Skip to main content Accessibility help
×
Home
Hostname: page-component-7f7b94f6bd-gszfc Total loading time: 0.279 Render date: 2022-06-30T08:25:33.822Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Recovery: an international perspective

Published online by Cambridge University Press:  18 May 2011

Mike Slade*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry King's College London, London (United Kingdom)
Michaela Amering
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy Division of Social Psychiatry, Vienna (Austria)
Lindsay Oades
Affiliation:
lllawarra Institute for Mental Health, University of Wollongong, Australia
*
Address for correspondence: Dr. M. Slade, Health Service and Population Research Department Institute of Psychiatry, King's College London, Denmark Hill, London SE5 8AF, (United Kingdom). E-mail: m.slade@iop.kcl.ac.uk

Summary

Aims – To review developments in recovery-focussed mental health services internationally. Methods – Two forms of ‘recovery’ which have been used in the literature are considered, and international examples of recovery-focussed initiatives reviews. A ‘litmus test’ for a recovery-focussed service is proposed. Results – ‘Clinical recovery’ has emerged from professional literature, focuses on sustained remission and restoration of functioning, is invariant across individuals, and has been used to establish rates of recovery. ‘Personal recovery’ has emerged from consumer narratives, focuses on living a satisfying, hopeful and contributing life even with limitations caused by the illness, varies across individuals, and the empirical evidence base relates to stages of change more than overall prevalence rates. Clinical and personal recovery are different. Two innovative, generalisable and empirically investigated examples are given of implementing a focus on personal recovery: the Collaborative Recovery Model in Australia, and Trialogues in German-speaking Europe. The role of medication is an indicator: services in which all service users are prescribed medication, in which the term ‘compliance’ is used, in which the reasoning bias is present of attributing improvement to medication and deterioration to the person, and in which contact with and discussion about the service user revolves around medication issues, are not personal recovery-focussed services. Conclusions – The term ‘Recovery’ has been used in different ways, so conceptual clarity is important. Developing a focus on personal recovery is more than a cosmetic change – it will entail fundamental shifts in the values of mental health services.

Declaration of Interest: None.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alanen, Y.O. (1997). Schizophrenia. Its Origins and Need-Adapted Treatment. Karnac Books: London.Google Scholar
American Psychiatric Association (2005). Position Statement on the Use of the Concept of Recovery. American Psychiatric Association: Washington DC.Google Scholar
Amering, M. & Schmolke, M. (2007). Recovery. Das Ende der Unheilbarkeit. Psychiatrie-Verlag: Bonn.Google Scholar
Amering, M., Hofer, H. & Rath, I. (2002). The “First Vienna Trialogue” – experiences with a new form of communication between users, relatives and mental health professionals. In Family Interventions in Mental Illness: International Perspectives (ed. Lefley, H.P. and Johnson, D.L.). Praeger: Westport CT.Google Scholar
Andresen, R., Oades, L. & Caputi, P. (2003). The experience of recovery from schizophrenia: towards an empirically-validated stage model. Australian and New Zealand Journal of Psychiatry 37, 586594.CrossRefGoogle ScholarPubMed
Andresen, R., Caputi, P. & Oades, L. (2006). The Stages of Recovery Instrument: Development of a measure of recovery from serious mental illness. Australian and New Zealand Journal of Psychiatry 40, 972980.CrossRefGoogle ScholarPubMed
Anthony, W.A. (1993). Recovery from mental illness: the guiding vision of the mental health system in the 1990s. Innovations and Research 2, 1724.Google Scholar
Australian Health Ministers (2003). National Mental Health Plan 2003-2008. Australian Government: Canberra.Google Scholar
Bellack, A. (2006). Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophrenia Bulletin 32, 432442.CrossRefGoogle ScholarPubMed
Bleuler, M. (1978). The Schizophrenic Disorders. Yale University Press: New Haven, CT.Google Scholar
Bock, T. & Priebe, S. (2005). Psychosis seminars: an unconventional approach. Psychiatric Services 56, 14411443.CrossRefGoogle Scholar
British Psychological Society Division of Clinical Psychology (2000). Recent Advances in Understanding Mental Illness and Psychotic Experiences. British Psychological Society: Leicester.Google Scholar
Cabinet Office (2006). Reaching Out: An Action Plan on Social Inclusion. Cabinet Office: London.Google Scholar
Care Services Improvement Partnership, Royal College of Psychiatrists & Social Care Institute for Excellence (2007). A Common Purpose: Recovery in Future Mental Health Services. CSIP: Leeds.Google Scholar
Ciompi, L. & Hoffmann, H. (2004). Soteria Berne: an innovative milieu therapeutic approach to acute schizophrenia based on the concept of affect-logic. World Psychiatry 3, 140146.Google ScholarPubMed
Ciompi, L. & Muller, C. (1976). The Life-Course and Aging of Schizophrenics: a Long-Term Follow-up Study into Old Age. Springer: Berlin.Google Scholar
Clarke, D. (2003). Faith and hope. Australasian Psychiatry 11, 164168.CrossRefGoogle Scholar
Cohen, P. & Cohen, J. (1984). The clinician's illusion. Archives of General Psychiatry 41, 11781182.CrossRefGoogle ScholarPubMed
Coleman, R. (1999). Recovery – an Alien Concept. Hansell: Gloucester.Google Scholar
College of Occupational Therapists (2006). Recovering Ordinary Lives: The Strategy for Occupational Therapy in Mental Health Services 2007-2017. College of Occupational Therapists: London.Google Scholar
Copeland, M. & Mead, S. (2003). WRAP and Peer Support: A Guide to Individual, Group and Program Development. Peach Press: Dummerston, VT.Google Scholar
Crowe, T., Deane, F., Oades, L.G., Caputi, P. & Morland, K.G. (2006). Effectiveness of a collaborative recovery training program in Australia in promoting positive views about recovery. Psychiatric Services 57, 14971500.CrossRefGoogle ScholarPubMed
Davidson, L. & Strauss, J. (1992). Sense of self in recovery from severe mental illness. British Journal of Medical Psychology 65, 131145.CrossRefGoogle ScholarPubMed
Davidson, L., O'Connell, M., Tondora, J., Styron, T. & Kangas, K. (2006). The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services 57, 640645.CrossRefGoogle ScholarPubMed
Davidson, L., Schmutte, T., Dinzeo, T. & Andres-Hyman, R. (2008). Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophrenia Bulletin 34, 58.CrossRefGoogle ScholarPubMed
Deane, F., Crowe, T., King, R., Kavanagh, D. & Oades, L. (2006). Challenges in implementing evidence-based practice into mental health services. Australian Health Review 30, 305309.CrossRefGoogle ScholarPubMed
Deegan, P. (1988). Recovery: the lived experience of rehabilitation. Psychosocial Rehabilitation Journal 11, 1119.CrossRefGoogle Scholar
Deegan, P. (1990). Spirit breaking: When the helping professions hurt. Humanistic Psychology 18, 301313.CrossRefGoogle Scholar
Department of Health (2001). The Journey to Recovery – The Government's Vision for Mental Health Care. Department of Health: London.Google Scholar
Department of Health (2006). From Values to Action: The Chief Nursing Officer's Review of Mental Health Nursing. HMSO: London.Google Scholar
De Sisto, M.J., Harding, C.M., McCormick, R.V., Ashikage, T. & Brooks, G. (1995). The Maine and Vermont three-decades studies of serious mental illness: II. Longitudinal course. British Journal of Psychiatry 167, 338342.CrossRefGoogle Scholar
Drukker, M., Gunther, N. & van Os, J. (2007). Disentangling associations between poverty at various levels of aggregation and mental health. Epidemiologia e Psichiatria Sociale 16, 39.Google ScholarPubMed
Harding, C.M., Brooks, G., Ashikage, T., Strauss, J.S. & Brier, A. (1987). The Vermont longitudinal study of persons with severe mental illness II: long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry 144, 727735.Google Scholar
Harrison, G., Hopper, K., Craig, T., Laska, E., Siegel, C., Wanderling, J., Dube, K.C., Ganev, K., Giel, R., and der Heiden, W., Holmberg, S.K., Janca, A., Lee, P.W., Leon, C.A., Malhotra, S., Marsella, A.J., Nakane, Y., Sartorius, N., Shen, Y., Skoda, C., Thara, R., Tsirkin, S.J., Varma, V.K., Walsh, D. & Wiersma, D. (2001). Recovery from psychotic illness: a 15-and 25-year international follow-up study. British Journal of Psychiatry 178, 506517.CrossRefGoogle ScholarPubMed
Healthcare Commission (2006). State of Healthcare 2006. Commission for Healthcare Audit and Inspection: London.Google Scholar
Henderson, C., Thornicroft, G. & Glover, G. (1998). Inequalities in mental health. British Journal of Psychiatry 173, 105109.CrossRefGoogle ScholarPubMed
Hopper, K., Harrison, G., Janca, A. & Sartorius, N. (2007). Recovery From Schizophrenia: An International Perspective. A Report From the WHO Collaborative Project, the International Study of Schizophrenia. Oxford University Press: Oxford.Google Scholar
Huber, G., Gross, G. & Schuttler, R. (1975). A long-term follow-up study of schizophrenia: Psychiatric course and prognosis. Acta Psychiatrica Scandinavica 52, 4957.CrossRefGoogle Scholar
Jacobson, N. (2001). Experiencing recovery: a dimensional analysis of consumers' recovery narratives. Psychiatric Rehabilitation Journal 24, 248256.CrossRefGoogle Scholar
Jenkins, J.H., Strauss, M.E., Carpenter, E.A., Miller, D., Floersch, J. & Sajatovic, M. (2007). Subjective experience of recovery from schizophrenia-related disorders and atypical antipsychotics. International Journal of Social Psychiatry 51, 211227.CrossRefGoogle Scholar
Knuf, A. (2004). Vom demoralisierenden Pessimismus zum vernünftigen Optimismus. Eine Annäherung an das Recovery-Konzept. Soziale Psychiatrie 1, 3841.Google Scholar
Kuhn, T. (1962). The Structure of Scientific Revolutions. Chicago University Press: Chicago.Google Scholar
Lapsley, H., Nikora, L.W. & Black, R. (2002). Kia Mauri Tau! Narratives of Recovery from Disabling Mental Health Problems. Mental Health Commission: Wellington.Google Scholar
Libermann, R.P. & Kopelowicz, A. (2002). Recovery from schizophrenia: a challenge for the 21st Century. International Review of Psychiatry 14, 242255.CrossRefGoogle Scholar
Libermann, R.P. & Kopelowicz, A. (2005). Recovery from schizophrenia: a concept in search of research. Psychiatric Services 56, 735742.CrossRefGoogle Scholar
Marneros, A., Deister, A., Rohde, A., Steinmeyer, E.M. & Junemann, H. (1989). Long-term outcome of schizoaffective and schizophrenic disorders, a comparative study, I: Definitions, methods, psychopathological and social outcome. European Archives of Psychiatry and Clinical Neuroscience 238, 118125.CrossRefGoogle ScholarPubMed
Marshall, S.L., Crowe, T., Oades, L., Deane, F., & Kavanagh, D. (2007). A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm. Psychiatric Services 58,396401.CrossRefGoogle ScholarPubMed
Masterson, S. & Owen, S. (2008). Mental health service user's social and individual empowerment: Using theories of power to elucidate far-reaching strategies. Journal of Mental Health 15, 1934.CrossRefGoogle Scholar
McIntosh, Z. (2005). From Goldfish Bowl to Ocean: Personal Accounts of Mental Illness and Beyond. Chipmunkapublishing: London.Google Scholar
McNaught, M., Caputi, P., Oades, L. & Deane, F. (2007). Testing the validity of the Recovery Assessment Scale using an Australian sample. Australian and New Zealand Journal of Psychiatry 41,450457.CrossRefGoogle ScholarPubMed
Mental Health Commission (1998). Blueprint for Mental Health Services in New Zealand. Mental Health Commission: Wellington.Google Scholar
Mental Health Commission (2005). A Vision for a Recovery Model in Irish Mental Health Services. Mental Health Commission: Dublin.Google Scholar
National Institute for Mental Health in England (2004). Emerging Best Practices in Mental Health recovery. NIMHE: London.Google Scholar
New Freedom Commission on Mental Health (2005). Achieving the Promise: Transforming Mental Health Care in America. U.S. Department of Health and Human Services: Rockville, MD.Google Scholar
Oades, L., Deane, F., Crowe, T., Lambert, W.G., Kavanagh, D. & Lloyd, C. (2005). Collaborative recovery: an integrative model for working with individuals who experience chronic and recurring mental illness. Australasian Psychiatry 13, 279284.Google ScholarPubMed
Office of the Deputy Prime Minister (2004). Mental Health and Social Exclusion. Social Exclusion Unit: London.Google Scholar
Ogawa, K., Miya, M., Watarai, A., Nakazawa, M., Yuasa, S. & Utena, H. (1987). A long-term follow-up study of schizophrenia in Japan, with special reference to the course of social adjustment. British Journal of Psychiatry 151, 758765.CrossRefGoogle ScholarPubMed
O'Hagan, M. (2004). Recovery in New Zealand: Lessons from Australia? Australian e-Journal for the Advancement of Mental Health 3, 13. Retrieved March 25, 2008, from www.auseinet.com/journal/voBissl/ohaganedi torial.pdf.Google Scholar
Oyebode, F. (2004). Invited Commentary on: The rediscovery of recovery. Advances in Psychiatric Treatment 10, 4849.CrossRefGoogle Scholar
Priebe, S. & Turner, T. (2003). Reinstitutionalisation in mental health care. British Medical Journal 326, 175176.CrossRefGoogle ScholarPubMed
Ralph, R.O. (2000). Recovery. Psychiatric Rehabilitation Skills 4, 480517.CrossRefGoogle Scholar
Raymont, V., Bingley, W., Buchanan, A., David, A.S., Hayward, P., Wessely, S. & Hotopf, M. (2004). Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet 364, 14211427.CrossRefGoogle ScholarPubMed
Rickwood, D. (2004). Recovery in Australia: Slowly but surely. Australian e-journal for the Advancement of Mental Health 3. Retrieved March 25, 2008, from www.auseinet.com/journal/voBissl/ohaganeditorial.pdf.CrossRefGoogle Scholar
Ridgway, P. (2001). Restorying psychiatric disability: Learning from first person narratives. Psychiatric Rehabilitation Journal 24, 335343.CrossRefGoogle Scholar
Rosen, A. (2007). Return from the vanishing point: a clinician's perspective on art and mental illness, and particularly schizophrenia. Epidemiologia e Psichiatria Sociale 16, 126132.CrossRefGoogle ScholarPubMed
Rosen, A., Hadzi-Pavlovic, D. & Parker, G. (1989). The life skills profile: a measure assessing function and disability in schizophrenia. Schizophrenia Bulletin 15, 325337.CrossRefGoogle Scholar
Ruggeri, M. & Tansella, M. (2007). Achieving a better knowledge on the causes and early course of psychoses: a profitable investment for the future? Epidemiologia e Psichiatria Sociale 16, 97101.CrossRefGoogle ScholarPubMed
Schrank, B. & Slade, M. (2007). Recovery in Psychiatry. Psychiatric Bulletin 31, 321325.CrossRefGoogle Scholar
Scottish Recovery Network (2006). Journeys of Recover Stories of Hope and Recovery from Long Term Mental Health Problems. Scottish Recovery Network: Glasgow.Google Scholar
Seeker, J., Membrey, H., Grove, B., & Seebohm, P. (2002). Recovering from illness or recovering your life? Implications of clinical versus social models of recovery from mental health problems for employment support services. Disability & Society 17, 403418.CrossRefGoogle Scholar
Sibitz, I., Swoboda, H., Schrank, B., Priebe, S. & Amering, M. (2007). Mental Health Service User Involvement in Therapeutic and Service Delivery Decisions: Professional Service Staff Appear Optimistic. Psychiatrische Praxis, Nov [epub ahead of print].Google Scholar
Slade, M. & Hayward, M. (2007). Recovery, psychosis and psychiatry: research is better than rhetoric. Ada Psychiatrica Scandinavica 116, 8183.CrossRefGoogle ScholarPubMed
Spaniol, L., Wewiorski, N., Gagne, C. & Anthony, W. (2002). The process of recovery from schizophrenia. International Review of Psychiatry 14, 327336.CrossRefGoogle Scholar
Stastny, P. & Lehmann, P. (Eds.) (2007). Alternatives Beyond Psychiatry. Peter Lehmann Publishing: Shrewsbury.Google Scholar
Steinert, T. (2007). Perspektivenwechsel. Psychiatrische Praxis 43, 362.Google Scholar
Substance Abuse and Mental Health Services Administration (2005). National Consensus Conference on Mental Health Recovery and Systems Transformation. Department of Health and Human Services: Rockville, MD.Google Scholar
Thornicroft, G. (2005). Shunned: Discrimination against People with Mental Illness. Oxford University Press: Oxford.Google Scholar
Tondora, J. & Davidson, L. (2006). Practice Guidelines for Recovery-Oriented Behavioral Health Care. Connecticut Department of Mental Health and Addiction Services: Connecticut.Google Scholar
Tsuang, M.T., Woolson, R.F. & Fleming, J. (1979). Long-term outcome of major psychosis. Archives of General Psychiatry 36, 12951301.CrossRefGoogle Scholar
Warner, R. (2007). Review of “Recovery From Schizophrenia: An International Perspective. A Report From the WHO Collaborative Project, the International Study of Schizophrenia”. American Journal of Psychiatry 164, 14441445.CrossRefGoogle Scholar
Wing, J.K., Beevor, A.S., Curtis, R.H., Park, S.B., Hadden, S. & Burns, A. (1998). Health of the Nation Outcome Scales (HoNOS). Research and Development. British Journal of Psychiatry 111., 1118.CrossRefGoogle Scholar
World Health Organization (2005). Mental Health Declaration for Europe: Facing the Challenges, Building Solutions. Retrieved March 25, 2008, from http://www.euro.who.int/document/mnh/ edoc06.pdf.Google Scholar
Wynaden, D & Orb, A (2005). Impact of patient confidentiality on carers of people who have a mental disorder. International Journal of Mental Health Nursing 14, 166171.CrossRefGoogle ScholarPubMed
206
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Recovery: an international perspective
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Recovery: an international perspective
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Recovery: an international perspective
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *