Recovery

Recovery is a rather recent understanding in psychiatry that people can recover from the "illnesses" they have been diagnosed with by psychiatrists and psychologists. This includes schizophrenia which has been thought the "most severe mental illness".

Below is the QSOS pamphlet on recovery. See our pamphlet in the following languages:

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Note: the following is intended to provide general medical information only. If you need medical advice, you should speak with your doctor or other health professionals.

‘Mental illness’ is still seen as a lifelong disease that has no cure. But over the last three decades, more and more studies confirm that people who experience serious and chronic problems with depression, anxiety, mood swings, 'delusions and hallucinations' can fully recover from such problems with the help of supportive people. Recovery is generally defined as the ability to work or study, to live independently, and to keep social contacts without experiencing ‘symptoms’, and may be acheived without drugs as Jonathan Nash did (see article).

Dr. Courtenay Harding, psychiatrist and professor, shows in numerous studies with other researchers that up to 68% of people get much better or fully recover from "chronic schizophrenia". In 1980, the World Health Organization concluded that people in "developing" countries recover more quickly than people in countries that have more hospitals and medications.7 People can recover over time with the right social supports, even without any psychiatric treatment, Dr. Harding says. "Systems of treatment are not as yet able to cure, but they should be able to remove the obstacles that stand in the way of natural self-healing processes."3

• Published research on recovery by psychiatric survivors in the Toronto GTA.
• Links to Alternative Strategies and Health Systems
• Further Reading and Research on Recovery

In the last few years, people who have experienced the mental health system have started operating peer-run services. Professionals are also developing "client-centred care" to "empower consumers". William Anthony, PhD, says that "recovery" is a new way of working in mental health, and that it may revolutionize the field.1 Still, diagnostic manuals predict that natural recovery from ‘mental illness,’ especially schizophrenia, is near impossible. Drug treatment is used to control some symptoms, but patients are often told to expect less in life, and that they might not be able to work or hold meaningful relationships. Added to this, the isolation and the stigma of a psychiatric diagnosis can leave people open to discrimination and many forms of abuse.

Recovery Without Treatment: NY Times

Though recovery is possible, most people believe schizophrenia is an incurable genetic disease. No physical markers for schizophrenia, let alone the genes responsible, have yet been found. Researchers estimate that identical twins, who have the exact same genetic make-up, only both get schizophrenia in less than 50% of cases.

It’s also said that the mentally ill have a high risk of passing on the illness to their children. Karl-Erik Wahlberg, a researcher in Finland, found in a nation-wide study that children of people with a diagnosis of schizophrenia do not develop mental illness when adopted by nurturing families.9 Genetics may be important, but environment seems to play a bigger role than was once believed.

Recovery in the Mainstream: US News

If environment is key, what helps a person recover? A supportive friend or helper who listens without judgement, who believes in you during hard times, can be more helpful than professionally trained staff. According to studies done by Dr. Loren Mosher, people in small, inexpensive "safe houses", with no trained staff or medication, are able to reduce psychotic symptoms within six weeks6 (his work is now being repeated in Switzerland, Sweden and Germany). After 2 years in a "safe house", 58% of people were living independently (as opposed to 33% of people from hospital wards), and 32% were working full-time (in higher-status occupations compared to those from hospital).

A diagnosis of severe and persistent mental illness doesn’t have to mean "forever". If a person believes they can recover, and someone is willing to assist and nurture that belief, the odds of recovery are very strong. Recovery is not only possible– it’s becoming popular.

See a more recent annotated bibliography on recovery as it evolves, especially in the US.

Some Further Reading and Sources

1. Anthony, W. A. (2000). A recovery-oriented service system: Setting some system level standards. Psychiatric Rehabilitation Journal. 24 (2): 159-168.

2. Bassman, R. (2001). Overcoming the impossible: My journey through schizophrenia. Psychology Today. 34 (1): 34-40.

3. Harding, C. M., Brooks, G. W., Takamaru, A., Strauss, J. S., & Breier, A. (1987b). The Vermont longitudinal study of Persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. Am. J. Psychiatry, 144 (6): 718-726.

4. Harding, C. M., Zubin, J., & Strauss, J. S. (1987a). Chronicity in schizophrenia: Fact, partial fact, or artifact? Hospital and Community Psychiatry. 38 (5): 477-486.

5. Mental Health Weekly. (1999). New York moves toward recovery model with RFP release for special-needs plans. July 26. Manisses Communications Group.

6. Mosher, L. R., Vallone, R., & Menn, A. (1995). The treatment of acute psychosis without neuroleptics: Six weeks psychopathology outcome data from the Soteria Project. International Journal of Social Psychiatry. 41 (3): 157-173.

7. World Health Organization, (1979) Schizophrenia: An international follow-up study. New York: John Wiley & Sons.

8. De Girolamo, D. (1995). World Health Organization Studies on Schizophrenia: An overview of their results and their implications for an understanding of the disorder. The Psychotherapy Patient. 9: 213-31.

9. Wahlberg, K. E., Wynne, L. C., Oja, H., Keskitalo, P., et al,. (1997). Gene-environment interaction in vulnerability to schizophrenia: Findings from the Finnish Family Study of Schizophrenia. American Journal of Psychiatry. Vol. 154 (3): 355-362.

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