History of Recovery In the past providers of mental health services often failed to emphasise positive possibilities for people

with mental health issuesparticularly those with the most severe diagnoses. Psychiatric services emphasised maintenance, and many survivors report that receiving a psychiatric label has been severely detrimental to their efforts to lead a worthwhile and enjoyable life. (TurnerCrowson and Wallcraft, 2002) An accepted prognosis for an individual diagnosed as having a mental health issue was that they would always remain a burden on society and that they must be taken care of rather than encouraged to become independent, contributing members of society. (Ralph and Muskie, 2000; McGrath and Jarrett, 2004; Turner-Crowson and Wallcraft, 2002) In the last few decades, however, there are signs of greater appreciation for the potential of those considered to have a severe mental health problem. This has happened partly because of a burgeoning consumer empowerment movement in Australia, the UK, the US, and some other countries. People with severe mental health problems have formed influential local and national organizations, have become increasingly visible in conferences and committee rooms, are advocating for more empowering services, and are helping to shape both services and research. (Turner-Crowson and Wallcraft, 2002) The seeds of the recovery vision were sown in the aftermath of the era of deinstitutionalization. The failures in the implementation of the policy of deinstitutionalization confronted us with the fact that a person with severe mental illness wants and needs more than just symptom relief. (Anthony, 1993) In the early 1980s, the term recovery seldom appeared in articles or concept papers. In the late 1980s and early 1990s, the word recovery was introduced by consumer/survivors (many of them accomplished mental health professionals themselves), who gave voice to the recovery vision by publishing accounts of their own experience in professional journals (Deegan, 1988; Lovejoy, 1984; Houghton, 1982; Leete, 1989). (Ralph and Muskie, 2000) Such articles showed how some patients originally considered by mental health professionals to have a poor prognosis were overcoming many of their difficulties and discovering ways to live satisfying and contributing lives, despite some continuing problems. At the same time, it was also becoming apparent in the selfhelp and consumer movements that many people earlier considered to have severe and disabling mental illnesses were becoming leaders and examples for others. (Turner-Crowson and Wallcraft, 2002) Stimulated by such writings and experiences, the rehabilitation research and training center at Boston University has for some time been collaborating with

various consumer/survivor leaders to develop the concept of recovery. By the early 1990s, the centers director, William Anthony, began urging that the idea of facilitating recovery be adopted as the guiding vision for mental health services and research, on a par with preventing mental illness, and providing effective treatment and care (Anthony, 1993). (Turner-Crowson and Wallcraft, 2002) The implementation of deinstitutionalization in the 1960s and 1970s, and the increasing ascendance of the community support system concept and the practice of psychiatric rehabilitation in the 1980s, have laid the foundation for a new 1990s vision of service delivery for people who have mental illness. Recovery from mental illness is the vision that will guide the mental health system in this decade. (Anthony, 1993) This challenge was heard, and consumer-survivors, professionals, and researchers began to explore the process of recovery and define the recovery paradigm. (Carpenter, 2002) In the US, the emergence of strong consumer organizations has been accompanied by growing discussion of a new vision: the vision of reorienting both services and research toward recovery from severe or long-term mental illness (Anthony, 1991, 1993). During the 1990s, the implications of a recovery vision have been extensively debated by the various stakeholder groups. Indeed, the recovery vision has become so influential in the US that the Surgeon General (1999) in a landmark report on mental health has urged all mental health systems to adopt a recovery orientation. (Turner-Crowson and Wallcraft, 2002) Recently, the recovery vision has attracted considerable interest in Australia, and it is now government policy to include consumer participation in all levels of mental health service provision (McGrath and Jarrett, 2004). Today the paradigm continues to evolve, but a number of central beliefs, values, and concepts are common to most of the recovery literature (Bullock, Ensing, Alloy, & Weddle, 2000). (Carpenter, 2002)