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Taking Issue   |    
How to Support Recovery for People With Mental Illness
Ronald J. Diamond, M.D.
Psychiatric Services 2009; doi: 10.1176/appi.ps.60.9.1155
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I was recently asked what five things a psychiatrist can do to support recovery. Psychiatrists are often more focused on diagnosis and medication than on "recovery." Psychiatrists are high-status members of the treatment team with the power to influence the attitudes and behavior of team members and consumers. Other clinicians will find it much more difficult to support recovery if the psychiatrist does not support it.

Recovery, as I use the term, does not mean cure of illness or absence of symptoms. It means having the best life possible, despite illness and symptoms. It is an ongoing process rather than a state that can be achieved in some final sense.

First, support the attitude of recovery whenever and wherever it occurs. Support hope. We must believe that this person's life can get better. We can help other staff focus on the hope that this person can go back to school, get a car, have a friend, or get a job.

Second, celebrate the small victories of each client. Support strengths. It is easy to find things that the person is not doing well. Rather, focus on what is going a bit better, even a small bit better. What new behavior has the person tried? Can we get excited by something that the client is doing or even thinking about?

Third, view medication as a tool that the client can use to support his or her own recovery. The issue with medication is effectiveness, not compliance. Medication is just a tool that is useful or not. The issue is not whether the client is adherent. The issue is whether the client uses this tool in a way that is effective in accomplishing what he or she wants the medication to do.

Fourth, start with the client's own goals. We need to support strengths and support risk taking when appropriate. What does the client want, in his or her own words? Is treatment really directed to helping the client achieve this goal? How can medication help the client to move in this direction? Look for areas of agreement. We may not agree with all of the client's goals, and the client may not agree with all of ours. Focus on the goals that we share.

Fifth, support activities that the client can undertake to promote recovery.What is the client doing to maintain and improve his or her own health? How can we support these activities? What are the barriers that make them difficult? Be concerned about all the things that can help the client's life get closer to how he or she would like to live it.




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