Recently people are talking about recovery from mental illness. This is a great step forward. Even using the word recovery in a field too long dominated by the goal of stabilization is refreshing. But whose vision of recovery are people talking about? I thought we were all talking about the same view of recovery.
People can fully recover from mental illness; it is not a life-long process
I see two distinctly different visions of recovery emerging, however. We will call these the Rehabilitation and Empowerment views of recovery. It is especially important to clarify what recovery means in each model because many states and counties nationally are proposing to create recovery-centered policies and services. Distinctly different policies would result depending on whose picture of recovery those policies are based on. Rehabilitation View: Recovery of Function despite Still Having the Permanent Impairment of Mental Illness
According to this view, mental illness is seen as a primary, permanent impairment similar to a spinal cord injury resulting in paralysis. This impairment causes a disability depending on the degree to which it interferes with a person’s capacity to function in a major social role such as worker, parent, or student. The rehabilitation view of recovery from spinal cord injury is that, with supports, a person can once again function in society. Their impairment however remains permanent.
As William Anthony, from the Boston University Center for Psychiatric Rehabilitation states, “a person with paraplegia can recover even though the spinal cord has not. Similarly, a person with mental illness can recover even though the illness is not ‘cured.'” (Recovery from Mental Illness Psychosocial Rehabilitation Journal, 16:12-23, 1993)
The rehabilitation view of recovery from mental illness is that people can regain some social functioning, despite having symptoms, limitations, medication, and remaining mentally ill. Though this rehabilitation view works in describing recovery from the effects of physical impairments, it does not help explain how people can recover from mental illness. Whereas in paralysis a person’s spinal cord is injured, separating their functioning head from the rest of their poorly functioning body, in mental illness the whole person is separated from the people around them. They are considered less than human. They experience a loss of civil rights.
Once a person is labeled mentally ill, they are discredited and disqualified from full membership in society solely as a result of that label. Therefore, to say that the person’s mental illness is a permanent condition is to forever ostracize the person from society and say that they will never be able to regain a major social role. No wonder there is such a high rate of unemployment (85-90%) among those labeled with mental illness. The label defines the person as being incapable of work. No wonder so many people labeled with mental illness lose their children; the label itself defines the person as being an incompetent parent.