Skip to main content
Erschienen in: The Journal of Behavioral Health Services & Research 2/2007

01.04.2007 | Regular Article

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

verfasst von: Larry Davidson, PhD, William White, MA

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 2/2007

Einloggen, um Zugang zu erhalten

Abstract

Despite a range of long-standing historical, political, ideological, professional, structural, and practical barriers, there has been, and continues to be, a clear consensus that integration between mental health and addiction services is sorely needed and long overdue. This paper focuses on one dimension of the challenge of integration from among the several – the conceptual – and proposes the construct of recovery as an organizing principle for bridging the divide between the two domains. After reviewing briefly the parallel history of the two traditions and their shared need for transformation to a recovery orientation, the authors offer an integrated model of recovery for persons with co-occurring disorders. They then derive from this model the underlying values, guiding principles, key strategies, and essential ingredients of recovery-oriented systems of care that comprise a common approach across both addictions and mental illness, offering a strengths-based solution to achieving integration where pathology-focused approaches have failed.
Literatur
1.
Zurück zum Zitat Drake RE, Mueser KT, Brunette MF, et al. A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatric Rehabilitation Journal. 2004;27(4):360–374.PubMedCrossRef Drake RE, Mueser KT, Brunette MF, et al. A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatric Rehabilitation Journal. 2004;27(4):360–374.PubMedCrossRef
2.
Zurück zum Zitat Caton CLM. The new chronic patient and the system of community care. Hospital and Community Psychiatry. 1981;32:475–478.PubMed Caton CLM. The new chronic patient and the system of community care. Hospital and Community Psychiatry. 1981;32:475–478.PubMed
3.
Zurück zum Zitat Pepper B, Krishner MC, Ryglewicz H. The young adult chronic patient: overview of a population. Hospital and Community Psychiatry. 1981;32:463–469.PubMed Pepper B, Krishner MC, Ryglewicz H. The young adult chronic patient: overview of a population. Hospital and Community Psychiatry. 1981;32:463–469.PubMed
4.
Zurück zum Zitat Schwartz SR, Goldfinger SM. The new chronic patient: clinical characteristics of an emerging subgroup. Hospital and Community Psychiatry. 1981;32:470–474.PubMed Schwartz SR, Goldfinger SM. The new chronic patient: clinical characteristics of an emerging subgroup. Hospital and Community Psychiatry. 1981;32:470–474.PubMed
5.
Zurück zum Zitat Bachrach LL. The context of care for the chronic mental patient with substance abuse problems. Psychiatric Quarterly. 1986;58:3–14.PubMed Bachrach LL. The context of care for the chronic mental patient with substance abuse problems. Psychiatric Quarterly. 1986;58:3–14.PubMed
6.
Zurück zum Zitat Carey KB. Emerging treatment guidelines for mentally ill chemical abusers. Hospital and Community Psychiatry. 1989;40:341–349.PubMed Carey KB. Emerging treatment guidelines for mentally ill chemical abusers. Hospital and Community Psychiatry. 1989;40:341–349.PubMed
7.
Zurück zum Zitat Dickey B, Azeni H. Persons with dual diagnoses of substance abuse and major mental illness: their excess costs of psychiatric care. American Journal of Public Health. 1996;86:973–977.PubMedCrossRef Dickey B, Azeni H. Persons with dual diagnoses of substance abuse and major mental illness: their excess costs of psychiatric care. American Journal of Public Health. 1996;86:973–977.PubMedCrossRef
8.
Zurück zum Zitat Drake RE, Mercer-McFadden C, Mueser KT, et al. Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin. 1998;24:589–608.PubMed Drake RE, Mercer-McFadden C, Mueser KT, et al. Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin. 1998;24:589–608.PubMed
9.
Zurück zum Zitat Drake RE, Museser KT, eds. Dual Diagnosis of Major Mental Illness and Substance Abuse, Volume 2: Recent Research and Clinical Implications. San Francisco: Jossey-Bass; 1996. Drake RE, Museser KT, eds. Dual Diagnosis of Major Mental Illness and Substance Abuse, Volume 2: Recent Research and Clinical Implications. San Francisco: Jossey-Bass; 1996.
10.
Zurück zum Zitat Drake RE, Wallach MA. Dual diagnosis: 15 years of progress. Psychiatric Services. 2000;51:1126–1129.PubMedCrossRef Drake RE, Wallach MA. Dual diagnosis: 15 years of progress. Psychiatric Services. 2000;51:1126–1129.PubMedCrossRef
11.
Zurück zum Zitat Kofoed L, Kania J, Walsh T, et al. Outpatient treatment of patients with substance abuse and co-existing psychiatric disorders. American Journal of Psychiatry. 1986;143:867–872.PubMed Kofoed L, Kania J, Walsh T, et al. Outpatient treatment of patients with substance abuse and co-existing psychiatric disorders. American Journal of Psychiatry. 1986;143:867–872.PubMed
12.
Zurück zum Zitat Minkoff K. An integrated treatment model for dual diagnosis of psychosis and addiction. Hospital and Community Psychiatry. 1989;40:1031–1036.PubMed Minkoff K. An integrated treatment model for dual diagnosis of psychosis and addiction. Hospital and Community Psychiatry. 1989;40:1031–1036.PubMed
13.
Zurück zum Zitat Minkoff K, Drake RE, eds. Dual Diagnosis of Major Mental Illness and Substance Disorder. San Francisco: Jossey-Bass; 1991. Minkoff K, Drake RE, eds. Dual Diagnosis of Major Mental Illness and Substance Disorder. San Francisco: Jossey-Bass; 1991.
14.
Zurück zum Zitat Ridgely SM, Goldman HH, Willenbring M. Barriers to the care of persons with dual diagnoses: organizational and financing issues. Schizophrenia Bulletin. 1990;16:123–132.PubMed Ridgely SM, Goldman HH, Willenbring M. Barriers to the care of persons with dual diagnoses: organizational and financing issues. Schizophrenia Bulletin. 1990;16:123–132.PubMed
15.
Zurück zum Zitat Thacker W, Tremaine L. Systems issues in serving the mentally ill substance abuser. Hospital and Community Psychiatry. 1989;40:1046–1049.PubMed Thacker W, Tremaine L. Systems issues in serving the mentally ill substance abuser. Hospital and Community Psychiatry. 1989;40:1046–1049.PubMed
16.
Zurück zum Zitat Torrey WC, Drake RE, Cohen M, et al. The challenge of implementing integrated dual disorders treatment services. Community Mental Health Journal. 2002;38:507–521.PubMedCrossRef Torrey WC, Drake RE, Cohen M, et al. The challenge of implementing integrated dual disorders treatment services. Community Mental Health Journal. 2002;38:507–521.PubMedCrossRef
17.
Zurück zum Zitat Mueser KT, Bellack A, Blanchard J. Comorbidity of schizophrenia and substance abuse. Journal of Consulting and Clinical Psychology. 1997;60:845–856.CrossRef Mueser KT, Bellack A, Blanchard J. Comorbidity of schizophrenia and substance abuse. Journal of Consulting and Clinical Psychology. 1997;60:845–856.CrossRef
18.
Zurück zum Zitat Fenton WS. Comorbid conditions in schizophrenia. Current Opinion in Psychiatry. 2001;14:17–23.CrossRef Fenton WS. Comorbid conditions in schizophrenia. Current Opinion in Psychiatry. 2001;14:17–23.CrossRef
19.
Zurück zum Zitat Deutsch A. The Mentally Ill in America: A History of their Care and Treatment from Colonial Times. New York: Columbia University Press; 1937. Deutsch A. The Mentally Ill in America: A History of their Care and Treatment from Colonial Times. New York: Columbia University Press; 1937.
20.
Zurück zum Zitat LaFond JQ, Durham ML. Back to the Asylyum: The Future of Mental Health Law and Policy in the United States. New York: Oxford University Press; 1992. LaFond JQ, Durham ML. Back to the Asylyum: The Future of Mental Health Law and Policy in the United States. New York: Oxford University Press; 1992.
21.
Zurück zum Zitat Lamb HR, Weinberger LE. Persons with severe mental illness in jails and prisons: a review. Psychiatric Services. 1998;49:483–492.PubMed Lamb HR, Weinberger LE. Persons with severe mental illness in jails and prisons: a review. Psychiatric Services. 1998;49:483–492.PubMed
22.
Zurück zum Zitat Torrey EF, Steiber J, Ezekiel J, et al. Criminalizing the Mentally Ill: The Abuse of Jails as Mental Hospitals. Washington D.C.: Public Citizen’s Health Research Group and the National Alliance for the Mentally Ill; 1992. Torrey EF, Steiber J, Ezekiel J, et al. Criminalizing the Mentally Ill: The Abuse of Jails as Mental Hospitals. Washington D.C.: Public Citizen’s Health Research Group and the National Alliance for the Mentally Ill; 1992.
23.
Zurück zum Zitat White W, Boyle M, Loveland D. Addiction as chronic disease: from rhetoric to clinical application. Alcoholism Treatment Quarterly. 2002;3–4:107–130.CrossRef White W, Boyle M, Loveland D. Addiction as chronic disease: from rhetoric to clinical application. Alcoholism Treatment Quarterly. 2002;3–4:107–130.CrossRef
24.
Zurück zum Zitat Department of Health and Human Services. Achieving the Promise: Transforming Mental Health Care in America. Rockville: Substance Abuse and Mental Health Services Administration; 2003. Department of Health and Human Services. Achieving the Promise: Transforming Mental Health Care in America. Rockville: Substance Abuse and Mental Health Services Administration; 2003.
25.
Zurück zum Zitat Department of Health and Human Services. Transforming Mental Health Care in America. Federal Action Agenda: First Steps. Rockville: Substance Abuse and Mental Health Services Administration; 2005. Department of Health and Human Services. Transforming Mental Health Care in America. Federal Action Agenda: First Steps. Rockville: Substance Abuse and Mental Health Services Administration; 2005.
26.
Zurück zum Zitat Turner JC, TenHoor WJ. The NIMH community support program: pilot approach to a needed social reform. Schizophrenia Bulletin. 1978;4(3):319–349. Turner JC, TenHoor WJ. The NIMH community support program: pilot approach to a needed social reform. Schizophrenia Bulletin. 1978;4(3):319–349.
27.
Zurück zum Zitat Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville: Substance Abuse and Mental Health Services Administration; 1999. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville: Substance Abuse and Mental Health Services Administration; 1999.
28.
Zurück zum Zitat White W. Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement (Papers of William L. White). Washington, D.C.: Johnson Institute and Faces and Voices of Recovery; in press. White W. Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement (Papers of William L. White). Washington, D.C.: Johnson Institute and Faces and Voices of Recovery; in press.
29.
Zurück zum Zitat Chamberlin J. Speaking for ourselves: an overview of the Ex-Psychiatric Inmates’ Movement. Psychosocial Rehabilitation Journal. 1984;2:56–63. Chamberlin J. Speaking for ourselves: an overview of the Ex-Psychiatric Inmates’ Movement. Psychosocial Rehabilitation Journal. 1984;2:56–63.
30.
Zurück zum Zitat Dennis ML, Scott CK, Funk R. An experimental evaluation of recovery management checkups (RMC) for people with chronic substance use disorders. Evaluation and Program Planning. 2003;26(3):339–352.CrossRef Dennis ML, Scott CK, Funk R. An experimental evaluation of recovery management checkups (RMC) for people with chronic substance use disorders. Evaluation and Program Planning. 2003;26(3):339–352.CrossRef
31.
Zurück zum Zitat McKay JR. Is there a case for extended interventions for alcohol and drug use disorders? Addiction. 2005;100(11):1594–1610.PubMedCrossRef McKay JR. Is there a case for extended interventions for alcohol and drug use disorders? Addiction. 2005;100(11):1594–1610.PubMedCrossRef
32.
Zurück zum Zitat McLellan AT, Lewis DC, O’Brien CP, et al. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association. 2000;284(13):1689–1695.PubMedCrossRef McLellan AT, Lewis DC, O’Brien CP, et al. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association. 2000;284(13):1689–1695.PubMedCrossRef
33.
Zurück zum Zitat Institute of Medicine. Improving the Quality of Health Care for Mental and Substance-Use Conditions. Washington, D.C.: The National Academies Press; 2006. Institute of Medicine. Improving the Quality of Health Care for Mental and Substance-Use Conditions. Washington, D.C.: The National Academies Press; 2006.
34.
Zurück zum Zitat Davidson L, Staeheli MR, Leary F. Concepts of recovery in mental illness: competing or complimentary? Current Opinion in Psychiatry. 2005;18:664–667.PubMedCrossRef Davidson L, Staeheli MR, Leary F. Concepts of recovery in mental illness: competing or complimentary? Current Opinion in Psychiatry. 2005;18:664–667.PubMedCrossRef
35.
Zurück zum Zitat Davidson L. Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia. New York: New York University Press; 2003. Davidson L. Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia. New York: New York University Press; 2003.
36.
Zurück zum Zitat Davidson L, O’Connell M, Tondora J, et al. Recovery in serious mental illness: a new wine or just a new bottle? Professional Psychology: Research and Practice. 2005;36(5):480–487.CrossRef Davidson L, O’Connell M, Tondora J, et al. Recovery in serious mental illness: a new wine or just a new bottle? Professional Psychology: Research and Practice. 2005;36(5):480–487.CrossRef
37.
Zurück zum Zitat Davidson L, O’Connell MJ, Tondora J, et al. The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services. 2006;57(5):640–645.PubMedCrossRef Davidson L, O’Connell MJ, Tondora J, et al. The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services. 2006;57(5):640–645.PubMedCrossRef
38.
Zurück zum Zitat Davidson L, Stayner DA, Nickou C, et al. “Simply to be let in”: inclusion as a basis for recovery from mental illness. Psychiatric Rehabilitation Journal. 2001;24:375–388.PubMed Davidson L, Stayner DA, Nickou C, et al. “Simply to be let in”: inclusion as a basis for recovery from mental illness. Psychiatric Rehabilitation Journal. 2001;24:375–388.PubMed
39.
Zurück zum Zitat White W. Recovery: its history and renaissance as an organizing construct. Alcoholism Treatment Quarterly. 2005;23(1):3–15.CrossRef White W. Recovery: its history and renaissance as an organizing construct. Alcoholism Treatment Quarterly. 2005;23(1):3–15.CrossRef
40.
Zurück zum Zitat White W, Boyle M, Loveland D. Recovery from addiction and recovery from mental illness: shared and contrasting lessons. In: Ralph R, Corrigan P, eds. Recovery and Mental Illness: Consumer Visions and Research Paradigms. Washington, D.C.: American Psychological Association; 2004:233–258. White W, Boyle M, Loveland D. Recovery from addiction and recovery from mental illness: shared and contrasting lessons. In: Ralph R, Corrigan P, eds. Recovery and Mental Illness: Consumer Visions and Research Paradigms. Washington, D.C.: American Psychological Association; 2004:233–258.
41.
Zurück zum Zitat White W, Kurtz E. The varieties of recovery experience. International Journal of Self Help and Self Care. 2006;3(1–2):21–61. White W, Kurtz E. The varieties of recovery experience. International Journal of Self Help and Self Care. 2006;3(1–2):21–61.
42.
Zurück zum Zitat White W, Kurtz E, Sanders M. Recovery Management. Chicago, IL: Great Lakes Addiction Technology Transfer Center; 2006. White W, Kurtz E, Sanders M. Recovery Management. Chicago, IL: Great Lakes Addiction Technology Transfer Center; 2006.
43.
Zurück zum Zitat Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal. 1993;16(4):11–23. Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal. 1993;16(4):11–23.
44.
Zurück zum Zitat Deegan PE. Recovery: the lived experience of rehabilitation. Psychosocial Rehabilitation Journal. 1988;11(4):11–19. Deegan PE. Recovery: the lived experience of rehabilitation. Psychosocial Rehabilitation Journal. 1988;11(4):11–19.
45.
Zurück zum Zitat Deegan PE. The Independent Living Movement and people with psychiatric disabilities: taking back control over our own lives. Psychosocial Rehabilitation Journal. 1992;15:3–19. Deegan PE. The Independent Living Movement and people with psychiatric disabilities: taking back control over our own lives. Psychosocial Rehabilitation Journal. 1992;15:3–19.
46.
Zurück zum Zitat Jacobson N, Curtis L. Recovery as policy in mental health services: strategies emerging from the states. Psychiatric Rehabilitation Journal. 2000;23:333–341. Jacobson N, Curtis L. Recovery as policy in mental health services: strategies emerging from the states. Psychiatric Rehabilitation Journal. 2000;23:333–341.
47.
Zurück zum Zitat Jacobson N, Greenley D. What is recovery? A conceptual model and explication. Psychiatric Services. 2001;52(4):482–485.PubMedCrossRef Jacobson N, Greenley D. What is recovery? A conceptual model and explication. Psychiatric Services. 2001;52(4):482–485.PubMedCrossRef
48.
Zurück zum Zitat Mead S, Copeland ME. What recovery means to us: consumers’ perspectives. Community Mental Health Journal. 2000;36(3):315–328.PubMedCrossRef Mead S, Copeland ME. What recovery means to us: consumers’ perspectives. Community Mental Health Journal. 2000;36(3):315–328.PubMedCrossRef
49.
Zurück zum Zitat Ralph R, Corrigan P, eds. Recovery in Mental Illness: Broadening our Understanding of Wellness. Washington, D.C.: American Psychological Association; 2004. Ralph R, Corrigan P, eds. Recovery in Mental Illness: Broadening our Understanding of Wellness. Washington, D.C.: American Psychological Association; 2004.
50.
Zurück zum Zitat Davidson L, Andres-Hyman R, Tondora J, et al. From “double trouble” to “dual recovery”: integrating models of recovery in addiction and mental health. Dual Diagnosis. In press. Davidson L, Andres-Hyman R, Tondora J, et al. From “double trouble” to “dual recovery”: integrating models of recovery in addiction and mental health. Dual Diagnosis. In press.
Metadaten
Titel
The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services
verfasst von
Larry Davidson, PhD
William White, MA
Publikationsdatum
01.04.2007
Erschienen in
The Journal of Behavioral Health Services & Research / Ausgabe 2/2007
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-007-9053-7

Weitere Artikel der Ausgabe 2/2007

The Journal of Behavioral Health Services & Research 2/2007 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.