Recovery - Moving Recovery Oriented Service Provision from Policy to Practice in NSW
One of NSW CAG's key lobbying areas is for improvement in the provision of recovery oriented service provision. Through consultations with consumers throughout the state, we have heard and observed that although "recovery oriented service provision" is a clear government policy direction for mental health care in Australia, this has not been realised in practice. One reason is that there has been no discussion within NSW around what recovery oriented services are. A component of NSW CAG's advocacy work has therefore been to further the development of truly recovery based services in NSW.
What is recovery?
Recovery means different things to different people - and that is because every person has unique experiences and responds to mental illness in their own way. There are many different definitions on what recovery is, including that it may be a process (journey) for some people and an outcome (being well) for others, and for this reason the way that each person defines recovery will be different, depending on their individual circumstances and perceptions.
Recovery may mean:
- Being able to live a meaningful life
- Being symptom free or having control over one's symptoms
- Healing
- Being able to participate in the community
- Taking responsibility
- Having good relationships
- Having a positive identity
- Being able to share experiences and stories
- Making certain life adjustments
- Overcoming stigma and discrimination
- Understanding the illness
- Knowing how to stay well
- Having goals
- Having a healthy lifestyle, and
- Living with or without mental illness
Thus, recovery is about people being able to live a meaningful life with hope for the future, with support from professionals, peers, family and friends, when needed. This view supports that everyone who experiences a mental illness can experience recovery.
NSW CAG is aware that there is difficulty in defining recovery within mental health services, with conflict between the clinical view of recovery, which says recovery is about getting better and no longer having symptoms or needing treatment, and the personal view of recovery.
Clinical View of Recovery:
The clinical view of recovery stems from the medical model in health care, where recovery is seen as being objective (not based on human thought or feeling). Recovery is understood to be a return to a former state of health. Through the clinical view, recovery is measured through reduced symptoms, hospitalisation and medication use. This concept is similar to the everyday use of the term "recovery" where it is associated with "being cured".
Personal View of Recovery:
The personal view of recovery is viewed as a journey that is a unique and personal experience for each individual. It has often been said to be about: gaining and retaining hope, understanding of ones abilities and limitations, engagement in an active life, personal autonomy, social identity, meaning and purpose in life, and a positive sense of self. Essentially, the personal view of recovery is about a life journey of living a meaningful and satisfying life.
NSW CAG's Recovery Forum
NSW CAG hears through consultation with consumers and through our network that consumers want services that are going to:
- Work with their own definition of recovery, and
- Offer hope in their recovery process.
In order to define recovery oriented service provision successfully, NSW CAG noted that discussions needed to happen between the people who use, experience and deliver mental health services in NSW. The discussions needed to come from the knowledge and experience of consumers, carers, service providers, administrators, government representatives and academics.
The Recovery Forum was hosted by NSW CAG on the 10th December 2009, with the aim of producing concrete actions for progressing recovery oriented mental health service provision in NSW. Helen Glover who is an internationally renowned lecturer and trainer in recovery oriented practice, who also has the lived experience of mental illness, was engaged by NSW CAG to facilitate the day. About 120 people from diverse backgrounds and experiences in mental health services within the state, including consumers, carers, service providers, clinicians, academics, researchers, NGO representatives, Area Health Service staff and representatives from NSW Health, including the Director of Mental Health, Drug and Alcohol Office attended the day.
World Café
The structure of the Recovery Forum was based on the World Café facilitative process. World Café is an internationally utilised conversation process that allows all participants to contribute equally to ideas and discussions. During the day participants sat at round tables, where everyone had the opportunity to contribute to the discussions on the questions that were posed.
During each discussion, opportunities were allowed for people to move between tables to create a "cross-pollination" of ideas, to create richer thinking, and encourage diverse perspectives to be shared. Participants were asked to capture their ideas on the paper table cloths, to ensure all the experience and expertise in the room was recorded.
Introduction to the day
The Recovery Forum was opened by NSW CAG's Executive Officer Karen Oakley, and was followed by an interview between Karen and Helen. The interview set the tone for the remainder of the day. During the interview, Helen identified several key issues in delivering recovery oriented services in NSW, such as:
- The need to address the effectiveness of the recovery environment, noting that the role of mental health services is to provide a conducive environment for people's recovery journey
- The need for all mental health service workers to believe in the consumer's ability to recover from mental illness
- For consumers to recognise their own voice, and draw upon their own expertise and experience to enhance their recovery journey, and
- Connecting the expertise and experience of everyone involved in experiencing and delivering mental health services to inform service delivery
NSW CAG videotaped the interview between Karen and Helen. To view it please click on the links below:
(Part 1 of 4) Moving Recovery from Policy to Practice - Interview with Helen Glover |
(Part 2 of 4) Moving Recovery from Policy to Practice - Interview with Helen Glover |
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(Part 3 of 4) Moving Recovery from Policy to Practice - Interview with Helen Glover |
(Part 4 of 4) Moving Recovery from Policy to Practice - Interview with Helen Glover |
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Recovery Discussion Paper:
The Recovery Forum aimed to find out the views of people who use and provide mental health services around the topic of recovery oriented service provision. Conversations held during the day are being drawn on to create a discussion paper to assist NSW CAG in continuing this discussion with people. The outcomes from the discussion paper will then be drawn on to inform NSW CAG's formal position on progressing recovery oriented service provision in NSW. This will provide a concrete direction for NSW CAG to lobby and inform NSW Health around what is needed to advance recovery oriented service provision in NSW.
Please keep an eye out for the discussion paper which will be released in April.
For further information on the Recovery Forum please contact NSW CAG at info@nswcag.org.au.