We begin this second chapter where we left off in the preceding one, with the question of what is involved in the work of recovery and how practitioners can best support this work. On one hand, we understand the answer to this question to be very much a work in progress. There is much still to learn about recovery and recovery-oriented care, and we consider the field—including our own efforts in this regard—to be in the very early stages of its development. On the other hand, we have begun to learn some things about what processes of recovery entail and what the provision of recovery-oriented care looks like in practice, as well as about some of the structural conditions necessary for this kind of care to be implemented. In this chapter, we share some of these lessons by describing components and processes of being in recovery that we have integrated into a model that can then serve as the foundation for developing recovery-oriented practices. The assumption of this approach, as we mentioned in the previous chapter, is that this form of recovery is primarily the responsibility of the person with a serious mental illness. What practitioners do should thus be oriented to supporting and facilitating the person’s own efforts. We describe this perspective as a “bottom up” approach to service development, as it begins with the needs, preferences, and goals of the person in recovery— not only at the individual level of a person’s “recovery plan” but also at the collective level of the system as a whole. What services and supports should a mental health system offer? Those, we suggest, that will enable persons with serious mental illness to lead safe, dignified, and gratifying lives beyond the illness—when possible— or, when that is not possible, within the boundaries imposed by the illness. Before turning to the question of what services and supports we need to offer to promote and sustain recovery, we need to understand better what being in recovery entails. To frame the question in this way is not to ignore the other form of recovery (i.e., recovery from mental illness).
Continuity of care in serious mental illness
