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NASMHPD/NTAC e-Report on Recovery – Fall 2004

Implementing Recovery-based Care: Tangible Guidance for SMHAs

According to renowned researcher Courtenay Harding, Ph.D., recovery from mental illness has been researched and proven for decades, and she will cite ten studies from all over the globe as evidence (Harding, 2004). The irony is, as Harding will point out, you won’t find a section on recovery in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders. In fact, you won’t even find the word in the manual’s index. Only a small minority of graduate mental health programs features a recovery focus, and on the administrative side, the topic of recovery is often overlooked, misunderstood, or moved to the back burner in the face of competing priorities.

Without any infrastructure for recovery-based mental health care, it’s no wonder that so many administrators and clinicians haven’t bought in to what is essentially a basic human right to feel better. In fact, just mentioning the word recovery seems to cause a stir depending on your training, beliefs, and role in the mental health rehabilitation system.

For the purposes of this issue, we will attempt to define ‘recovery’ so that the following articles have some context for all readers. We’ll begin by quoting Ruth Ralph, Ph.D., “Recovery can be defined as a process of learning to approach each day’s challenges, overcome our disabilities, learn skills, live independently and contribute to society. This process is supported by those who believe in us and give us hope” (2000).

Augmenting this definition, we cite a description from the President’s New Freedom Commission on Mental Health’s Achieving the Promise report, “The process in which people are able to live, work, learn, and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms” (2003).

Our addition to these descriptions would be that recovery is also supported by the power of consumer choice. (All of these thoughts and ideas are represented in a conceptualization [available on the Web at www.nasmhpd.org], produced by staff of the New York State Office of Mental Health, that attempts to illustrate the ups and downs of a recovery journey in a positive and illuminating light.)

Thanks to the tireless work of recovery advocates and a boost from the rehabilitation language in Achieving the Promise, the concept of recovery from serious mental illness remains in the spotlight. However, this ongoing emphasis on an issue that some may feel is too intangible for action also presents practical challenges to state mental health authorities. What exactly is recovery-based care? How do you transform your system to reflect this concept? How do you measure your success?  

We hope this NASMHPD/NTAC e-Report, with its preview of measurement tools now in development; its case studies of successful systems and ideas at federal, state and local

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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