What is recovery and wellbeing?
(If you want to see videos / podcasts on this then click here)
In mental health, the word 'recovery' has two meanings.
The first involves clinical recovery – when someone 'recovers' from the illness and no longer experiences its symptoms.
The second involves personal recovery – recovering a life worth living (without necessarily having a clinical recovery). It is about building a life that is satisfying, fulfilling and enjoyable. This meaning of recovery is what we use on this web-site.
This understanding of recovery comes from people who have experienced it, and is based on the idea that each person should be able to feel in control of, and take decisions about, their own lives, rather than simply doing what a health professional tells them.
The most widely cited definition of personal recovery in mental illness was written by Bill Anthony, now a professor emeritus at the Boston Center for Psychiatric Rehabilitation in the USA. In 1993, he wrote that recovery is described by consumer/survivors/clients as:
'a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness. Recovery from mental illness involves much more than recovery from the illness itself.'
(Recovery from mental illness: the guiding vision of the mental health system in the 1990s, Psychosocial Rehabilitation Journal, 16(4), April 1993, 11-23.)
Researchers around the world are focusing on finding ways of supporting people's personal recovery and encouraging mental health professionals to work in a recovery-orientated way.
This means acknowledging the expert knowledge every person has about their own illness and symptoms, and working together to take joint decisions about what treatment is appropriate.
It also means helping each person to live well and to achieve their individual recovery goals – getting a job, or making new friends, or learning a new skill, for example.
Many governments now support recovery as a principle they want to put into practice within mental health services. Research teams are investigating the best way of doing that – for example, the employment of peer professionals and the setting up of new sorts of services such as Recovery Colleges. In a Recovery College, people with mental health problems are given the opportunity to access training and education programmes designed to help them on their road to recovery and give them the skills and confidence they need to get on with their lives.
In England, the government published the mental health strategy No health without mental health in February 2011.
One of the strategy's six main objectives is that 'more people with mental health problems will recover' by having 'a good quality of life – greater ability to manage their own lives, stronger social relationships, a greater sense of purpose, the skills they need for living and working, improved chances in education, better employment rates and a suitable and stable place to live.'
Another two objectives also support recovery – that care and support offered by mental health services should give people 'the greatest choice and control over their lives, in the least restrictive environment' and that 'fewer people will experience stigma and discrimination'.
An overview of the evidence base for recovery is given in:
Slade M, Amering M, Farkas M, Hamilton B, O'Hagan M, Panther G, Perkins R, Shepherd G, Tse S, Whitley R (2014) Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems, World Psychiatry, 13, 12-20.
No health without mental health also talks about promoting and fostering wellbeing. The definition given in the strategy is: 'A positive state of mind and body, feeling safe and able to cope, with a sense of connection with people, communities and the wider environment.' The government went on to commission the Office for National Statistics to work out how to 'measure' wellbeing on a regular basis. (Measuring National Well-being Programme)
Research about psychological wellbeing – a state of contentment and fulfillment – has demonstrated positive effects. Wellbeing leads to better health, for example.
A previous government report published in 2008 advocated the importance of wellbeing. The Foresight Project on Mental Capital and Wellbeing report summarised the available scientific evidence and proposed ways of achieving and wellbeing. This included five evidence-based actions to improve personal wellbeing: connect with people; be active; take notice of your surroundings and savour your activities; keep learning; give – volunteer or do something for other people.
Having a sense of wellbeing is an integral part of recovery and researchers are investigating ways of promoting wellbeing to people who have experience of mental health problems, particularly with regard to the use of positive psychology. This discipline focuses on people's strengths and positive thoughts, rather than trying to ameliorate symptoms of a mental health or physical health problem.