Recovery and Mental Health a critical sociological account. David Pilgrim & Ann McCranie
The support of personal recovery in mental health now represents a stated goal for most mental health providers within the UK. Representations of personal recovery are complex however, with Anthony providing one of the most commonly cited definitions:
“…a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness.” (Anthony, 1993, p527)1
Anthony’s definition has been criticised however in its focus on limitations and illness. Service user researchers and organisations often emphasise different goals, focussing on individuation and personal development:
“The goal is not normalization. The goal is to become the unique, awesome, never to be repeated human being that we are called to be.” (Deegan 1996, p92)2
In this important book Pilgrim and McCranie seek to provide an overview of the sociological context within which mental health services develop recovery orientated care models.3 Through six chapters the authors review this central concept from a variety of angles: – Recovery from what? What research and meanings exist in relation to the concept of recovery? What is the state of current recovery orientated services? Who are the invested parties in the recovery process? How can we evaluate recovery orientated policy?
The arguments are clearly presented and concisely argued, allowing the book to maintain a short length but with a depth of discussion and invitation for further consideration through the use of reflective case vignettes. The thesis is powerful however, and at times can provide discomforting reading, yet such critical arguments are essential if psychiatry is to adequately grasp the varying implications and interpretations of the recovery position, or movement.
The authors clearly highlight the tensions that exist between the implications of recovery orientated practice, mental health legislation and the traditional division of power between clinician and patient. These are important points in desperate need of greater research to allow the experiences of patients and professionals to be adequately synthesised and considered. While this is a challenging book it contains important material that needs to be considered by all psychiatrists in relation to their clinical practice. Ultimately the arguments raised may have implications reaching beyond the provision of mental health care to society in general; however catalysts to promote these discussions are definitely required.
1 Anthony WA. Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 1993; 16: 521–38.
2 Deegan P. Recovery as a journey of the heart. Psychiatric Rehabilitation Journal 1996; 19: 91–7.
3 Pilgrim D, McCranie A. Recovery and Mental Health: A Critical Sociological Account. Palgrave Macmillan, 2013.
The above is a book review that I submitted to the British Journal of Psychiatry which was unfortunately rejected by the Editors. They stated that this was as they rarely accept unsolicited reviews – this is unfortunate as previously both the reviews I’d submitted to the BJP had been accepted. I don’t know too many other journals that would accept unsolicited reviews at all so I thought this would make a reasonable blog post to share.