When we talk about personal recovery, it should involve participation, agency, and a sense of belonging. Reflections from an Irish context suggests that perhaps recovery is an empty concept, one which leads to experiences of surveillance from society.
The idea of recovery as a personal journey is well documented in service delivery worldwide. It is a great example of collective action from the lived experience community in promoting structural change beyond the medical model. This was driven by accounts from key experts such as Anthony (1993) and Deegan (1988) regarding living a life beyond what services had offered to them and others. It can never be taken for granted how storytelling and alternative narratives to the status quo provide hope and inspiration to many individuals, families and communities seeking a better world, one which provides participation, agency and belonging to all in our society. The recovery journey is unique to each person, with different values and beliefs of what is important to them. At a very basic, humane, rights-based level, recovery should embody the following:
“Somewhere to live, something to do, someone to love”
(Dimakos et al., 2016, p.130)
It is important to note at this juncture, that these factors are ones which speak to this author, it is not to say that another person may see recovery very differently. It is a about people having choice and opportunity to be who they want to. A significant challenge is how our society constructs meaning in relation to concepts like recovery, illness, wellness, normal, love, gender, race, age etc. These ‘constructs’ are categorised into binary understandings. For example, you either have an illness or you do not. How services and society respond to you once you are no longer acutely unwell, is that no longer need help or support. There is an expectation that you now are on your own to return to ‘normal society’. However, for many if a life course perspective was taken and actually actioned, viewing mental illness as a continuum of care, with varying levels of support available along the life journey of recovery, then individuals and families would not feel so disillusioned with their experiences of services. However, how we construct meaning and maintain meaning in our society is through ‘binary constructs’, ones which often disempower and isolate the unique identities of many individuals. Our society does not appreciate the diversity, subjectivity and continuum of identities that should be welcomed and accepted by our society.
It is an everyday challenge, one where society doesn’t really allow for individuals to be vulnerable, accepted, and supported to move on with their lives. The personal recovery journey should provide opportunities for individuals to develop new roles and identities which can instil confidence, belonging and participation. It is about being able to enjoy the ordinary things in life:
“You can live well with even the presence of mental health challenges, that recovery is not a lofty thing where everything is going to be perfect all the time, it’s quite ordinary in many ways, it’s about being able to enjoy the ordinary things in life and living an ordinary fulfilling life is what recovery would mean to me”
(Service User Perspective, Swords & Houston, 2024, p.101)
Interestingly, for many practitioners and those delivering services on the frontline, they are frustrated and deflated due to the ‘revolving door experiences’ felt by individuals, families and communities. It feeds into the idea of ‘moral injury’ which refers to the experiences of practitioners feeling alienated from their values and worldview in terms of what they set to out to achieve (support someone to move beyond services and reclaim old and new opportunities/identities/roles within society) and the disconnect which can often transpire:
“The idea is great but putting it into practice is another thing as well. So we talk about recovery and this way and that way, but say if somebody has been in hospital, they are discharged home; I work in the community, there’s only so many resources that I have and you try to link them in with community to get them living back to a normal life. . . we would love to be able to provide a service. Our own local service, as a team and all that. It makes it very difficult. You know in terms of trying to run a group for, trying to do one to one’s and all that sort of stuff. It definitely makes it difficult.”
(Community Mental Health Professional Perspective, Swords & Houston, 2023, p.7)
These experiences of disconnect and sometimes alienation can extend to families supporting their loved ones. They too have their own recovery journey, yet the absence of resources and funding has led to promising policy developments in recent times remaining aspirational for many.
Reflecting on the arguments made in this piece so far, one could argue that personal recovery in some instances could be seen as an empty concept if we look at a range of perspectives. Recovery can be a short journey, but also, it can be lifelong. Not only is it about “somewhere to live, something to do and someone to live” (Dimakos et al., 2016, p.130), but it is also about “making someone feel like a loved member of society again” (Swords & Houston, 2023, p.6). The way that our society and services are constructed, is driven by individualism; it is entirely up to you succeed. If you fail in your recovery journey, that is on you. There is no responsibility placed on the failure of society to support you to move on with your life, to be viewed as ‘the friend, the sibling, the worker, the student, the parent, the lover”.
Similarly, frontline practitioners are faced with pressures to be efficient and time-limited in their approaches to supporting individuals on their recovery journey. If they are not achieving the outcomes desired? Then they just need to work even harder because they must not be a ‘good enough practitioner’. If services fail in meeting the needs of individuals and families, frontline services and professionals are often scapegoated by societal discourse – they should have done better.
Family members, viewed by many as ‘pseudo clinicians’ in the care plan of their loved one’s recovery journey. They are expected to provide the care and support around the clock, judged by society on their ability to be unpaid carers and supporters to their loved ones. Like their loved ones, they would also love to have the time and opportunity to be viewed as ‘the friend, the sibling, the worker, the student, the parent, the lover” beyond the identity as a family member of someone living with a mental illness.
Neoliberalism is a significant influence on why service delivery and society continue to fail many stakeholders, especially individuals and families seeking help and support for their mental health challenges. It is the underlining driver of government economics across western society. It places emphasis on privatisation and free markets within countries and in terms of state policies. Value is focused on efficiency, self-sufficiency and prosperity. It creates a culture within governments and politics where spending on welfare and public services is minimised. Essentially, individuals are judged in society by their ability to be successful in terms of personal attributes: how hard can you work; you need to be more resilient; it is your fault you couldn’t hold down that job. It transcends beyond private into public services.
Ultimately, there is no one answer or solution to this issue, but there is a need to change the narrative surrounding the concept of ‘personal recovery’. There is a need for society to recognise that collective responsibility is necessary. I would probably go a step further to say it needs to be a moral duty to support individuals, families and communities to overcome these barriers facing them in their everyday lives regarding mental health recovery. There is a need for our political systems which represent our democratic society, to recognise that the ‘personal’ is also ‘social’ when looking at mental health and recovery outcomes.
Read the full research paper upon which this article is based here