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Jan Wallcraft
Recovery - a double-edged sword?
Who owns recovery now it has become a key part of Government policy?
Without a strong, vocal national service user movement, is it going the way of
'normalisation', and 'choice'?
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.
Recovery is seen by many survivors as an evangelical movement trying to swallow up
everything that sounds good:
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.
The critics mock the idea of there being something, e.g Thriving, that is beyond even
recovery!
I've gone into a 'beyond Recovery' state of mind. I used to have a phobia about telephones, couldn't
answer them at all. Since my WRAP, DBT, MFI and ADHD training, I now answer the phone
whether it's ringing or not......
I have recovered from the coercive 'mental health'/illness system but it is difficult to recover from
life problems because they are part of the human condition--- everyone has these, no one escapes.
Most ' mental health' providers consider themselves to be this rare breed who exist without
problems. Who is delusional?!!
I remember a training session with trainee psychologists and one of them claimed to have
"unbreakable internal resources". People who don't know their own vulnerabilities are scary!
Recovery and minority ethnic groups
Recovery is criticised as being a white movement which does not work for minority ethnic groups:
Suman Fernando says:
• 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.)
One of my own concerns – how can Recovery be compatible with the new Mental Health Act? is
reflected in this quote from a survivor:
• 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 ...
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?
Can recovery discourse be saved?
O’Hagan says that in user/survivor and New Zealand literature,
‘recovery is a social process and responsibility, as well as a service and individual one.
Our version rejects many of the defining features of most contemporary mental health services –
their fixation on deficits and on clinical services, and their tendency to control and ghettoise
people.
She lists the following from an unpublished paper agreed on by an international group of
user/survivor experts.
Recovery-based services support people to live the life they choose through:
• Respecting and promoting their self determination
• Fostering their leadership in services as individuals and collectives
• Preventing coercive practices
• Expecting recovery rather than lifelong disability
• De-pathologising mental health struggles and viewing them as extremely challenging but
essentially human [and meaningful] experiences.
• Recognising the psychological, social, spiritual, existential and biological determinants and
consequences of mental health struggles
• Providing people with access to a broad range of services, community resources and
opportunities that affirm their personal power and their value in the world
• Providing equal opportunities to education, employment, independent housing and citizen
participation
• Developing a positive, diverse workforce, where the wisdom gained from mental health
struggles is highly valued.
(O’Hagan 2009)
I continue to think that Recovery is a natural word which has obvious and useful meanings
in mental health, but as a specific policy in mental health the concept is becoming
seriously damaged and compromised from the perspectives of service users.
References
CSIP, Royal College of Psychiatrists, SCIE (2007), A common purpose: Recovery in future
mental health services Joint Position Paper 08, available in print and online from
ww.scie.org.uk.
Anonymous. How I've managed chronic mental illness. Schizophrenia Bulletin, No l5, pp
635-640, l989.
Anthony, W, Recovery from Mental Illness: The new vision of service researchers.
Innovations and Research. vol. 1, no 1, pp 13-14, December, 1991.
Anthony, W, Recovery from Mental Illness: The guiding vision of the mental health service
system in the 1990s. Psychosocial Rehabilitation Journal, vol. l6, no 4, pp 11-23, April
l993.
Anthony, W. Recovery from Mental Illness: The guiding vision of the mental health service
system in the l990s. Psychosocial Rehabilitation Journal, vol. 16, no 4, pp 11-23, April
l993.
Anthony, W. The recovery vision. The Journal of the California Alliance for the Mentally
Ill,1111 Howe Avenue, Suite 475, Sacramento, CA. vol. 3, no3, p 5, 1994.
Anthony, W, Cohen, M & Farkas, M. Psychiatric Rehabilitation. Centre for Psychiatric
Rehabilitation, Boston, MA, 1990.
Arthurson K. & Jacobs K. (2003) A critique of the concept of social exclusion and its utility
for Australian Social Housing Policy, UK Housing Studies Association Conference, Bristol
(unpublished paper)
Carling, P, and Allot P. Core Vision and Values for Mental Health: Directional paper 1 on
developing modern community mental health systems. International Mental Health
Network, West Midlands Partnership for Mental Health, 1999.
Carling, P. & Allott, Piers. Beyond Mental Health Services: Integrating Resources and
Supports in the Local Community. Directional paper 2, International Mental Health
Network, for the West Midlands Partnership for Mental Health, l999.
Carling P., Allott P., Smith M., and Coleman R., Helping to Articulate the Direction of the
Mental Health System of the Future: Directional paper 3: Principles of Recovery,
International Mental Health Network, for the West Midlands Partnership for Mental Health,
l999.
Chamberlin J. On our own, London, MIND, 1988
Coleman R., Recovery: An Alien Concept, Handsell Publishing, 32 Furlong Road,
Gloucester GL1 4UT, 1999
Davidson, L & Straus, J. Sense of self in recovery from severe mental illness. British
Journal of Psychiatry, 65, pp 131-145, l992.
Deegan, P. (l988). Recovery: The lived experience of rehabilitation. Psychosocial
Rehabilitation Journal, Vol. 11, no 4, pp 11-19, 1988.
Facebook – Anti Recovery Group
Farkas, M, Gagne, M, Anthony, W, Recovery and rehabilitation: A paradigm for the new
millennium. Centre for Psychiatric Rehabilitation, Boston University, Boston MA,
02215,unpublished, no date.
Fischer, D. Hope, Humanity and Voice in Recovery from Psychiatric Disability, The
Journal. California Alliance for the Mentally Ill, Vol. 3, no 3, pp 13, 1994.
Foucault (1972) Archaeology of Knowledge, London: Routledge.
Harding, C.M., Brooks, G.W., Ashikaga, T., Strauss, J.S. and Breier, A. (1987) ‘The
Vermont longitudinal study of persons with severe mental illness, I: methodology,
study sample, and overall status 32 years later’, American Journal of Psychiatry, June,
vol 144, no 6, pp 718-26.
Hatfield, A. Recovery from Mental Illness, The Journal. California Alliance for the Mentally
Ill, Vol. 3 no3, pp 6, 7, 1994.
Kirkpatrick, H, Landeen, J., Bryne, C, Woodside, H, Patrick, J, and Bernardo, A, Hope and
Schizophrenia: Clinicians identify hopeful strategies. Journal of Psychosocial Nursing.
33(6) p, l5-19, l995.
Koehler, M, Values and Love in Recovery: Is there life after coping? Innovations and
Research, vol. 3, no 2, l994.
Leete, E, The treatment of schizophrenia: A patient's perspective. Hospital and Community
Psychiatry, vol. 38, no 5, pp 486-491, l988.
Leete, E, Stressor, Symptom, or Sequelae? Remission, Recovery, or Cure? The Journal,
California Alliance for the Mentally Ill. Vol., 5, no. 3. pp l6-l7, l994.
Lieberman, R and A Kopelowicz, Recovery from schizophrenia: Is the time right?
The Journal, California Alliance for the Mentally Ill, Vol. 3 , no 3, pp 67-69, 1994.
Liebrich J., A Gift of Stories: Discovering how to deal with mental illness, University of
Otago Press/Mental Health Commission, Dunedin New Zealand 1999
Lovejoy, M. Expectations and the recovery process. Schizophrenia Bulletin, vol. 8, no 4,
pp605-619, 1982.
May R., Routes to Recovery from Psychosis: The Roots of a Clinical Psychologist.
Clinical Psychology Forum. . (in press)
Mental Health Foundation. Knowing our own Minds: A survey of how people in emotional
distress take control of their lives. 21 Cornwall Terrace, London, l997.
(£7.00 for user groups; £15 full price).
Mental Health Foundation: Strategies for Living: A report of user-led research into people’s
strategies for living with mental distress, 21 Cornwall Terrace, London, 2000 (£10.00 for
user groups; £22 full price).
Mental Health Foundation (2001) Something inside so strong: Strategies for surviving
mental distress. London: Mental Health Foundation
Michaelson J. and Wallcraft J., Alternatives to the biomedical model of mental health crisis,
Breakthrough, Vol. 1 no. 3, 1997
NIMHE (National Institute for Mental Health in England) (2005) NIMHE guiding statement
on recovery -kc.nimhe.org.uk/upload/Recovery%Guiding%20Statement.
pdf).
O’Hagan, M. (2001) Recovery competencies for New Zealand mental health workers,
Wellington: Mental Health Commission (
www.mhc.govt.nz/publications/2001/Recovery_Competencies.pdf).
O’Hagan M.(2009) The colonisation of recovery, Openmind 156, March/April, p.20
Reeve, A., Recovery: A Holistic Approach, Handsell Publishing, City Works, Gloucester
GL1 4DF (1999)
Ridgway, Priscilla (2001) ReStorying Psychiatric Disability: Learning from First Person
Recovery Narratives, Psychiatric Rehabilitation Journal, 24(4), 335-343.
Russinova, V, (1989) Promoting Recovery from Serious Mental Illness Through Hope-
Inspiring Strategies. Community Support Network News, vol. 13, no 1, pp l, 4-6, 1989.
Centre for Psychiatric Rehabilitation, Boston, MA
Spandler H. (2007) From Social Exclusion to Inclusion? A critique of the inclusion
imperative in Mental Health, University of Central Lancashire (unpublished paper)
Spaniol, L, Koehler, M & Hutchinson, D. The experience of recovery: Self reports by
people with mental illness. Centre for Psychiatric Rehabilitation, Boston University, Boston,
MA, 89 pages, l994.($10.00 plus shipping)
Surgeon General (l999). Mental health: A report of the surgeon general. Department of
Health and Human Services, Bethesda, MC: United States.
Unzicker, R, Stressor, Symptom, or Sequale; Remission, Recovery or Cure? The Journal,
California Alliance for the Mentally Ill. Vol. 5, no. 3, pp. , l9 ).
Turner-Crowson J, Wallcraft J. The recovery vision for mental health services and
research: a British perspective. Psychiatr Rehabil J. 2002;25:245–254.
Warner, R. (1994) Recovery from schizophrenia: Psychiatry and political economy (2nd
edn), London: Routledge.