Ioana Arbone and Alireza Jamshidi
Mental health recovery. Is it even possible? If it is possible, what does it mean? According to McCranie (2011), mental health recovery is both a concept and a movement. It represents a philosophical shift in the mental health system, and a move away from the biomedical model (Piat et al., 2009). It is frequently referenced in policy documents across the world, especially in English-speaking countries (Pincus et al., 2006).
There is no agreed-upon definition of recovery. Despite this, recovery has become a very popular concept (Pincus et al., 2006). This article will examine why exactly recovery is so popular and will propose four answers to this question: recovery is the type of concept that everyone wants to believe in; recovery unites people against a common “enemy” or against the current system; recovery uses visionary language; recovery has charismatic leaders.
Though there is no agreed upon definition of recovery, authors agree on several key ingredients: social Connectedness, Hope and optimism, establishment of Identity, Meaning and purpose as well as Empowerment (CHIME) (Leamy et al., 2011). That is, to be recovered, one needs to be socially connected, have something to look forward to, know who they are, and feel that they can achieve their goals.
Alternatively, Braslow (2013) offers three different definitions subsumed under the term recovery: the first definition refers to recovery as a mental health outcome; the second definition refers to recovery as an experience which cannot be articulated in words; the third definition refers to recovery as a social movement.
Recovery is popular because it is a positive concept. It is an utopia towards which service providers and service users of mental health services aspire. It represents the possibility of returning to normal. It is the type of concept that people want to believe in.
Recovery also unites people against a common “enemy”: the current mental health system. It defines a set of beliefs for the in-group and a set of beliefs of the outgroup. The in-group beliefs are that recovery is possible and that mental illness does not make someone particularly different from others.
Visionary language is oftentimes used in the recovery movement. It is therefore unclear whether people are mesmerized by the appearance and the beautiful language that covers recovery, or whether they are for the concept of recovery itself. It is not clear whether people are simply enthralled by beautiful speech.
Such visionary language is found throughout major policy documents. The Canadian mental health policy “Toward Recovery and Well-Being” (2009) has recovery as its first goal, and states (p.26): “A transformed mental health system fosters hope for a better quality of life and respects the dignity and rights of each person at every stage of life. Building on individual, family, cultural, and community”
Another example of such visionary language is found in the 2012 policy document authored by the Mental Health Commission of Canada (p.27): “Drawing on the recovery principles of hope, informed choice, dignity and responsibility will contribute as much to the well-being of children and seniors as to that of adults who are living with mental health problems and illnesses.”
Conceptually, this enthrallment relates to Weber’s notion of enchantment, which Weber sees as absent from the cold and mechanical view of science (Jenkins, 2000). Enchantment is a feeling of awe and appreciation for the miracle of life. The coldness of the scientific method may take away from the experience itself.
Furthermore, taking the word “recovery” from its original medical context and using it to mean a social-kind of recovery, may imbue recovery (and places designed as recovery-oriented) with a new framework for understanding mental health. In this way, services are not designed with a biomedical model in mind. Recovery services are created within a biopsychosocial model.
Another important piece of what makes recovery successful is its leaders (Cleary et al., 2016). There are several key figures that promote recovery internationally, such as Dr. Mike Slade, Dr. Larry Davidson, Dr. Skye Barbic, Dr. Myra Piat, and Dr. Sean Kidd. Committed leaders are important in making recovery popular.
On the other hand, recovery may be popular because it is a useful concept, despite its murkiness. It may be that recovery tapped into an important area. Maybe those with mental illness do not feel that they can recover in the current mental health system. More research needs to be done on why exactly recovery speaks to individuals.
Personally, we are attracted to recovery because this concept assumes everyone to be recovered or in the process of recovery. There is no “us” versus “them.” Everyone is on a journey to improve their mental health. This means that a diagnosis does not mean the person is different – or, in Goffman’s (1963) terms, a mark of disgrace.
At the same time, we recognize that recovery needs to be implemented judiciously and that no one can be considered fully recovered. A fully recovered person is a fully functional person in the society, a person who can find and maintain a job, keep the pace of changes in the job market, and find friends. Absence from the normal social life for a long time, keeps people with wellness problems behind the normal social life for a relatively long time. This makes it very difficult for the person to resume a normal life in the society after overcoming a disease.
Indeed, people with major wellness problems are deprived from a normal life style and social interactions for a long time. Social trends, pop culture, technology, social media, job market, academic centers, and as a result, family members and friends change fast, much faster than the person with the wellness problem.
It could be even worse for those who started battling with severe wellness challenges from very early stages of their lives, before they had had any meaningful and productive social roles. Long battles; make many people resentful and defiant in different situations. They find themselves different from other people and are concerned about other people’s judgments. They tend to underestimate their skills and capabilities and over-estimate difficulties of running a normal life.
In this short paper, we argued that recovery is popular because it represents a positive concept, it unites people under the same banner, and it uses visionary language. Recovery is enticing to us because it speaks to the principles of equality. However, in the same way that we can say that everyone is on the road to recovery, we can say that no one can be fully recovered. Recovery is a continuous journey.
As a last thought, recovery may be persuasive precisely because it is so undefined. Everyone that reads about recovery sees in it what they want to see.
References:
Braslow, J.T. (2013). The Manufacture of Recovery. Annual Review of Clinical Psychology, 9: 781-809.
Cleary, M., Lees, D., Escott, P., & Molloy, L. (2016). Leadership and Mental Health Recovery: Rhetoric or Reality. International Journal of Mental Health Nursing, 25, 267–269.
Goffman, E. (1963). Stigma. London: Penguin Books.
Jenkins, R. (2000). Disenchantment, Enchantment and Re-Enchantment: Max Weber at the Millennium. Max Weber Studies, pp.11-32.
Leamy, M., Bird, V.J., Le Boutillier, C., Williams, J. & Slade, M. (2011) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. British Journal of Psychiatry, 199:445-452.
McCranie, A. (2011). Chapter 23: Recovery in Mental Illness: The Rooots, Meanings, and Implementations of a “New” Services Movement. The SAGE Handbook of Mental Health and Illness, London: SAGE Publications, 471-489.
Mental Health Commission of Canada (2009). Toward Recovery and Well-Being: A Framework for a Mental Health Strategy for Canada.
Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada.
Piat, M., Sabetti, J., Couture, A., Sylvestre, J., Provencher, H., Botschner, J., & Stayner, D. (2009). What Does Recovery Mean for Me? Perspectives of Canadian Mental Health Consumers. Journal of Psychiatric Rehabilitation, 32(3): 199-207.
Pincus, H.A., Spaeth-Rublee, B., Sara, G., Goldner, E.M., Prince, P.M., & Ramanui, P. (2016). A Review of Mental Health Recovery Programs in Selected Industrialized Countries. International Journal of Mental Health Systems, 10(1), [73]. DOI: 10.1186/s13033-016-0104-4
Ioana Arbone, doctoral student at the University of Toronto interested in mental health recovery and ethnic minority mental health. Alireza Jamshidi, research assistant at the University of Toronto since 2017 interested in philosophical aspects of cognitive psychology in mental health