Recently I overheard two senior mental health officials discussing recovery. One said, “I think recovery is a very important concept.” The other replied, “I agree,” and then he whispered, “But what is it?”
Indeed, we have a field and a society that have been highlighting the importance of recovery—and that have had little agreement about its meaning.
The New Freedom Commission stated: “We see a future when everyone with a mental illness will recover.” This vision has inspired many to advocate for recovery at the state and national levels. In 2006, SAMHSA published the 10 Components of Recovery. The Recovery to Practice initiative represents the next step in implementing recovery.
In this new era of healthcare reform, however, we need a broader concept of recovery. We need a concept that gives hope to those of us labeled with a psychiatric diagnosis—and that at the same time can be understood by the rest of society.
Most persons with a variety of other disabilities cannot relate to the concept of recovery. Many think our concept of recovery means that people in wheelchairs will walk or that people with autism will be able to relate socially the way most everyone else does. These are not the primary goals of the independent living movement.
To frame recovery more broadly, we need to go beyond a narrow medical definition of mental health issues. For many years, professionals and researchers have described mental illness as a severe form of mental disorder, characterized by a permanent biological defect and a chemical imbalance from which recovery rarely occurs. In the eyes of this group, recovery would occur only if there were a cure. Countless studies have been carried out to define the supposed biological basis of mental illness. No consistent deficit has been found. It was believed that at best the illness could go into remission, during which the symptoms are managed. This is the maintenance model, which leaves persons who experience distress feeling hopeless.
Recently, through a dialog by the Steering Committee of the Recovery to Practice initiative, we have drafted a broader description of recovery:
[T]he recovery paradigm views mental health issues as challenges that a person can grow beyond through the assistance of culturally appropriate, trauma-informed services and natural supports in the process of the person building a full and gratifying life in the community of his or her choice.
This description fits with the goals mapped out for persons with all disabilities in the Americans with Disabilities Act signed into law 20 years ago:
- Equality of opportunity
- Full participation [in the community]
- Independent living [consumer control and consumer choice of services and supports]
- Economic self-sufficiency
This broader definition of recovery can also span the fields of mental health and substance use. In the substance use field, these elements are vital aspects of recovery.
- Daniel Fisher, M.D., Ph.D.,
Executive Director,
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