Recovery and Mental Health Promotion

1. Recovery and Mental Health Promotion Margit Schmolke, Ph.D. German Academy for Psychoanalysis (DAP) Munich, Germany

2. Agenda • Developments towards a philosophy of positive health • Mental health promotion • Empirical studies • Recovery process • Role of recovery in mental health promotion • Implications for clinical practice

3. Towards a Philosophy of Positive Health (1) • Morbidity rates and chronicity still high • Prevention and health promotion necessary • Knowledge and needs of users essential • Shift from only minimizing risks and focusing on deficits and pathology towards strengthening positive health of a person

4. Towards a Philosophy ofPositive Health (2) • Positive (mental) health increasingly discussed in - Health psychology - Development psychopathology - Prevention and health promotion - Psychoneuroimmunology - Psychiatry and psychiatric nursing

5. Health Promotion(WHO Ottawa Charter, 1986) • Positive health potential • Strengthening individual and community resources • Health to be actively produced in daily life • Health promotion • Health promotive policy, • environments, • community actions • Developing personal competences • Reorienting health services

6. Mental Health Promotion(WHO, 1999; Herrman et al., 2003) • Mental health: - Realizing one‘s own abilities - Coping with normal stresses of life - Working productively and fruitfully - Contributing to one‘s community • Mental health promotion: - Improved physical health - Better educational performance of children - Better productivity of workers in business/industry - Improved relationships within families and broader community - Lower rates of some mental disorders

7. Empirical Studies (1) • Victorian Health Promotion Foundation, Australia (VicHealth, 1999; Herrman et al., 2003) Some determinants of mental health, e.g. • Social connection and inclusion • Freedom from discrimination and violence • Economic participation

8. Empirical Studies (2) • Study on health protective resources of persons suffering from schizophrenia (Schmolke, 2001, 2003) • Resources related to illness experience • Personal resources • Social resources • Material resources

9. Recovery and Recovery Process • No standard or universal characteristics • Highly subjective and contextual • Ongoing, dynamic, interactional process between strengths, vulnerabilities, resources and environment • Actively self-managing psychiatric disorder • Reclaiming, gaining, maintaining positive sense of self, roles and life beyond the mental health system

10. Role of Recovery in Mental Health Promotion • Overlapping concepts in mental health promotion and recovery • Authors in recovery are persons themselves recovering from a mental disorder • Recovery as subjective experience has an eminent place in the spectrum Prevention ↔ Health Promotion ↔ Treatment ↔ Recovery ↔ Rehabilitation

11. Implications for Clinical Practice • Researchers and clinicians benefit from learning about - individuals‘ recovery processes - mental health strengthening factors - self-help and regulatory activities • Risk of transforming autobiographical accounts by professionals • Implementing knowledge in clinical interventions in mental and physical health care • Claim expressed in WPA Consensus Statement on Psychiatric Prevention (Lecic-Tosevski et al.,2003)