Psychiatric Bulletin, 31(9), September 2007, pp.321-325.
Publisher:
Royal College of Psychiatrists
In recent years, the concept of recovery from severe mental illness has increasingly gained relevance in the mental health field. Countries all over the world have been introducing recovery policy into mental health services However, there is still debate about the concept, such as whether symptom reduction is central or not. This article proposes a conceptual framework for recovery and identifies emergent practical issues. The term, two meanings, two classes of definitions which emerged from two different influences, can be identified for the term recovery in mental health. In psychiatry the idea of recovery is based on longitudinal studies demonstrating a widely heterogeneous course for severe mental illnesses. In this context, remission is defined as an improvement in symptoms and other deficits to a degree that they would be considered within a normal range. Recovery can be seen as a long-term goal of remission This is named service-based definition of recovery. A second definition of the term recovery came from the self-help and consumer/user/survivor movement. Here, recovery may include, but does not require, symptom remission or a return to normal functioning. However, recovery is seen as a process of personal growth and development, and involves overcoming the effects of being a mental health patient, with all its implications, to regain control and establish a personally fulfilling, meaningful life This is named the user-based definition of recovery. This is exemplified by the National Institute for Mental Health in England definition of recovery as the ‘achievement of a personally acceptable quality of life’.
In recent years, the concept of recovery from severe mental illness has increasingly gained relevance in the mental health field. Countries all over the world have been introducing recovery policy into mental health services However, there is still debate about the concept, such as whether symptom reduction is central or not. This article proposes a conceptual framework for recovery and identifies emergent practical issues. The term, two meanings, two classes of definitions which emerged from two different influences, can be identified for the term recovery in mental health. In psychiatry the idea of recovery is based on longitudinal studies demonstrating a widely heterogeneous course for severe mental illnesses. In this context, remission is defined as an improvement in symptoms and other deficits to a degree that they would be considered within a normal range. Recovery can be seen as a long-term goal of remission This is named service-based definition of recovery. A second definition of the term recovery came from the self-help and consumer/user/survivor movement. Here, recovery may include, but does not require, symptom remission or a return to normal functioning. However, recovery is seen as a process of personal growth and development, and involves overcoming the effects of being a mental health patient, with all its implications, to regain control and establish a personally fulfilling, meaningful life This is named the user-based definition of recovery. This is exemplified by the National Institute for Mental Health in England definition of recovery as the ‘achievement of a personally acceptable quality of life’.
Subject terms:
mental health problems, outcomes, psychiatry, rehabilitation, service users, treatment, therapy and treatment;
This brief summary guide provides ideas for working with service users, both those with mental health problems and those with addiction or dependency, in a recovery orientated fashion. The guide is based on two beliefs; first, that recovery is something worked towards and experienced by the person with the problem, it is not something a service can do to the person; and secondly every journey of recovery is individual. The role of the staff is to provide support. The guide looks at recovery tasks, the personal recovery framework and the central importance of relationships and peer involvement. Traditional and recovery-orientated services are compared. A link is provided to the full 32 page guide published by Rethink which identifies 100 action points for staff in supporting recovery.
This brief summary guide provides ideas for working with service users, both those with mental health problems and those with addiction or dependency, in a recovery orientated fashion. The guide is based on two beliefs; first, that recovery is something worked towards and experienced by the person with the problem, it is not something a service can do to the person; and secondly every journey of recovery is individual. The role of the staff is to provide support. The guide looks at recovery tasks, the personal recovery framework and the central importance of relationships and peer involvement. Traditional and recovery-orientated services are compared. A link is provided to the full 32 page guide published by Rethink which identifies 100 action points for staff in supporting recovery.
Subject terms:
intervention, mental health problems, person-centred care, self-concept, self-help groups, substance misuse, therapies, therapy and treatment;
British Journal of Psychiatry, 186(2), February 2005, pp.146-152.
Publisher:
Cambridge University Press
The aim was to investigate the relationship between the items in four staff-rated measures recommended for routine use. Correlation analysis of total scores and factor analysis using combined data from the Health of the Nation Outcome Scales (HoNOS). The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Threshold Assessment Grid (TAG) and the Global Assessment of Functioning (GAF) were performed. Procrustes analysis on factors and scales, and Ward's cluster analysis to group the items, were applied. The total scores of the measures were moderately correlated. The Procrustes analysis, factor analysis and cluster analysis all agreed on better coverage of the patients' problems by HoNOS and CANSAS. A global severity factor accounts for 16% of the variance, and is best measured with TAG or GAF. The CANSAS and HoNOS each provide a detailed characterisation of the patient; only CANSAS provides information about met needs.
The aim was to investigate the relationship between the items in four staff-rated measures recommended for routine use. Correlation analysis of total scores and factor analysis using combined data from the Health of the Nation Outcome Scales (HoNOS). The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Threshold Assessment Grid (TAG) and the Global Assessment of Functioning (GAF) were performed. Procrustes analysis on factors and scales, and Ward's cluster analysis to group the items, were applied. The total scores of the measures were moderately correlated. The Procrustes analysis, factor analysis and cluster analysis all agreed on better coverage of the patients' problems by HoNOS and CANSAS. A global severity factor accounts for 16% of the variance, and is best measured with TAG or GAF. The CANSAS and HoNOS each provide a detailed characterisation of the patient; only CANSAS provides information about met needs.
Subject terms:
mental health problems, needs, outcomes, psychiatry, treatment, therapy and treatment, assessment, diagnostic tests;
This book evaluates a range of research methodologies and examines what types of 'evidence' have been appealed to. It comprises an historical and conceptual analysis of what was regarded as evidence and how this has impacted on mental health care. Presenting different methodological approaches it discusses their strengths and weaknesses in providing evidence, an how evidence is applied in different treatment and care modalities. Different angles on the the way forward for providing evidence to improve current treatments are scrutinised.
This book evaluates a range of research methodologies and examines what types of 'evidence' have been appealed to. It comprises an historical and conceptual analysis of what was regarded as evidence and how this has impacted on mental health care. Presenting different methodological approaches it discusses their strengths and weaknesses in providing evidence, an how evidence is applied in different treatment and care modalities. Different angles on the the way forward for providing evidence to improve current treatments are scrutinised.
Subject terms:
medication, mental health, mental health problems, mental health services, participatory research, psychiatry, research methods, severe mental health problems, treatment, therapies, therapy and treatment, user participation, evidence, evidence-based practice;