The impact on psychiatric rehabilitation of personal recovery-oriented approach

Alessandra Martinelli, Mirella Ruggeri

Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Italy

Objectives

Psychiatric rehabilitation focuses on the main disabling consequence of mental disorder and has the ultimate aim of helping the person to heal, meant as to control the symptoms, to remove the interpersonal and environmental barriers caused from disability, to recover the abilities to live independently, to socialize, and to effectively manage daily life and accept one-self limits. In recent years, rehabilitation services have been closely associated with the ‘recovery’ approach. Thus, the purpose of this article is to highlight the contribution in psychiatric rehabilitation of a virtuouse contamination with a recovery-oriented framework. 

Methods

In this narrative review paper, we focus on a review of conceptual papers and empirical studies that proposed new methods or concepts or engendered important debate in the field of psychiatric rehabilitation. We used three online databases: PubMed, GoogleScholar, SCOPUS, and the following keywords: ‘mental health rehabilitation’ or ‘psychiatric rehabilitation’, ‘mental health recovery’ and ‘mental health recovery-oriented practices’ or ‘mental health recovery-oriented interventions’.

Results 

Since its development, psychiatric rehabilitation has undergone continuous evolutions in vision, mission, and principles. Born in the mid-eighteenth century, during the moral treatment era, and developed after the deinstitutionalization in the 1960s and 1970s, in the beginning, the task of the psychiatric rehabilitation was considered completed with the discharged of thousands of chronic patients from hospitals. It was soon clear that, for the discharget patients, there were not enough interventions, therapeutic programs or opportunities to spend time and socialize. In the 80s and 90s, the effort of traditional rehabilitation to achieve the goal to prevent or reduce social disadvantages and functional limitations and increase role performances was insufficiently achieved with a predominance of non-specific interventions. Later, non specific psychiatric rehabilitation interventions were reduced, and recovery values and principles were embodied in their vision. The concept that individuals with a psychiatric disability can live as normally as possible in society became an important goal of treatment. Nowadays, evidence shows that recovery-oriented approach and recovery-oriented interventions have positive health and social outcomes in people with severe mental illness.

Conclusions

The overall review of the interplay between rehabilitation and recovery-oriented practices highlights that the mission now is to further implement patients and their caregivers’ engagement to collaborate in a treatment process that favors empowerment and provides support to disease management, psychosocial functioning, and personal satisfaction. However, recovery-oriented rehabilitation practices are still a matter of further development, and the concrete declination of these principles into everyday life seems to be still inhomogeneous and conditioned by local factors.

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