A few months ago, I wrote about recovery as it relates to mental health (Time to Start Walking the Walk). In that piece, I described a scientific approach to recovery that is based on two measurable conditions: human agency – the ability to exert control over oneself and one’s environment – and self-efficacy – a set of beliefs about one’s capacity to exert control.
Although the term recovery is much used by consumer advocates, service providers and government policymakers, I rarely hear it mentioned in the same breath with science and measurable outcomes. The Substance Abuse and Mental Health Services Administration (SAMHSA), one of the chief proponents of a recovery model of care, does a disservice to millions of Americans living with mental illness when it makes a statement on its website that: “Today, when individuals with mental and/or substance use disorders seek help, they are met with the knowledge and belief that anyone can recover and/or manage their conditions successfully.” Sounds easy, doesn’t it? No wonder prominent mental health advocate Liza Long has entered a national plea to retire the word recovery from our mental health vocabulary. The SAMHSA statement seems to imply that if anyone can manage their conditions, the failure of many thousands of people with serious mental illness to actually do so must result from a lack of will and trying.
The name Resources to Recover speaks to the purpose of this website: to help people with mental illness and their families identify vetted resources that help make recovery possible. But there’s a problem with that word recovery, as Liza Long makes clear. When it comes to mental health, most definitions of recovery abound with positive affirmations of hope and a person’s right to self-determination. But isn’t recovery also about getting better? For this website to achieve its purpose, the second R in RtoR.org must stand for more than hope. It should also tell you what must happen for people with mental illness to improve their condition.
Yale Professor Larry Davidson, Director of the Program for Recovery & Community Health, describes two types of recovery in mental health: recovery from mental illness (in effect, an end to illness), and being in recovery with a mental illness – a process of “minimizing the illness and its deleterious effects on the person’s life over time” and “reclaiming (one’s) right to a safe, dignified, and personally meaningful and gratifying life in the community.” This concept of recovery as a process is essential to our understanding of the word as it relates to mental health. It means that people can strive to have a good life, even though they live with mental illness.
In light of the of the confusion caused by overly optimistic statements of intent, I have crafted a functional definition of recovery that builds on the idea of recovery as a process, while conveying hope and addressing the critical issue of improved functioning:
Recovery is a process of setting goals, learning skills and taking actions that enable a person living with mental illness to connect with others and effectively pursue his or her aspirations for a life of meaning.”
With this definition, I try to convey a sense of progress as well as process. Recovery is not a passive pursuit and I do not pretend that it is easily adhered to for someone who has struggled with serious, lifelong mental illness. But I do believe it is realistic and within the reach of all people.
In my work with hundreds of people who have struggled with serious mental illness, I cannot recall one who did not in some way strive for connection with others and a meaningful existence. Many of them lacked the skills to create and execute an effective plan of action to pursue their dreams. But they all dreams. The purpose of my functional definition of recovery is to nudge providers, persons with mental illness and their families onto a real-world path leading in the direction of those dreams, no matter how small or slow the steps.
This functional definition of recovery is very much a working definition, still in process. I welcome your reactions, comments, and responses in the Comments section below.
Jay Boll, Editor in Chief
Throughout the month of May, RtoR.org will release a daily Post
of the Day in observance of Mental Health Awareness Month
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