New research shows value of embracing recovery to improve mental health services

30 November 2010

The relationships between staff and service users need to change radically to improve outcomes in mental health services, according to a report published today by the National School of Government and supported by Centre for Mental Health.

Recovery Begins with Hope, by Su Maddock and Sophy Hallam, finds that implementing recovery in mental health care depends upon radically changing staff and service-user relationships and the status of patients in making decisions about the support they get.

The study provides evidence of how two NHS mental health trusts, one in London and the other in Devon, have embarked on implementing recovery throughout adult mental health services. It shows that the recovery approach is based on three key principles - hope, control, and opportunities - and that successful implementation demands a radical change in staff attitudes to mental illness and to those experiencing it.

Recovery Begins with Hope reveals that recovery is not only a personal journey but also one of deinstitutionalisation, for both staff and service users. It involves radical changes in leadership, HR, training and performance management for the NHS. Devon Partnership, for example, moved from being a single agency provider to a platform for social networks, inter-agency working and social enterprise.

Report author Su Maddock said: "This is a challenging time for public service innovation when all the attention is on savings. The recovery approach is not magical, but it is an innovation that can support people to make better lives for themselves and therefore in the longer term could radically reduce some health and benefit budgets, not through compulsion but through supportive relationships and an appreciation of what it feels like to be mentally distressed.

"The two NHS Trusts we studied acknowledge that they still have a way to go but they are humanising services and helping people recover. They are changing cultures by employing those who have lived with mental illness and who show other staff that 'recovery' is possible.

"Currently, there is a strong interest in the Big Society and the personalisation of services but very little evidence on how existing services can coexist with social enterprise and community groups to get the best for their users. Recovery Begins with Hope shows how public sector commissioners and providers can create more connections with civic society to build services that support people to grow in resilience and recover their lives."

Professor Geoff Shepherd, Implementing Recovery project lead at Centre for Mental Health, said: "Centre for Mental Health has been working on a methodology to help specialist NHS mental health services more effectively support the people using them in their personal recovery journeys. It uses 'action research' to help NHS organisations, independent sector partners, user and carer groups to work through the key organisational challenges to making Recovery a reality in their area.

"The methodology has now been incorporated into a project commissioned by the Department of Health, overseen by the National Mental Health Development Unit (NMHDU) and delivered by Centre for Mental Health and the Mental Health Network of the NHS Confederation with an evaluation by Edinburgh Napier University. More than 30 organisations have applied to be part of the project, which will begin early in 2011 and provide expert support to services willing to make the radical changes necessary to put Recovery at the centre of everything they do."