What is Mental Health Recovery?
Recovery in the Context of Mental Health
Prior to the 1980s, the term “recovery” had been used primarily to describe the alleviation of both physical and mental health “symptoms” experienced by an individual, and once these symptoms were alleviated the person would be regarded as “cured” or “recovered”.
During this time there was a prevailing belief within the mental health system that some types of mental health difficulties experienced by people were life-long and would deteriorate over time, and in the case of that there would be limited or no symptom alleviation, and, as a result, there would be no recovery.
However, an emergence of personal narratives and research studies published from the 1970s began to challenge these pessimistic assumptions and pointed to a more sophisticated and empowering understanding of mental health recovery.
Specifically, longitudinal research studies began to provide empirical evidence that challenged the belief that a mental health diagnosis would lead to life-long deterioration and no symptom alleviation.
In a study published in 1979, that was carried out over a 37 year period, Huber, Gross & Schuttler found that in terms of symptom alleviation, 53% of people diagnosed with schizophrenia were recovered or had significantly improved. More recently, a review of the international literature (Hopper, Harrison, Janca & Sartorius, 2007) investigating long-term outcomes for people with a diagnosis of schizophrenia that involved over 1,000 individuals followed up over 12 to 26 year periods has led Psychiatrist Richard Warner to conclude that “the view that a deteriorating course is a hallmark of the illness just isn’t true” (2007, p. 1444).
In addition to the earlier research publications, personal narratives began to emerge highlighting how people who had been given diagnoses relating to severe and enduring mental illnesses were finding ways to live personally satisfying and meaningful lives, and for some this occurred while continuing to experience difficulties or “symptoms”.
Life stories were being told of people remaining in or finding new employment, developing social and romantic relationships, looking after themselves within their own homes, continuing to participate within their local communities, and maintaining their sense of identity without allowing their mental health difficulties to define who they were.
As a result of these publications and personal narratives, a new and alternative understanding of the concept of recovery in a mental health context has been put forward by people with lived experience of mental health difficulties.
This new understanding does not necessarily imply “cure” or require the alleviation of symptoms in the traditional sense but involves the creation of a good life regardless of whether or not a person continues to experience difficulties; this is neatly summarised by Julie Repper and Rachel Perkins:
Recovery is not the same as ‘getting better’: people are not recovering from illnesses, but recovering meaningful and valuable lives whether or not their problems can be eliminated (2003, p. 59).