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Position Statement 11: In Support of Recovery-Based Systems Transformation
The Mental Health America (MHA) envisions a just, humane and healthy society in which all people are accorded respect, dignity and the opportunity to achieve their full potential free from stigma and prejudice. Consistent with this philosophy, Mental Health America supports and promotes services and systems that facilitate the recovery of people with mental health and substance use conditions. MHA believes mental health and substance abuse systems transformation will occur only when all stakeholders view recovery as the primary goal. We define recovery broadly as a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.1
MHA is committed to the notion that every individual with a mental health or substance use condition can recover. Individuals must define for themselves what recovery means to them. For some it may mean achieving personal goals to live a fulfilling and productive life and for others it may mean effectively managing the effects of their condition. For an individual to engage in the recovery process, it is important that she or he possess hope that recovery is possible, have choices regarding community-based services and supports, have access to resources that allow for basic needs to be met such as food, clothing and housing, and have a strong community network. Such a network can include but is not limited to friends, family and faith-based organizations.
Mental Health America was established in 1909 by former psychiatric patient, Clifford W. Beers. During his stays in public and private institutions, Beers witnessed and was subjected to horrible abuse. From these experiences, Beers set into motion a reform movement that took shape as the Mental Health America. The efforts of Beers and other early pioneers of this movement set a course for reform, to the point where today, and increasingly, if treatment and support are provided (and support is of paramount importance), recovery from mental health and substance use conditions is the expected outcome.
In July 2003, the President's New Freedom Commission on Mental Health issued its report, "Achieving the Promise: Transforming Mental Health Care in America". An overarching recommendation in the report was that services and treatments for persons with psychiatric disabilities must be recovery-oriented and consumer-driven.
On December 16-17, 2004, the Center for Mental Health Services (CMHS) convened a National Consensus Conference on Mental Health Recovery and Systems Transformation. Over 110 consumers, family members, providers, researchers, advocates, State and local mental health authorities, Federal partners and others met to develop a consensus statement on mental health recovery.
The resulting National Consensus Statement identified the key elements of recovery as follows:
The 10 Fundamental Components of Recovery
Self-Direction: Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.
Individualized and Person-Centered: There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health.
Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.
Holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services, addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.
Non-Linear: Recovery is not a step-bystep process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery.
Strengths-Based: Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). Th e process of recovery moves forward through interaction with others in supportive, trust-based relationships.
Peer Support: Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community.
Respect: Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives.
Responsibility: Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.
Hope: Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process. Mental health recovery not only benefi ts individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life. America reaps the benefi ts of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation.2
Mental Health America agrees that each of the tenets articulated by the National Consensus Statement should be incorporated into mental health systems transformation, at both the individual and systems levels. The National Consensus Statement sets ambitious goals for the recovery movement, which MHA enthusiastically supports.
Call to Action
Mental Health America supports consumers to
- Understand their illness and believe that recovery is possible;
- Explore treatment options and supports that match their desires, goals and strengths; and
- Participate in peer support programs and explore leadership roles that can help others recover.
Mental Health America calls on public mental health systems and policy-makers to:
- Incorporate the principles of recovery-based care into the mission and day-to-day activities of local, state and federal mental health departments and agencies;
- Invest in evidence-based and emerging practices that are community-based and consumer/family-driven; and
- Ensure that consumers have meaningful involvement in the planning, delivery and evaluation of mental health service systems.
Mental Health America encourages mental health advocates to:
- Educate decision makers that recovery is possible and is the expected outcome of proper treatment and supports;
- Correct misinformation reported in the media with positive, factual, and prompt responses expressed with the dignity we demand for those who suffer from a mental illness;
- Promote policies which are consistent with the recovery philosophy; and
- Identify opportunities for consumers to have meaningful involvement in advocacy efforts in addition to the planning, delivery and evaluation of mental health services.
Mental Health America encourages mental health practitioners to
- Utilize a strengths-based, individualized, recovery-oriented approach for all clients;
- Encourage and guide clients to an active role in leading their own recovery; and
- See individuals as whole human beings, not just as their illness.
Mental Health America urges the media to:
- Learn the facts about mental illness;
- Report upon and portray mental illnesses with appropriate sensitivity; and
- Recognize that stigmatizing language and attitudes prevent effective treatment of mental illnesses.
The Mental Health America Board of Directors adopted this policy on September 18, 2010. It is reviewed as required by the Mental Health America Public Policy Committee.
Expiration: December 31, 2015