edited by Glenn Roberts, Sarah Davenport, Frank Holloway, and Theresa Tattan; London, Royal College of Psychiatrists, 2006, 405 pages, $25 softcover
Dr. Maggie Bennington-Davis is medical director of Cascadia Behavioral Healthcare, Portland, Oregon.
The opportunity to review this book was my good fortune. I know little of the mental health system in the United Kingdom, but within the first chapter I found myself in familiar territory and privy to an excellent synopsis of where recovery and rehabilitation in mental health treatment have come thus far, including in the United States. This book is a collection of stories; a comprehensive review of recovery principles, therapeutic techniques, and systems of care; and an analysis of what we know and what we think.
The editors begin with a preface containing a warning that the book is more a collection of narratives from many people than it is a rigorously organized academic tome. The book models the essence of recovery, and the warning is actually more of a heralding. All of the contributors are from the United Kingdom, many at organizations in London. Julian Leff's chapter, "The Social Context of Mental Illness," as is true for most of the material, could easily be written about the American experience with mental illness. As such, this book is as excellent a resource and as provocative a collection as any I know regarding recovery.
The book is divided into five major sections. Part 1 marks where we are currently in our thinking about values and principles of recovery or rehabilitation psychiatry. It offers a history, pertinent to both the United Kingdom and the United States. Part 2 reviews current therapeutic practices, familiar to any reader acquainted with recovery-oriented thinking. Part 3 offers an organizational approach to thinking about these practices and how to deliver them. Here we may learn from the British experience; the chapter by Frank Holloway about the Care Program Approach has particular wisdom for components of community services. Part 4 includes three contributions regarding unique populations—those with brain injury, with learning disability, and in forensic programs. Part 5 is written by the editors, who brainstorm about where to go from here. The sections seem particularly fortuitous; the contributors apparently wrote their contributions independent of each other, which puts the book at risk of being choppy. Instead the flow is excellent, and one contribution is as good as the next. The book's appendices are worth mentioning: there is an excellent list of rating scales, a good reference list of Web sites, and a recommended reading list.
There is no happy ending with a clear roadmap or how-to guide, but the book provides a tidy collection of stories to help with our thinking and planning about recovery. The editors hoped to appeal to a wide audience: mental health colleagues of all types, caregivers, and service users. They succeed. I will keep this collection in my office as a resource as I work to build recovery-oriented community mental health services. This book does what psychiatric rehabilitation does; as explained in the preface, it "offers a positive response to the problems, needs, and aspirations of people with long-term, complex and life-limiting mental health problems."