Recovery in schizophrenia

Recovery in schizophrenia is becoming increasingly achievable. There has been increasing recognition that outcomes for schizophrenia are improving, that schizopohrenia is not always a chronic illness that will have a deteriorating course in all patients. Criteria for remission have been developed by the Remission in Schizophrenia Working Group. Formal criteria for recovery have not been developed but a suggestion has been put forward that it should comprise a 2 year duration of remission of symptoms, engagement in productive activity, like work or school, independent mangement of day-to-day needs, cordial family relationships, recreational activities, and satisfying peer relationships. This however is the clinical view point of recovery.

There is a personal view point of recovery that has emerged from the expertise of people who have lived the experience of having a mental illness. US agencies have defines recovery as a journey of healing, and positive change, allowing a person with a serious mental illness to live a meaningful and fulfilling life while livng in the community of his or her choice.

The following points have also been highlighted:

  • Recovery in schizophrenia can occur without professional involvement
  • Recovery can occur even if there a relapse or symptoms reoccur
  • Recovery is best achieved if there is personal support
  • Recovery does not focus on the causality of the mental illness
  • Recovery is more than just remission from symptoms.
  • Recovery is not a linear process, it can proceed forwards, backwards, stall, restart etc
  • Recovery is a slow process of a series of small steps
  • Recovery focuses on consumer choice
  • Recovery is ongoing; there is no end point.

Recovery in schizophrenia or any form of mental illness will mean different things for different people. Many people have heard about the 12-Step Program of Alcoholics Anonymous. The priciples for recovery from mental illnes evolved from this, as well as from the Civil Rights Movement following the deinstitutionalisation of psychiatric patients. Today the Recovery Model or various versions of it have been adopted by numerous countries around the world.

The Recovery Model places the responsibility and decision making in the hand of the patient, instead of the doctor, relying on support from other individuals at various other points along their journies to recovery. This provides the patient with more control over their pathway and allows them to discover their what works best for them through their own, and others' experiences.

There are various concepts underpinning Recovery in Schizophrenia. Each person's journey to recovery is deeply personal and related to the individual's community and society.

Hope

Hope is essential and has to be found, nurtured and maintained. It has been described as the key to recovery, and it includes a belief in oneself, persevering through the uncertain times and setbacks which inevitably do occur, with the belief that there is a better future.

Meaning
Developing a new sense of meaning and purpose in your life is important. Patients must be encouraged or assisted in finding this through developing new skills, or new social or vocational roles. New meaning can also be found through adopting a new philosophical, political or religious practices. This is essentially a self discovery process.

Empowerment and self identity
An important tenant of recovery is that of empowerment of the patient and recovering an enduring sense of self. This is important because having a serious mental illness can result in patients being disempowered through experiences such as involuntary confinement, stigma, and paternalistic attitudes of carers and treatment teams. This can result in patients adopting a new identity, conforming to an image of incapacity and worthlessness, and adopting a disabled role. Patients are assisted in developing confidence, independence, assertiveness and appropriate help-seeking strategies.

Supportive relationships

Friends and family who believe in and support the patient are invaluable in the recovery process. These relationships are far more important than those with mental health professionals. Other service users, and others who hold the same values and concerns can also be of significant importance to the recovering patient. Always consider advice from family and friends, as well as mental health professionals.

Self
Recovering the sense of self is important. One strategy that has been employed is to regulate your social involvement restricting it only to others who provide a positive, safe and meaningful relationship, allowing the individual the space to develop an understanding of their self, spirituality and interests. This nurturing of the self is assisted by relationships and atmospheres where there is acceptance, mutuality and a sense of belonging.

Recovery in schizophrenia is always a personal decision and journey. It can be facilitated through various programs. Before any start can be made, the individual has to accept help and begin to take responsibility for their own mental wellbeing. Hope and belief that life will improve is important. The process is learnt through interaction in supportive and therapeutic relationships, with the development of increasing self reliance.

Practical steps include taking responsibility, managing your mental health, addictions, relationships and self-care, developing a vocation or work, living skills and social networks, and developing trust, hope, identitity and self-esteem.

There are active programs of the Recovery Model worldwide. Speak to your mental health advisor about it and start taking charge of your life.



If you have anything to you would like to publish, click here to go to my blog.



FREE E-Book