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Guidelines for Recovery-Oriented Practice

Purpose

In the spring of 2006, the landmark report Out of the Shadows at Last called for recovery to be “placed at the centre of mental health reform” in Canada. Since then impressive strides have been made across the country to embrace and implement a “recovery orientation,” both in policy and in practice. Many provinces and territories have incorporated the concept of recovery into their strategic and planning documents, and some have begun important initiatives to support recovery-oriented change. Many health and mental health facilities have embraced recovery as the goal and transformed the way they work. Recovery-oriented services and supports based in the community are becoming more widely available throughout Canada.

A recovery orientation also lies at the heart of Changing Directions, Changing Lives: The Mental Health Strategy for Canada released in 2012. In the words of the Strategy:

An orientation toward recovery is helping to bring about important changes in the mental health systems of many countries. Here in Canada, recovery has strong roots in theadvocacy efforts of people with lived experience and in the psychosocial rehabilitation field.… Recovery and well-being form the base of this Strategy and are now embraced by most provincial and territorial mental health policies.

The Strategy put forward two specific recommendations to help strengthen the commitment to a recovery orientation and its implementation across the mental health system:

2.1.1 Implement a range of recovery-oriented initiatives in Canada, including the development and implementation of recovery guidelines, and
2.1.2 Promote the education and training of mental health professionals, health professionals, and other service providers in recovery-oriented approaches.

These Guidelines for Recovery-Oriented Practice represent an important contribution to achieving these recommendations. They constitute a key element of the work undertaken by the Mental Health Commission of Canada (MHCC) to build on the significant pockets of practice already oriented towards recovery and well-being across the country. Over the past two years, stakeholders and recovery champions have worked with the Commission to identify objectives that will help accelerate the implementation of recovery-oriented approaches across the mental health system.

The Guidelines have been written to provide a comprehensive Canadian reference document for understanding recovery and to promote a consistent application of recovery principles. They seek to build a common understanding, shared language and knowledge about recovery in order to:

  • Provide a conceptual framework to help transform culture and practice.
  • Promote the centrality of supporting people with lived experience, along with their families and caregivers, to play an active leadership role in their personal recovery; delivering ser vices; program design and development; policy setting; recruitment and development of staff; and evaluating services.
  • Identify principles, values, knowledge, skills and behaviour that underlie recovery-oriented services and supports.
  • Assist in implementing a recovery orientation across the country at a policy, program and practice level.
  • Provide a benchmark against which to measure service alignment with evidence-informed recovery-oriented practices.
MOVING THE RECOVERY CONCEPT FORWARD

The idea of recovery and the need for a mental health system geared to its promotion is not a new one. A key impetus for the development of the concept came directly from people with a lived experienced of mental health problems in the 1980s and 1990s. They described their own experience and journeys and affirmed their personal identity beyond their diagnoses. They advocated for a system that provided hope, treated people with dignity and respect and supported everyone in finding their path to better mental health and well-being.
At the same time, there are many ideas that underpin the recovery philosophy – such as self-help, empowerment and advocacy – that have an even longer history, both inside and outside the mental health field. Some of these ideas had their roots in the Civil Rights movements of the 1960s and 1970s in the United States and in self-help groups such as Alcoholics Anonymous, where the concept of being “in recovery” remains a central tenet.

Recovery was key to the approach taken by pioneer psychiatric rehabilitation professionals in the United States, who began to challenge mental health services to adopt a recovery vision and transform their services to a recovery orientation.
In Canada, PSR providers have long incorporated recovery ideas and practices and have actively advocated for the widespread adoption of a recovery orientation.

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