Recovery in services
The recovery approach is based on the belief and understanding that everyone has the potential for mental health recovery.
This commitment is based on learning directly from people who are in recovery, or who have recovered from mental health problems, and then applying that learning to the way we support people in services.
Recovery has become a driving force in mental health policy and practice internationally. In Scotland, this shift has been underway for more than a decade and helped focus attention on the question of how services most effectively help people experiencing mental health problems to recover.
Adopting a recovery approach demonstrates a commitment to person centredness. It is a rights and strengths-based approach which seeks to improve personal outcomes and foster empowerment.
Certain ways of working are encouraged and supported in line with recovery principles and values. These may be at the level of systems and services or at the individual practitioner level.
The starting point for any recovery focused service is a belief in and commitment to the reality of recovery. Adopting a recovery approach in mental health services suggests that supporting recovery must be a joint endeavour where the person being supported has an active part to play in managing their wellbeing and directing the support they receive. In support of this opportunities for self-management are made available and supported decision making is prioritised.
Services that aspire to a recovery approach make choices available to people in support of their individual goals. These choices include access to peer support where people are able to share experiences and learn together, founded on a sense of equality and empowerment.
Recovery oriented services offer consistency and continuity in the support they provide, recognising changing needs and wishes at different points on the recovery journey.
Such services are flexible and adaptable as opposed to all or nothing – services which are experienced as being ‘on tap, not on top’.
Another important characteristic of a recovery focused service is a willingness to reflect on and review their approach against recovery principles. We support services in this process with the Scottish Recovery Indicator (SRI 2) service development tool and its ten indicators of a recovery oriented service:
- Basic needs are identified and addressed
- Goals are identified and addressed
- Personalised services are provided
- Service is strengths based
- Service promotes social inclusion
- Service promotes and acts on service user involvement
- Informal carers are involved
- Service encourages advance planning and self management
- Staff are supported and valued
- Practice is recovery focused
SRI 2 reflects the values and best practice described in Rights, Relationships and Recovery and the 10 Essential Shared Capabilities for Mental Health Practice. It also complements a range of other policy programmes and initiatives. SRI 2 can help services produce evidence that they are responding positively to these policy drivers.
At SRN we recognise that realising recovery approaches in mental health services can be complex and challenging. We adopt a supportive and facilitative approach to our work with services in recognition of this complexity.
The quality of relationships between people providing and receiving mental health services can have a significant impact on recovery. For example, the way in which messages are conveyed, can have a powerful impact on whether someone receiving a service feels a sense of hope or empowerment.
Encouragingly there is an increasingly broad range of approaches available to support practitioners and enhance recovery focused relationships. This will include developing skills such as:
- Active listening
- Guiding and supporting – doing with not to
- Supporting self-management and autonomy
- Asking powerful and enabling questions
- Eliciting and mobilising the persons’ resources and skills
- Building collaborative relationships
- Eliciting and valuing dreams and aspirations leading to personal outcomes
- Enabling and understanding change processes
- Using language to reframe, for example, problems as challenges or stubbornness as tenacity
- Implementing solution focused approaches
Behaviours and attitudes are also of paramount importance. Warmth, compassion, kindness empathy and patience are fundamental to recovery practice. These qualities and behaviours in themselves can alleviate distress and promote hope.
Of course all of this demands considerable self-awareness, ongoing personal development, organisational support and a commitment to maintaining a good work-life balance. Recovery focused practitioners benefit from environments where they are valued and supported.