Rights and the recovery model
The recovery model in mental health emerged in the 1990s from William A. Anthony , who defined recovery as the possibility of living a full life despite experiencing symptoms. It is thus understood as both a subjective process, a proposal to orient mental health interventions towards a new goal, and a large-scale strategy to transform services.
Some fundamental principles of the model are:
- Recovery can also occur without the intervention of professionals.
- Social support is essential for the person's recovery, and greater community involvement and guidance is needed.
- Recovery is not linear: there are better and worse moments, and they are all part of the process.
- The relationship with the people being treated must be more empathetic and take into account their needs and desires, beyond diagnoses and symptoms.
- The participation of the people being cared for and their families in the design of services and interventions is necessary.
This model, almost thirty years later, has been partially implemented in the mental health systems of many countries. The experience of countries such as the Anglo-Saxons shows us that the application of the recovery model without a human rights perspective can generate distortions and barriers to people's recovery processes. Recovery cannot occur without respecting the person's preferences and desires, the exercise of their citizenship rights and their inclusion in the community.
The recovery model, a paradigm shift in the approach to mental health
Some recovery practices based on the rights and autonomy of the person are:
Mutual aid and peer support
They are based on the consideration that social proximity fosters motivation, helps to expand social networks, offering acceptance, support, empathy and a sense of community, and this increases hope, autonomy and the assumption of responsibilities. Peer support responds to the principles of respect and horizontality, and in no case to directing, convincing or persuading.
Peer support agent
Technical people in accompaniment and mutual support are people who have or have had mental health problems and who are trained to support other people in the recovery process.
This person provides professional support and is integrated into the professional teams of the mental health network services. They can carry out direct support tasks (defence of rights, support in the reconstruction of life in the community and facilitation of group activities) or indirect support tasks (related to administrative and information management, participation in team and supervision meetings, and training activities).
Mutual Aid Groups (MAG)
These are self-organized spaces or group activities, facilitated by people who have gone through an adverse experience or a common difficulty, such as a mental health problem, where they share their experiences in the first person.
They are differentiated spaces and, often, complementary to professional resources, in which experiential knowledge acquires a fundamental value for the person, where support is received and given from a horizontal, voluntary and respectful perspective.
Advance Decision Planning (ADP)
This structured and deliberative process allows the person to express their values, desires and preferences, formulate and plan how they would like the care they may receive in situations of crisis, serious illness or end of life, especially in circumstances in which they are not in a position to decide. Thus, it serves to promote and guarantee their decision-making capacity, both in conditions of clinical stability and during a crisis.
This process, unlike the Advance Directive (or living will), is not legally binding, but reflects an agreement between the affected person, a professional with the authority to guarantee that during a relapse the PDA will be fulfilled and the person's support environment (family, friends and other professionals that the person chooses).
Advance Care Planning in Mental Health
Training and capacity building in empowerment and recovery
Training and awareness-raising of professionals
It is essential for the implementation of the recovery model.
The objectives of this training are the acquisition of knowledge about the recovery model and its fundamental concepts, the practical application of this model and the analysis of situations with a critical and rights-based perspective. The fact that this training is taught (often also planned and led) by people with their own experience in mental health also allows them to connect with the needs and desires of these people in relation to their care and their life project.
PROSPECT training
European training project on empowerment in mental health aimed at people with their own experience, family members and professionals, created by the European Federation of Associations of Families of People with Mental Illness (EUFAMI). It consists of three specific modules, one for each group, and taught by people trained with the same profile as the participants (called facilitators), and a common module in which all people participate.
Housing First
This model was born as a program specially designed for people experiencing homelessness who have not been successful in other residential resources. Many of these people have mental health problems or addictions.
Housing First provides them with stable housing and professional support so that they can maintain themselves and carry out the best possible recovery process, always based on the strengths and preferences of each person, developing social roles that are meaningful to them.
Volunteering and first-person activism
Both volunteering and activism are tools for social change and the development of societies through the active participation of people in the community.
When volunteers and activists are people who have had or have a mental health problem, it allows them to give meaning to their lives, be part of the community and, at the same time, help in the fight against discrimination and stigma (and self-stigma) surrounding mental health and in the defense of their rights.