered and valued.

Whilst recovery is unique to each person there are common key factors. These include: Hope, Rights, Personal responsibility, Education, Self-advocacy, Mutual relationships and Support.

Consumers who are on a recovery journey are people who, in spite of symptoms, carve out a life for themselves. They have goals and they make choices to improve their situation with the right type of support. For recovery is ‘the expression of hope, the willingness to try and the discovery that you can do and be again’ (Deegan, 1996).

The promise of recovery is that it will lead to fuller lives. Recovery does not mean that you are cured nor does it mean that one is simply stabilised or maintained in the community.

In the National Mental Health Plan 2003-2008, recovery is defined as… ‘A personal process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life. Recovery involves the development of new meaning and purpose as the person grows beyond the effects of psychiatric disability’. In my opinion, the National Mental Health Plan definition of recovery only goes so far.

Recovery is a process rather than an event. The consumer directs the recovery process – therefore consumer input is essential throughout the process. This complicated, uniquely individual process is not well captured by mental health policy. It is ironic that both consumers and researchers are striving to make sense of the same experience, but to date this has been primarily done in isolation from one another.

It is a common misunderstanding that recovery is the new word for rehabilitation. In actual fact ‘the concept of recovery differs from that of rehabilitation inas-much as it emphasises that people are responsible for their own lives and that we can take a stand towards our disability and what is distressing to us’ (Deegan, 1996b).

Debates in Recovery

Recovery is not a new idea, though its recent prominence in mental health literature and policy may make it seem so. The people responsible for initiating the current dialogue are consumers.

Most of the literature on recovery for mental health consumers comes from the United States and has three main ideological sources. The first is the generic recovery or self-help movement exemplified by The Power of Positive Thinking, 12-step groups, co-dependency, self-help and new age philosophies. The second source is the mental health service user movement, and its underlying philosophy of human rights and self-determination. The third source is psychiatric rehabilitation with its focus on community integration and overcoming functional limitations.

The vision of recovery that comes out of the United States is more individualistic and mono-cultural than is appropriate for multicultural Australia.

We need to acknowledge cultural diversity and that a connection to one’s own culture is a key to recovery. Much of the literature focuses mainly on the individual’s process, without including the social, economic and political processes that also enable recovery. This approach therefore excludes the consideration the effect of the health system, environmental and social factors has on the consumer.

A philosophy of recovery provides a beacon of hope where, too often, people are told that mental illness means certain decline into unemployment, poverty and disability. In contrast, the philosophy of recovery focuses on health rather than illness and strengths/assets rather than problems.

The health system often disrupts the normalisation processes (that emphasise abilities and recovery) by continually introducing a ‘problem-saturated perspective’, which ‘services the illness’, rather than providing ‘the help one needs for getting on with life’ (Sullivan, 1994).

Two areas of discussion that require attention are the consideration of the social context in which recovery occurs and the range of roles consumers can play in the service system. Obviously the consumer must be in the driving seat of his/her own recovery but increasing literature now shows the benefits of consumers as deliverers of services as well. For example, roles such as peer support and peer counsellors, advocacy and providers of formal services.

Change and services

There is no way to predict who will recover and who won’t. Therefore, recovery services are grounded in the concept that people can recover from a mental illness if they are given sufficient opportunity to build skills and support. This has major ramifications for services for they must consider how this is reflected in their service provision. Services need also to be aware of their potential to enable and encourage consumer dependency.

Adopting recovery as the overall principle for the reform of mental health systems has ramifications such as the choice of services to be funded and how they are to be delivered.

As systems strive to create new initiatives consistent with this ‘new’ vision of recovery, new system standards are needed to guide the development of recovery-oriented mental health services.

Obvious benefits of a recovery definition for mental health services include:

· Reduced need for hospitalisation

· Increased possibility of positive outcomes

· As we normalise people’s feelings and symptoms, we build a more accepting, diverse culture

· Clinicians will enjoy the positive reinforcement of successful work experiences

· Cost effectiveness – at personal, family and community levels. Not discounting the obvious – the public purse.

The obvious benefits of recovery-focused services for consumers are too many to list here but can be summed up by saying that we regain a life and not just receive a prognosis.

For the Future

Recovery is about hope and my hopes for the future of recovery are that services that will be led by consumers; services that enhance our autonomy, recognise us as whole human beings, expect our recovery and offer us a broad range of solutions and resources.

I hope that the general community and the mental health community will be a strong supporter of recovery. Finally, I hope for a world in which consumers become free and whole persons in wholesome relationships and gentle builders of free and whole communities.

Bibliography

Deegan, P. (1996). Recovery as a journey of the heart. Psychiatric Rehabilitation Journal, 19(3), 91-7.

Deegan, Patricia E. (1996b) Recovery and the Conspiracy of Hope. Sixth Annual TheMHS Conference of Australia and New Zealand. Brisbane. 1996.

Ohio Department of Mental Health, USA. Emerging Best Practice and Guiding Principles in Recovery. Sullivan, W. P. (1994). A long and winding road: The process of recovery from severe mental illness. Innovations and Research, 3(3), 19-27. Australian Health Ministers (2003) National Mental Health Paln 2003-2008, Australian Government, Canberra.