Rediscovering Recovery: Reconceptualizing Underlying Assumptions of Citizenship and Interrelated Notions of Care and Support

Abstract

Over the last few decades, research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery have internationally concentrated on recovery as a promising concept. In this paper, a conceptual distinction is made between an individual approach and a social approach to recovery, and underlying assumptions of citizenship and interrelated notions and features of care and support are identified. It is argued that the conditionality of the individual approach to recovery refers to a conceptualization of citizenship as normative, based on the existence of a norm that operates in every domain of our society. We argue that these assumptions place a burden of self-governance on citizens with mental health problems and risk producing people with mental health problems as nonrecyclable citizens. The social approach to recovery embraces a different conceptualization of citizenship as relational and inclusive and embodies the myriad ways in which the belonging of people with mental health problems can be constructed in practice. As such, we hope to enable social services and professionals in the field to balance their role in the provision of care and support to service users with mental health problems.

Diasporic Muslims, Mental Health, and Subjectivity: Perspectives and Experiences of Mental Health Care Professionals in Ghent

“…In the last decades, marked by the deinstitutionalization of residential services and the development of community-based services, "recovery" became popular in mental health care in Flanders (Vandekinderen et al, 2012). "Recovery" is defined as "enabling people with mental health problems to 'regain control over their lives, and .…”

“…In recovery-oriented practice, an attempt is made to "reach beyond our storehouse of writings that describe psychiatric disorder as a catastrophic life event" (Ridgeway, 2001, p. 335), and priority is given to embracing strengths rather than weaknesses, hope rather than despair, and engagement and active participation in life rather than withdrawal and isolation (Secker, Membrey, Grove, & Seebohm, 2002;Leamy, Bird, Le Boutillier, Williams, & Slade, 2011). We argue, however, that it is necessary to theorize underlying notions of the human subject when studying how service users are approached in recovery-oriented mental health care (see Vandekinderen, Roets, Roose, & Van Hove, 2012). When people with mental health problems are expected to become self-responsible citizens, the responsibility for leading a fulfilling life is individualized (Craig, 2008).…”

“…As Vandekinderen et al (2012, p. 3) argue, it becomes particularly tricky and even impossible to provide high-quality mental health care "when this ideology of individual choice and opportunity denies the fact that some citizens have few available choices and resources". Unsurprisingly, the recovery paradigm has been critiqued, with an increasing number of authors arguing for a truly social approach to recovery, in which people with mental health problems and professionals have an alliance and share responsibility in shaping care and support practices in a continuous dialogue (Beresford & Croft, 2004;Vandekinderen et al, 2012).…”

Empowering knowledge and Quality of Recovery after hip or knee replacement

“…The most common distinction of recovery in psychiatric care is that made between personal and clinical recovery (Macpherson et al 2015). Another distinction, between the personal and social approach to recovery has also been made (Vandekinderen et al 2012). This division is supported by a qualitative study where it was shown that the recovery process after hip replacement could lead to changes in personal and social functioning that patients did not always anticipate (Grant et al 2009).…”

Untangling the Nonrecyclable Citizen

“…while they are cast as the dependent other, when they do attempt to gain a foothold on the ladder of individualism then they are expected to demonstrate extra-special, hyper- Hence, the focus of this notion of recovery relies on the characteristics and motivation of people with mental health problems rather than on discourses, policies and practices of the 30 support system (Vandekinderen, Roets, Roose & Van Hove, 2012). In our view, this individual approach to recovery leads easily to residual social practices, in which, chiefly, an economic rationality is brought to bear on social problems (Cruikshank, 1999).…”