King's College London, Health Service and Population Research Department, Institute of Psychiatry, Denmark Hill, London, SE5 8AF, UK.
World Psychiatry. 2014 Feb;13(1):12-20. doi: 10.1002/wps.20084.
An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship.
在心理健康系统中，人们逐渐将康复理解为一种个人化和主观的体验。目前，许多国家的心理健康政策都以这种康复意义为基础。关注这种类型的康复将涉及心理健康系统的转变。人类系统不容易转变。在本文中，我们确定了对康复概念的七种误用（“滥用”）：康复是最新的模式；康复不适用于“我的”患者；服务可以通过有效的治疗帮助人们康复；强制拘留和治疗有助于康复；以康复为导向意味着关闭服务；康复是让人们独立和正常；只有在人们康复后，他们才能为社会做出贡献。然后，我们确定了十个经实证验证的干预措施，通过针对关联性、希望、身份、意义和赋权等关键康复过程（CHIME 框架）来支持康复。这十个干预措施包括同伴支持工作者、预先指示、健康康复行动计划、疾病管理和康复、REFOCUS、优势模型、康复学院或康复教育项目、个人安置和支持、保障性住房以及心理健康对话。最后，我们确定了三个科学挑战：拓宽对康复的文化理解、实施组织变革以及促进公民身份。
