🎧We Hear Voices | Chapter 42

Sarah Fay

Oct 10, 2023

Article voiceover

1×

0:00

-3:01

🎧 Listen to Sarah read this chapter of Cured above or on Spotify:

If you haven’t already purchased access to Cured for $30—about the price of a hardcover book—you can do so here:

Purchase access to all of Cured

The biomedical/maintenance model alone isn’t working. As the New York Times reported in 2021, rates of mental distress and suicide have risen: “[T]he science did little to improve the lives of the millions of people living with persistent mental distress. Almost every measure of our collective mental health — rates of suicide, anxiety, depression, addiction deaths, psychiatric prescription use — went the wrong direction, even as access to services expanded greatly.” We are, by many counts, in the midst of a mental health crisis.

So why aren’t we publicizing recovery to the public, patients, and their families? Why isn’t recovery mentioned in more research studies and during every clinical appointment in which mental health is discussed and in at least some media coverage?

Part of the problem is that there are many definitions of recovery, and medicine prefers single answers. Officially, there are two types of mental health recovery: clinical and personal. Clinical recovery is rooted in the biomedical and maintenance model. It’s aimed at the reduction of symptoms. It says we’re basically all the same. Symptoms in one person are the same as symptoms in another. It’s determined by a physician. The expert defines the course of treatment and, often without telling the patient, decides if and when the patient has healed.

In personal recovery, we determine if we’ve healed. We set the standard. We create lives that signal our recovery—whatever that looks like.

Currently, research on recovery is term-dependent and narrow in focus. Recovery rates depend on whether clinical recovery (the complete absence of symptoms, many of which are part of the human experience, like depression) or personal recovery (hard-to-quantify properties like hope, optimism, empowerment, confidence, work satisfaction, finding meaning in life, having a safe living environment, and feeling part of one’s community) is the benchmark. Much of the research on recovery focuses on serious mental illness, particularly psychosis/schizophrenia, because those suffering are most in need, often have little access to services, and are typically thought of as “hopeless” cases whose conditions will continue to degenerate and bring early death.

More and more clinicians—those who believe recovery from mental illness is possible—now consider personal recovery a clinical outcome. We can recover and play an equal role in determining our treatment. Only then will we save lives and give people the futures they deserve.