Two ‘new’ phrases have entered the lexicon of mental health in recent years – “Recovery Orientation/Based Practice” and “Lived Experience”.  What does this rhetoric really mean and are the terms useful?

The concept of recovery has recently been ‘discovered’ and used to guide service delivery and mental health policy direction.  However it is used inconsistently, and carries with it a number of potential pitfalls.  There is no consistent definition of ‘recovery’ as it is said to have a personal meaning to each individual.  It is not synonymous with ‘cure’.  What it implies is developing greater self efficacy and the pursuit of personal goals and functional capacity, despite ongoing symptoms.  Lived experience is part of this, and the person with mental health problems is the ‘expert’ by virtue of their ‘lived experience’.

Recovery in terms of hope, autonomy and personal growth is very individual and much harder to ‘measure’ than formal assessment procedures.  Control of the recovery process sits with the individual rather than the service or service provider and hence runs the risk of leaving people to their own devices, with consequent neglect under the guise of ‘recovery’.  There is also incongruity between the recovery approach and the use of coercion for those whose illness puts themselves and/or others at significant risk.

The recovery approach could also become a modern day anti psychiatry movement, with the focus on individual recovery and self determination leading to failure to access mental health services.  This leads to another potential problem – where the individual is responsible for their own recovery (a process), and to not ‘recover’ (an outcome) is a great disappointment and perpetuates the sense of personal failure.  Another significant risk is that the concept of recovery may lead to a focus on the personal and the narrative, with exclusion of the systemic, which this may limit the extent of recovery.

It is a grave error to assume that there are two mutually exclusive groups, those with ‘learned experience’ and those with ‘lived experience’.  Many who are professionals in the field of mental health care, have BOTH lived experience and learned experience, though usually do not declare the former.  It may however be used to powerfully influence their work and produce deep understanding and empathy. 

Certainly, hopes, dreams, goals and autonomy are crucial to all of us, but the catch cry of ‘Recovery’ has the potential to do more harm than good.  The exclusive focus on ‘Lived Experience’ has the potential to increase marginalization and stigma, and could be the antithesis of ‘recovery’ - with a focus on difference rather than on universal issues of life.

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