Sir: David Whitwell discusses what may become one of the most important concepts in mental health over the coming decade; recovery (Psychiatric Bulletin, October 1999, 23, 621-622). However, his view of recovery as a myth is based on a medical understanding of the word, equating recovery with cure, or with returning to how you were before the illness started. In the growing literature on this issue in the USA and elsewhere, most service users put forward the concept of recovering a meaningful and fulfilling life. It may well be a quite different life to the one envisaged before the onset of mental illness, but it is none the less a valuable and valued life.
The analogy used by many people is that of suffering a permanent physical disability as the result of an accident. You may well need medical care, but it will not cure you. You may equally need social care, but are unlikely to want to be seen as a dependent service user for the rest of your life. The aim is to find ways around the problems which the disability may cause, to recover a life of purpose and meaning. That may well include searching out the strengths which the disability has brought, for example an understanding which may equip you to help others.
Many of the best mental health services and user groups in the UK already strive towards this approach. From open employment schemes to self-management training, they span a wide and growing group. The question is not so much over the approach, as over the word. Recovery can so easily be interpreted as cure. Will a word which seems to strike the right chord in other countries work here, or will we need to find an alternative?
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