Following the ImROC programme, we have made a number of key conclusions and recommendations for sites looking to focus their services around the principles of recovery.

What you can do - Commissioning

National and local policies aimed at supporting recovery must acknowledge the unique history and characteristics of individual sites. This means flexibility to enable services to assess their current position and set locally relevant goals. It also means accepting that sometimes progress is slow.

Provider and commissioner organisations must ensure that local users and carers are involved in service development as true partners. This means creating a culture of ‘co-production’ at every stage.

Health and Wellbeing Boards

Commissioning for Recovery involves two key principles:

  1. An overall commissioning strategy that reflects the importance of mental health and wellbeing and addresses the determinants of mental health;
  2. Ensuring that people with mental health problems (and those who are vulnerable to poor mental health) have access to resources, opportunities and support from services that promote recovery.
  • Addressing housing is associated with a very wide range of improved outcomes and is also cost-effective. Collaboration between mental health services and housing agencies is essential.
  • Employment is a key recovery outcome and important for wellbeing and inclusion. People with mental health problems should be supported to remain in work. There is a strong evidence base for schemes to support people with mental health problems into open employment. The joint strategic needs assessment should provide a view of the local mental health and employment situation.
  • Poverty, deprivation, exclusion and disadvantage are major barriers to recovery. Total place or ‘whole place’ approaches, which may include  community budgets, are based on growing evidence that neighbourhood life is a key factor in health and other outcomes and that poor outcomes cluster at a very local level.

What you can do - in practice

Here are some of the key changes that will be needed in the practices of mental health workers, the types of services provided and the culture of organisations:

  1. Changing the nature of day-to-day interactions and the quality of experience
  2. Delivering comprehensive, user-led education and training programmes
  3. Establishing a Recovery Education Unit to drive the programmes forward
  4. Ensuring organisational commitment, creating the culture
  5. Increasing personalisation and choice
  6. Transforming the workforce
  7. Changing the way we approach risk assessment and management
  8. Redefining user involvement
  9. Supporting staff in their recovery journey
  10. Increasing opportunities for building a life beyond illness

For more information, read Implementing Recovery: A new framework for organisational change.

  • Any attempt to change the attitudes or behaviour of front-line practitioners must be accompanied by parallel initiatives to inform and educate team leaders and managers. All training should be co-produced and co-delivered.
  • Organisations do not change from the ‘top-down’ or the ‘bottom-up’. For change to occur, developments have to be supported by the whole organisational culture. This requires effective management at an operational level, supported by an appropriate strategy at an organisational level. Existing staff who have their own lived experience can play a key role in leading these developments.
  • Services should review their current procedures and move towards a more recovery-oriented approach (‘safety-planning’) which involves the person directly managing their own risk in relation to their preferred goals.
  • Local services should consider how to expand the number of people with lived experience of mental health problems (‘peers’) in their workforce in a variety of paid positions.
  • All providers should consider how to establish a local Recovery College as a place of education for staff, service users and carers to learn about recovery principles. To be successful co-production is required at all stages in the development of the College.
  • All providers should consider how to expand the number of Peer Support Workers in their workforce and aim to establish a minimum of two peers in every team. These workers should be specifically recruited, trained and employed with clear job descriptions and appropriate management and supervision. Existing staff teams need to be prepared for the introduction of these new workers.
  • Services need support (and capacity) to develop and implement relevant outcome measures for individual recovery. The application of such measures is vital in the evaluation of new, recovery-related service interventions where the current evidence base is very limited.

For more information about the project, contact [email protected].