Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems
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An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship.
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There has been criticism about personal recovery being defined in individualistic terms that neglect collectivist values more present in some cultural groups.
“There has, however, been criticism about personal recovery being defined in individualistic terms (16) that neglect collectivist values that are more present in some cultural groups (17–20).”
From Recovery from Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives (2021) · cites this paper as [17]
Collaboration with peer support workers could enhance the ongoing support available to sustain changes beyond the groups themselves so as to support experiences of inclusion and citizenship, presently the least well-developed among recovery oriented practices.
“Furthermore, collaboration with peer support workers could enhance the ongoing support available to sustain changes beyond the groups themselves so as to support experiences of inclusion and citizenship, presently the least well-developed among recovery oriented practices (4).”
From Implementing an action over inertia group program in community residential rehabilitation services: group participant and facilitator perspectives (2021) · cites this paper as [4]
Imagining change as possible aligns with both instilling hope and the recovery process.
“Imagining change as possible aligns with both instilling hope and the recovery process (4, 9, 42).”
From Implementing an action over inertia group program in community residential rehabilitation services: group participant and facilitator perspectives (2021) · cites this paper as [4]
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Leamy, M. C., Clarke, E., Boutillier, C. L., Bird, V. J., Choudhury, R., Macpherson, R., Pesola, F., Sabas, K., Williams, J., Williams, P. R., et al. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.160739 · Cited by 51 · see citing works
Recovery from severe mental illness
Whitley, R., Palmer, V. J., & Gunn, J. M. (2015) · Canadian Medical Association Journal · doi:10.1503/cmaj.141558 · Cited by 51 · see citing works
Roosenschoon, B., Kamperman, A., Deen, M., van Weeghel, J., & Mulder, C. (2019) · PLoS ONE · doi:10.1371/journal.pone.0222378 · Cited by 48 · see citing works
An Introduction to Community and Primary Health Care
(2020) · Cambridge University Press eBooks · doi:10.1017/9781108868396 · Cited by 50 · see citing works
Development of the REFOCUS intervention to increase mental health team support for personal recovery
Slade, M., Bird, V., Boutillier, C. L., Farkas, M., Grey, B., Larsen, J., Leamy, M., Oades, L., & Williams, J. (2015) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.155978 · Cited by 47 · see citing works
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Recovery orientation in mental health inpatient settings: Inpatient experiences?
Waldemar, A. K., Esbensen, B. A., Korsbek, L., Petersen, L., & Arnfred, S. (2018) · International Journal of Mental Health Nursing · doi:10.1111/inm.12434 · Cited by 49 · see citing works
Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives
Fletcher, J. R., Hamilton, B. E., Kinner, S. A., & Brophy, L. M. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00462 · Cited by 50 · see citing works
Contested understandings of recovery in mental health
McCabe, R., Whittington, R., Cramond, L., & Perkins, E. (2018) · Journal of Mental Health · doi:10.1080/09638237.2018.1466037 · Cited by 48 · see citing works
Carers and co-production: enabling expertise through experience?
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Advance directives in mental health care: evidence, challenges and promise
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“Very much evolving”: a qualitative study of the views of psychiatrists about peer support workers
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- Authors
- Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., & Whitley, R.
- Affiliations
- King's College London (GB)
- University of Vienna (AT)
- Boston University (US)
- The University of Melbourne (AU)
- Education House; Wellington New Zealand
- Redpanther Research; Auckland New Zealand
- Centre for Mental Health (GB)
- University of Hong Kong (HK)
- Douglas Mental Health University Institute (CA)
- ORCID
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2014-02
- Volume
- 13
- Issue
- 1
- Pages
- 12-20
- ISSN
- 1723-8617 (ISSN-L)
- PMC
- PMC3918008
- OpenAlex
- W2117775582
- Cited by
- 949
- References
- 126
- Citations by year
- 2026: 71 · 2025: 83 · 2024: 67 · 2023: 81 · 2022: 78 · 2021: 114 · 2020: 121 · 2019: 76 · 2018: 79 · 2017: 71 · 2016: 43 · 2015: 41 · 2014: 23
- FWCI
- 107.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research (RP-PG-0707-10040, 10040)
- King's College London
- Programme Grants for Applied Research (RP-PG-0707-10040)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- recovery-oriented care, mental health system, CHIME framework, peer support, advance directives, Illness Management and Recovery, strengths model, recovery colleges, Individual Placement and Support, supported housing, organizational change, citizenship, compulsory detention, mental health policy
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