Thinking about recovery and well-being in a social context
Date | 13 August 2018 |
Pages | 161-166 |
DOI | https://doi.org/10.1108/MHSI-08-2018-058 |
Published date | 13 August 2018 |
Author | Rachel Perkins,Julie Repper |
Subject Matter | Health & social care,Mental health,Social inclusion |
Rachel Perkins and Julie Repper
Thinking about recovery and well-being in a social context
Recovery has often been defined as a “personal”journey (see Anthony, 1993). The concept itself
rose from the work of people who have themselves experienced the challenge of rebuilding their
lives with mental health challenges (see e.g. Chamberlin, 1977; Deegan, 1988). However, many
have described a professional “take over”of the concept and the way in which it supports a
politically neoliberal agenda (Perkins and Slade, 2012; Rose, 2014). Too often, problems are
located within the individual and it is seen as the individual’s responsibility, to find hope, take
back control over their life and access opportunities they value: the social, political and economic
context of recovery and all the discrimination and oppression that people face are minimised
or ignored.
“Wellbeing”is anothe r construct that risk s the same fate, as has the co ncept of “resilience”.
Too often, poor health (physical and mental) are attributed to “life-style choices ”that the person
has made: if only we stopped our lives of indolence –the lack of exercise, smoking and drinking
that lead to idleness and obesity –and followed the “five ways to wellbeing”then our well-b eing
would be assured. S imilarly, “resilience”is too often seen as the personal strategies that
a person has develop ed for coping with the vi cissitudes of life. Bo th emphasise “personal
responsibility”. The social determinants of health, well-being and resilience (like having
a decent place to live, friends, a partner, a family, the chance to do the things you value, a
good job, etc.) and community though well documented (see Marmot, 2015) receive but
scant attention.
Neither “recovery”nor “well-being”, nor “resilience”occur in a vacuum: they occur in the context
of a family, a community, a culture, an economic, social and political environment. These go a
long way in determining values and aspirations, the meaning of the challenges that a person
faces as well as the resources and possibilities for rebuilding a meaningful, valued and satisfying
life, as well as maintaining health and well-being.
This is not to say that individuals cannot change, or that personal responsibility has no role:
[…] personal responsibility should be right at the heart of what we are trying to achieve. But people’s
ability to take personal responsibility is shaped by their circumstances. People cannot take
responsibility if they cannot control what happens (Marmot, 2015, p. 51).
Poverty, unemployment, loneliness and poor (or no) housing are not a “life-style”choice. They are
circumstances in which a person is deprived of control over their life and their possibilities for
taking “personal responsibility”are severely constrained.
In this context, if services are to promote recovery and well-being we must first review their
purpose: from “getting rid of problems”to enabling people to “get decent lives”. Indeed, surgeon
Atul Gwande (2014) argues that this should be the primary purpose of health and social services:
We think our job is to ensure health and survival. But really it is larger than that. It is to enable
well-being –and well-being is ultimately about sustaining the reasons one wishes to be alive […].
Medicine must shift from a focus on health and survival to a focus on wellbeing –on protecting, insofar
as possible, people’s abilities to pursue their highest priorities in life (Gwande, 2014, p. 7).
This is not dissimilar to the New Zealand definition of recovery “living well in the presence
or absence of one’s mental illness”(O’Hagan, 2012, p. 1) which encapsulates both recovery
and well-being.
DOI 10.1108/MHSI-08-2018-058 VOL. 22 NO. 4 2018, pp. 161-166, © Emerald Publishing Limited, ISSN 2042-8308
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MENTALHEALTH AND SOCIAL INCLUSION
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PAG E 16 1
Editorial
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